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36051-36071 - Overview of Research Methods in Dentistry...

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Overview of Research Methods in Dentistry Robert Weyant, DMD DrPH Department of Dental Public Health and Information Management University of Pittsburgh
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2 What is “Causation” Koch-Henle postulates Bradford-Hill 'criteria' inductionist, refutationist, or hypothetico- deductivist view Provides the basis for “intervention” " Causality. There is no escape from it, we are forever slaves to it. Our only hope, our only peace is to understand it, to understand the why Larry, .; Andy Wachowski, . The Matrix: Reloaded.
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3 Hills Criteria of Causation Austin Bradford Hill (1897-1991), a British medical statistician as a way of determining the causal link between a specific factor (e.g., cigarette smoking) and a disease (such as emphysema or lung cancer). Hill's Criteria form the basis of modern epidemiological research, which attempts to establish scientifically valid causal connections (disease – and its cause) Temporal Relationship Strength Dose-Response Relationship Consistency Plausibility Consideration of Alternate Explanations Experiment Specificity Coherence
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4 Systems Deterministic Systems Events are part of an unbroken chain of prior occurrences. Outcomes occur predictably Newtonian Physics Stochastic Systems Outcomes are computationally and practically unpredictable. Present state does not fully determine the next state Biology and medicine are stochastic
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5 Statistical Causality Observational studies (like counting cancer cases among smokers and among non-smokers and then comparing the two) can give hints, but can never establish cause and effect. Hypothesis generation. The gold standard for causation here is the randomized experiment : One limitation of experiment is they do a good job of testing for the presence of some causal effect they do less well at estimating the size of that effect in a population of interest. Subject selection may lack generalizability. . Exp Med Outcome
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Research Designs In clinical research 6
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7 Essentials of Research Design Basic research Clinical research (often experimental) Epidemiological research (often observational, know denominator) Health services research limited to human research (in vivo)
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8 What are our research (and clinical) concerns? Exposure Good or bad: Chemical, biological, psychological, educational, etc. Outcome Good or bad: disease, cure, improved attitude, longer life, etc. We generally know one and want to measure the other Concerns are that we measure both accurately and understand what population is represented.
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9 Classification Schemes Descriptive vs. Analytical Experimental vs. Observational Time Referenced Prospective vs. Cross-sectional vs.
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