Evidence-based research methods and practise

A.Y. 2021/2022
4
Max ECTS
40
Overall hours
SSD
M-PSI/08 MED/01 MED/48
Language
Italian
Learning objectives
The course aims at
- providing the fundamentals of statistics useful for identifying, understanding and interpreting biomedical phenomena;
- providing the skills of structuring a bibliographic search and critically read the scientific literature.
- providing basic information on the different phases of a research process, and to be able to identify the differences between qualitative and quantitative research.
- providing the skills to implement a research project in the field of occupational therapy.
Expected learning outcomes
At the end of the course the student will be able to:
· discuss in general terms the fundamentals of statistics useful for identifying, understanding and interpreting biomedical phenomena;
· apply the main strategies for a bibliographic search relating to a scientific problem;
· read scientific articles critically;
· discuss the general organization of a scientific article;
· discuss the general organization of a scientific article in the field of occupational therapy;
· develop a research project in occupational therapy.
Course syllabus and organization

Single session

Responsible
More specific information on the delivery modes of training activities for academic year 2021/22 will be provided over the coming months, based on the evolution of the public health situation.
Prerequisites for admission
Be enrolled in the 3rd year of the program.
Assessment methods and Criteria
Written and oral exam
Medical statistics
Course syllabus
1.1 The role of Evidence Based Practice in occupational therapy: what is meant by Evidence Based Practice; reliability of efficacy tests; the classification of efficacy tests; observational and experimental studies
1.2 Descriptive observational studies: from the single clinical case to the series of clinical cases; transversal descriptive studies: punctual, period and lifetime prevalence; longitudinal descriptive studies: cumulative incidence and incidence density
1.3 Analytical observational studies: what is meant by risk, risk factor and exposure; how to associate the alleged risk factor with the harmful event; cross-sectional, case-control, cohort analytical studies
1.4 Experimental studies: in vitro preclinical phase, in vivo preclinical phase; experimental descriptive studies; clinical trials: randomization, blindness, placebo effect; the phases of the clinical trial: from phase 0 to phase 4; the role of the ethics committee: from the Nuremberg Code to the Helsinki Declaration
2. Collection, management, data processing: data collection methods (observation, interview, questionnaire, database); questionnaires: standardization and validation; the pitfalls of transcribing data; use of EXCEL to rationally store data; keep in mind: garbage in garbage out !; ABC of the representation of data in tables and graphs
3.1 Interpretation of cross-sectional studies (risk factor and harmful event detected at the same time) in occupational therapy: how to present a cross-sectional study; the ingredients to rationally define the size of the study: presumed size of the effect, extent of uncertainty, degree of certainty; how to associate the risk factor (type of health profession) to the harmful event (non-involvement of families in the rehabilitation process): comparison between percentages
3.2 Interpretation of case-control studies (from the detection of the harmful event to the previous exposure to a risk factor) in occupational therapy: how to present a case-control study; the odds as a measure of the frequency of exposure to a risk factor; the odds ratio (OR) as a measure of the association between a risk factor (presence of steps in the home environment) and a harmful event (fall and consequent fracture of the femur)
3.3 Interpretation of cohort studies (from the detection of exposure to a risk factor in the event of a harmful event) in occupational therapy: how to present a cohort study; absolute risk as a measure of the occurrence of a harmful event; relative risk (RR) as a measure of the association between risk factor (stroke hospitalization department) and harmful event (failure to start a rehabilitation program)
3.4 Interpretation of controlled and randomized trials in occupational therapy (evaluation of the effectiveness of interventions): how to present a randomized clinical trial (RCT); the measures of effectiveness of an occupational therapy intervention (home visit aimed at removing domestic hazards) in a randomized controlled trial: absolute risk reduction of femoral fracture (ARR), relative risk reduction (RRR), number of patients treat (NNT); why prefer NTN as an efficacy measure
3.5 The experimental model in the health sector: what is meant by an experimental model; how to isolate the effect of the intervention from the placebo effect and the effect of the singularity of the patient; role of blindness, simultaneity, sufficient definition of the target population, randomization, adequate size of the study in the definition of an experimental study; the confidence interval as a measure of the uncertainty of the efficacy indices of a rehabilitation intervention in a randomized clinical trial; statistical significance and clinical importance.
4.1 Systematic reviews: what is meant by Cochrane review and meta-analysis; Prism checklist, quality of efficacy tests, selection of studies to be included; forest plot; two examples of systematic reviews; take home message: absence of evidence (statistics) does not mean evidence of absence (of clinical importance).
Teaching methods
Interactive classroom lessons
Teaching Resources
Clemson L, Cumming RG, Roland M. Case-control study of hazards in the home and risk of falls and hip fractures. Age and Ageing, 1996; 25:97-101.
Cumming RG, Thomas M, Szonyi G, Salkeld G, O'Neill E, Westbury C, Frampton G. Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention. J Am Geriatr Soc, 1999; 47:1397-1402.
Hsuei-Chen Lee, Ku-Chou Chang, Yu-Ching Huang, Chung-Fu Lan, Jin-Jong Chen, Shun-Hwa Wei. Inpatient rehabilitation utilization for acute stroke under a universal health insurance system. Am J Manag Care, 2010; 16:e67-e74.
Rochette A, Korner-Bitensky N, Desrosiers J. Actual vs best practice for families post-stroke according to three rehabilitation disciplines. Rehabil Med, 2007; 39:513-519.
Research methods
Course syllabus
1.1 The role of Evidence Based Practice in occupational therapy: what is meant by Evidence Based Practice; reliability of efficacy tests; the classification of efficacy tests; observational and experimental studies
1.2 Descriptive observational studies: from the single clinical case to the series of clinical cases; transversal descriptive studies: punctual, period and lifetime prevalence; longitudinal descriptive studies: cumulative incidence and incidence density
1.3 Analytical observational studies: what is meant by risk, risk factor and exposure; how to associate the alleged risk factor with the harmful event; cross-sectional, case-control, cohort analytical studies
1.4 Experimental studies: in vitro preclinical phase, in vivo preclinical phase; experimental descriptive studies; clinical trials: randomization, blindness, placebo effect; the phases of the clinical trial: from phase 0 to phase 4; the role of the ethics committee: from the Nuremberg Code to the Helsinki Declaration
2. Collection, management, data processing: data collection methods (observation, interview, questionnaire, database); questionnaires: standardization and validation; the pitfalls of transcribing data; use of EXCEL to rationally store data; keep in mind: garbage in garbage out !; ABC of the representation of data in tables and graphs
3.1 Interpretation of cross-sectional studies (risk factor and harmful event detected at the same time) in occupational therapy: how to present a cross-sectional study; the ingredients to rationally define the size of the study: presumed size of the effect, extent of uncertainty, degree of certainty; how to associate the risk factor (type of health profession) to the harmful event (non-involvement of families in the rehabilitation process): comparison between percentages
3.2 Interpretation of case-control studies (from the detection of the harmful event to the previous exposure to a risk factor) in occupational therapy: how to present a case-control study; the odds as a measure of the frequency of exposure to a risk factor; the odds ratio (OR) as a measure of the association between a risk factor (presence of steps in the home environment) and a harmful event (fall and consequent fracture of the femur)
3.3 Interpretation of cohort studies (from the detection of exposure to a risk factor in the event of a harmful event) in occupational therapy: how to present a cohort study; absolute risk as a measure of the occurrence of a harmful event; relative risk (RR) as a measure of the association between risk factor (stroke hospitalization department) and harmful event (failure to start a rehabilitation program)
3.4 Interpretation of controlled and randomized trials in occupational therapy (evaluation of the effectiveness of interventions): how to present a randomized clinical trial (RCT); the measures of effectiveness of an occupational therapy intervention (home visit aimed at removing domestic hazards) in a randomized controlled trial: absolute risk reduction of femoral fracture (ARR), relative risk reduction (RRR), number of patients treat (NNT); why prefer NTN as an efficacy measure
3.5 The experimental model in the health sector: what is meant by an experimental model; how to isolate the effect of the intervention from the placebo effect and the effect of the singularity of the patient; role of blindness, simultaneity, sufficient definition of the target population, randomization, adequate size of the study in the definition of an experimental study; the confidence interval as a measure of the uncertainty of the efficacy indices of a rehabilitation intervention in a randomized clinical trial; statistical significance and clinical importance.
4.1 Systematic reviews: what is meant by Cochrane review and meta-analysis; Prism checklist, quality of efficacy tests, selection of studies to be included; forest plot; two examples of systematic reviews; take home message: absence of evidence (statistics) does not mean evidence of absence (of clinical importance).
Teaching methods
Interactive classroom lessons
Teaching Resources
Clemson L, Cumming RG, Roland M. Case-control study of hazards in the home and risk of falls and hip fractures. Age and Ageing, 1996; 25:97-101.
Cumming RG, Thomas M, Szonyi G, Salkeld G, O'Neill E, Westbury C, Frampton G. Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention. J Am Geriatr Soc, 1999; 47:1397-1402.
Hsuei-Chen Lee, Ku-Chou Chang, Yu-Ching Huang, Chung-Fu Lan, Jin-Jong Chen, Shun-Hwa Wei. Inpatient rehabilitation utilization for acute stroke under a universal health insurance system. Am J Manag Care, 2010; 16:e67-e74.
Rochette A, Korner-Bitensky N, Desrosiers J. Actual vs best practice for families post-stroke according to three rehabilitation disciplines. Rehabil Med, 2007; 39:513-519.
Research methods for occupational therapy
Course syllabus
1. Introduction to databases;
2. Introduction to clinical question;
3. Definition of P.I.C.O.S. and keywords extraction;
4. Guided exercises;
5. Group exercises.
Teaching methods
Interactive classroom lessons
Teaching Resources
Guyatt G, Rennie D, Meade MO, Cook D. Users' Guides to the Medical Literature - A manual for evidence-based clinical practice. New-York: Mc Graw Hill; 2015
Taylor RR. Kielhofner's Research in Occupational Therapy: methods of inquiry for enhancing practice. Philadelphia: F.A. Davis Company; 2017
Clinical psychology
Course syllabus
- Epistemological and practical differences between qualitative and quantitative research
- When it is appropriate to use a qualitative methodology (qualitative research questions and quantitative research questions)
- Phases of the qualitative research process (research question, design and methodology, data collection, data analysis, presentations of the results, conclusions)
- Main qualitative research methodologies (phenomenology, grounded theory and ethnography)
- Techniques to collect data in qualitative research (interview, narratives, focus groups, participant observation, naturalistic observation)
- The structured, semi-structured and unstructured interview
- How to conduct an unstructured interview
- How to analyze qualitative data according to the phenomenology approach (content analysis and interpretative analysis)
- How to write a scientific article reporting qualitative data
Teaching methods
Classroom lessons, group works and exercises will be used to facilitate the learning
Teaching Resources
Richards L, Morse J. Fare ricerca qualitativa. Prima guida. FrancoAngeli
Clinical psychology
M-PSI/08 - CLINICAL PSYCHOLOGY - University credits: 1
Lessons: 10 hours
Medical statistics
MED/01 - MEDICAL STATISTICS - University credits: 1
Lessons: 10 hours
Professor: Vener Claudia
Research methods
MED/01 - MEDICAL STATISTICS - University credits: 1
Lessons: 10 hours
Professor: Vener Claudia
Research methods for occupational therapy
MED/48 - NURSING IN NEUROPSYCHIATRY AND REHABILITATION - University credits: 1
Lessons: 10 hours
Professor: Battain Pier Carlo