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A groovy research literacy thread - just a bit of reading each day towards enlightenment....
.....well, it may not be TOTAL enlightenment, but it might be a wee glow and a wee glow is better than total darkness.
The squirrel is in learning and sympathy mode.
I'm in sympathy mode because I can relate to people being confused and overwhelmed (since I've been there!).
There's an information overload and let's face it - sometimes it's just difficult to know where to begin.
And so I've hatched a plan.
Every day over the next few weeks I'm going to add some reading material to this thread. Just one piece a day. The material will vary and it will come from different sources, but the sequence in which I present them will hopefully make sense. In some cases you might see some overlap in the information provided, but hey, I'm a big believer in repetition being the best way of learning.
At the end of the few weeks you will know what the p is all about. Yes, the p. The p is a big thing, believe it or not. You will know what internal validity means. Yes, that thing. Sounds intriguing, doesn't it? And best of all, you will have some level of ability to look at research with some level of discernment. And that's the whole reason for the thread.
OK, so here's the first piece from Ravensara Travillian.
Enjoy!
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Permalink Reply by Vlad on
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So I hope everyone liked the first step on the road to research literacy.
Did you notice the p in there? Yes, it's the wee p . The wee p has meaning and IT'S COMING SOON!
The article also touched on pubmed and the fact that there is so much information out there. Yep - so how do we get our heads around it? Hopefully after a few weeks of looking at the info on this thread, you'll be better equipped to do so.
OK, so now we know what research literacy is about and an example was given of how it can impact our practice (the case of the client who had a relative in final stages of kidney disease). Before we go any further on trying to understand the research, or find it, or anything else, let's look at some reasons why we need research. Since this seems to be a big question on quite a few therapist's minds and some have even been very honest in saying that it doesn't interest them, maybe some different perspectives might throw a different light on it.
So here's another piece written by Ben Benjamin that touches on the need for research literacy again (OK, so I warned you there might be some overlap), and he also touches on The Why? The Big Why. More to come on the Big Why......
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"We have an increasing responsiblity to rigorously tests it's effects, meeting the same standards of evidences as orther, more traditional therapies". Dr. Benjamin touched on some big issues regarding credibility of the profession overall and the importance of research.
Now, that was a pretty old article and you see how he listed research literacy in our education at the end of it? That was 5 years ago, folks, and although some schools are bringing in research literacy classes, we're far from having it as part of the core curricula in most of our schools. He also mentioned "testing the validity of our beliefs anbout massage and it's effects". Now THIS is something that we should all consider. What do you actually believe in as far as what your work is doing? And how did you come to have that belief?
I USED to believe that massage cleared lactic acid from the muscles after exercise. The therapist in the next room to me (who is a first class therapist, by the way - she has her little business and I have mine and we refer clients to each other if one is out sick or on vacation) brought up the lactic acid claim a couple of weeks ago when we were chatting about something and she, like most of us, had been told this in her basic training (which was about 10 years ago). I told her that research had shown that not to be the case. Now, further on down the thread we will go and find the studies about this. But I just wanted to highlight something here - 2 therapists in rooms next to each other. One of telling her clients the lactic acid claim (which I now refer to as a myth) and the other is trying to re-educate her clients that it is no longer valid. See the problem? If we don't keep up to date in research, we're sending mixed information and outdated information to the public.
OK, so Dr. Bejamin also stated that research has a vocabulary. The vocabulary is one of those things that we need to get our heads around and we'll be learning the lingo as the thread goes on.
Up until now I've only given articles from magazines. This next editorial comes from a journal. A peer-reviewed, scientific journal. There is a BIG difference between a magazine and a scientific journal and that is one of the first things that people need to recognize. When anyone says "I've done research on topic x", reading some websites and magazine articles is not the same as going to the source to actually look at the research and a research article is very different from an article in a magazine.
OK - those links I gave were just wee handy dandy references - it's not the main piece for this post, but it's the start of "the lingo". (peer-review, journal - and in one of those links there is a brief overview of the elements of an article, which we'll cover in much more detail further on down the thread).
No, this next piece is on The Big Why and it comes from the man with the lovely hair, Doc Moyer. After reading it you will may come to the conclusion that it's a pretty safe bet that you'll never find him out in a field with a wee stick looking for water.
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Permalink Reply by Robin Byler Thomas on
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Looking good Vlad; don't stop. Often, I have time to read these postings and not enough time to address certain points because I'd have to do more research; meaning going to a reliable and direct source. I suspect others may not post for the same reason.
I've read all these articles, you're posting, in the past, but am enjoying the review. Ben and Ravensara rock!
Moyer's piece was good; I don't always agree with him, or his delivery, but he can write well, and did so in the editorial you posted.
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Hey Robin!!! Thanks! I'm glad you've given the thumbs up to this. And I hope you'll check in and make sure I'm giving the right information.
Yes, Doc writes well and his work is an easy read and anyone could start reading his articles and understand the majority of his writing (if anyone starts reading articles and don't get the statistics yet, don't worry - the main gist of the stats is coming soon and even though you mightn't be able to get the guts of them, the interpretation of them is different from knowing the formula).
OK, so a couple of things things from his editorial. First of all he gives a pretty good argument as to why research is needed. Note how he says "to become too emotionally attached to ones theories is a mistake in science". I like that. Here's the thing. What if we changed it to "to become too emotionally attached to ones theories is a mistake in massage therapy"? Did any teacher ever mention that to anyone in massage school? Maybe it's something to think about.
OK, so in his editorial we also had some new lingo. He mentions the following : bias, placebo effect, control groups, randomization and blinding. These are all terms which everyone should be comfortable with and not only know what they are but why they are needed. This shouldn't just be a case of knowing what the definition of it is, but knowing why they are used used is key to understanding research - as we go on down the thread this will become clearer, but I just thought I'd throw in the handy dandy reference links so that you might want to get started. Handy dandiness is a good thing.
Right well, hopefully everyone has a better understanding on the Big Why.
Over the next few posts you might think that I'm taking speed or some other mind-altering drug. I wish that was the case, but no, it's just that I go from the general to the specific, back out to the general and back down to the specific for a reason which may become apparent later on. There is also a wee bit of method in my madness. Looking from something from a broad perspective, then going down to the minutiae, then backing back out again to the broad and then zeroing in on specifics again is not necessarily a bad thing to do when you start to look at studies with a critical eye. Anyway, the craziness will only go on for few posts, so bear with me.
This next piece identifies the main differences between Qualitative and Quantitative methods. It comes from the same journal as Doc's editorial. Now, I hope people checked out the handy dandy link on journals. If you did you will see the following: Scientific journals contain articles that have been peer reviewed, in an attempt to ensure that articles meet the journal's standards of quality, and scientific validity. Note the second part of that sentence. Here's the next thing that we should know about journals: standards of quality and scientific validity can vary significantly. The journal that I'm pulling from are hopefully of a pretty good standard, but it's something that you need to be aware of when you start looking at research.
OK. I'm off to have massage.
What? You don't think squirrels do the best thing on the planet too?
Think again.
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I hope everyone understands the main differences between qualitative and quantitative methods.
The table that was shown on the second page should be well understood. Note the reference to bias and how each method treats bias (and refer to the handy dandy link if you need a refresher on the definition of bias - it's quite a bit different from the everyday meaning - there's a lot more to it!).
OK...so I warned you yesterday that the next few posts might be a bit haywire, right?
Here goes.......
Have any of you heard about the decline in pirates causing climate change?
No?
Seriously. Take a look:
And you can get more information on this connection here - look at that google graph showing the trends. You can easily see that as pirates decreased, the global temperature increased.
Amazing, isn't it?
Yes, the fella that came up with this brilliant link is suggesting that more pirates will combat global warming.
Indeed, more evidence was given to the causal link by the fact that more people dress up as pirates during Halloween and this is when the cooler months start.
OK, so you think this is crazy, right?
Well, it's a demonstration of something on which everyone should become very clear when they are looking at research, or looking at what is going on in their practice or even looking at anything in life or any claim in a critical way and and that is the distinction between correlation and causation.
Today's snippet covers this topic and please forgive me for referring to a website, but I just happen to think that the content of it uses pretty easy to understand language for gaining familiarity with research terminology. You will find LOTs of good information on it relating to research and I suggest you peruse the site at your leisure and bookmark it. There may be terms that you don't understand when you first read the page, so read it once, then read it again and click on the terms that you don't understand (otherwise you could go down a hyperlink rabbit hole - stick to the primary page first, then re-read it to get some better understanding of the terms).
Happy clicking! I'm off to have lunch with Jack Sparrow.
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That website was a bit heavy, wasn't it?
Nearly too much info?
I know how it is, but hey, if you bookmark it, you'll find it a useful wee resource for further on down the thread OR if you're a go-getter-proactive-I-wanna-know-this-stuff-now type of person, just go to the home page of that site and start going through it.
Hopefully now you are a little more clear on differentiating between causation and correlation.
This is a big thing in research and I hope the examples gave you some insight into why that is the case.
This post's read is a LOT EASIER to digest and it's by Martha Brown Menard.
Note the reference to cause and effect and this is the first introduction to the Evidence Pyramid! We will be referencing the evidence pyramid further in another post.
Yes, today it's a nice easy read.......but beware - things will change again soon.
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Here's a wee story:
Once upon a time there was a confound named Fubar. He was a sneaky wee confound and he threw the scientists into a tizzy.
He left people thinking that they had figured out the the link between cause and effect, when really it was HE that was the reason for the effect.
His other confound buddies were jealous. The guys running the experiment knew about them, but failed to recognize Fubar. Fubar grinned with glee. He knew he was in the running for a prize at the national confound convention that year.
It would be a confound party and there would be much rejoicing.
Confounding Variables.
You've already been introduced to bias in experimental investigation in a handy dandy link in a previous post.
Confounds are different.
Here's a brief synopsis and when you're reading it, just think of the independent variable as "massage".
Why don't you go ahead and click on that "internal validity" link too (but don't go down the hyperlink rabbit hole). It references cause and effect.
(Oh, and the madness will end soon - we will go into a logical progression of very easy-to-read information right after the next post).
Oh, and if you're fed up with the links, just be glad you're not an engineer!
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OK, so the next piece of reading is also a bit heavy going and it will probably be the longest piece I'll put on here. It's from a fella called Edzard Ernst and I'll confess to having become a bit of an Ernst fan. The paper was written for new massage therapy researchers, but anyone can read it and glean a good basic understanding on the main types of studies that are done in massage therapy. He also will refer to some of the terms that you've been exposed to in the previous posts.
If you have been clicking on the handy dandy links in the previous posts, you will see how things start to come together in his writing. You will notice his reference to controlled studies and hopefully you will begin to understand the logic behind them now. If you look at the diagram on page 4 of his article, you will see how controlled studies aim to find the therapeutic effect.
And remember the previous posts on cause and effect?
One other thing which is brought up in his writing is that evidence pyramid again. MENARDS EXAMPLE in the post before last is actually a better one, but you will see examples of it in many places.
Here's another example of it from the biomedical world:
You'll notice case reports and case series are at the same level on this one - case series are held at a higher level actually (do you know why?).
Now, just ignore the "animal research" thing at the bottom. (That's a usual precursor to further research in the biomedical sciences).
As you go through Ernst's article, you might want to look at the pyramid as a reference multiple times.
NOTE: I have on here is different from the one in his article and Menard's article. Moreover, you will see something added to the top of it that is not addressed in his article. You will also see that his pyramid does not have cohort studies.
Just for a quick reference, here are some handy dandy links.
RCT stands for Randomized Control Trial
SR stands for Systematic Review
MA stands for Meta-analysis
Note the indicator for increased in levels of evidence as we go further up the pyramid.
Some questions you might want to ask yourself as you go through the article and click on the handy dandy links.
What is it about the way that the studies are carried out that give them increased weight evidence wise?
Why is the Systematic Reviews and Meta-analyses the big kahunas evidence wise?
Do you now think that one of the first things you will ask yourself when you start to look at studies is
"What type of study is this?".
If you're starting to get a grasp of this and can answer these questions, then you're on the right road.
If you're a little confused, it's OK. The next series of reading material is very easy and in a very logical progression. You've just been bombarded by a lot of new terms, but all it takes is a bit more exposure and things will be cool. Remember back to massage school when you'd to learn to differentiate between the supraspinatus and the infraspinatus? Same kind of deal - all you need is a bit more exposure.
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OK......so nobody called me out on a boo-boo in that last post.
It's not Randomized Control Trial, is it? It's Randomized CONTROLLED trial.
Do you know why it's referred to as Controlled? What about the word Randomized? (Selection and Assignment - know the difference?)
So where are we at? So far we've covered pirates and confound conventions in less than 10 posts. What could be better?
Never fear, me hearties. The lightbulb WILL go off if we keep on reading!
So these next posts are from Ravensara Travillian and after going through them you may well be transformed into a Travillianite (a fan). She has a lovely way of writing and explains things in way that is very easy to grasp. The first piece of reading on this thread was hers and I'm continuing on with the series that included that first piece. Here's this post's read.
Know what would be cool?
When research is addressed in her magazine articles (we need to remember the difference between a magazine article and a research article), how about finding the article online?
OK, so go to google scholar and type in the following into the search bar (yes, it's google scholar - the greatest thing in googledom):
author:"Wilkinson" "Effectiveness of aromatherapy massage"
When you typed this in, you're basically telling google scholar to search for research authored by Wilkinson (don't forget that wee colon after author) and the EXACT phrase "Effectiveness of aromatherapy massage"
See the study that is referred to in Ravensara's article? Click on the on the link to the right of it (ascopubs.org) at the top right and you'll see that we can easily get the full text for this piece of research online (we mightn't always be this lucky).
Now, is that not coolest thing since Dilbert?
In her article, she will address only part of the abstract and don't be put off by the lingo. Have a look at the full text and see what you can pick up from it.
What type of study was it?
Recognize any of the lingo?
Don't worry if you don't *get* most of it at the minute. Over the next week or so, the references posted on this thread will go over how to interpret studies.
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You've been introduced to IMRaD and you've touched on statistics.
In this article Ravensara goes more into what is meant by a hypothesis and she touched on statistics.
Did you find the abstract of the Labrecque Pilot Study in google scholar? The abstract should be easily found.
What about the Taxonomy study? You should have easily found the full text to that. If you're having any difficulty, just make sure you're in google scholar and not the regular google search engine.
I'm not putting any graphics on here today.
Why? Cos I'm in a hurry and I've to head off to work to massage a load of bods - you know how it is.
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Guess, what, people.
It's wee p time!!!
Yayyy!!!!
This article covers it!
Remember, it's all about cause and effect. Different from correlation, right?
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