Information gathering and the final analysis

Chapter 42 Information gathering and the final analysis

Chapter contents

Internet portals and gateways 342

Professional journals 342

Websites 345

As first-hand experimental evidence is not likely to be generally available to the normal complementary healthcare professional, it is important to know where to go to find reliable information and how to use it.

Internet Portals and Gateways

These are websites, quite often run by governmental bodies, which allow access to the databases of reliable websites in specialist areas. Entering through these portals and gateways usually ensures you will be accessing relatively reliable information.

Professional Journals

Many of these are available online and in many instances, providing the embargo date has passed, there is free online access to articles. Note: just because a paper is published in a professional journal does not mean it is flawless.

Critical Analysis of Papers

This requires some practice and it is not possible, given the scope of this book, to enter into a detailed discussion on evidence-based medicine or to dissect a scientific paper. However, a brief summary of the important factors should give an appreciation of what might constitute a well-written paper.

How is it Possible to make Sense of the Information Available and Place it in a Clinical Setting?

As a clinician exploring the subject of pharmacology, you will probably come across two main types of paper:

• Evidence-based medicine: a way of bringing together clinical experience with the best available clinical evidence from systematic research.

• Scientific experiment: limited to work in the rigidly controlled environment of a laboratory.

• Evidence-Based Medicine

Evidence-based papers can be:

• Quantitative: involving numbers and statistics.

• Qualitative: more descriptive, giving background to a study such as the participants’ personal feelings or experiences. These are more like reading a story and do not involve statistics.

General Questions to be Asked of an Evidence-Based Paper

• Does the title of the paper reflect the content?

• Is the quantitative or qualitative approach appropriate?

• Was the type of study used appropriate: e.g. if the researcher wanted to examine the relationship between a particular drug and its effects on a group of people over a period of time it is more appropriate to use a cohort study than a randomized controlled trial (see below).

• Have the authors thoroughly justified the methods they used?

• Bias: was the study biased by, for example, the selection of participants or the funding body?

• Was the data that was collected appropriate?

• Had ethical considerations been taken into account?

• Has the data been analysed properly: in the case of evidence-based medicine the statistics should be directly relevant to the clinical situation, e.g. numbers needed to treat (NNT).

• Are statements appropriately referenced?

• Is the research of clinical value?

Both the Critical Appraisal Skills Programme (CASP) and the Scottish Intercollegiate Guidelines Network (SIGN 50) have more detailed work sheets for critical appraisal (p. 347).

Evidence-Based Statistics

These are becoming more user friendly; for example, numbers needed to treat (NNT) gives an idea of how effective a treatment might be, as the fewer the number of patients needed for a response, the more effective the treatment. Details of the statistics associated with evidence-based medicine are available at the websites listed at the end of this chapter.

• Scientific Experiments

These are done in a laboratory environment, which is much easier to control than the conditions under which evidence-based medicine investigations are carried out. However, scientific experimentation is not without its problems. Most serious is that the results of scientific experiments, because of the way the experiments are conducted, are far removed from the conditions encountered in everyday life.

In many cases, at the start of an experiment an assumption is made regarding a drug or an active plant metabolite that might not apply to the normal consumption of that compound. The experiment then proceeds as follows:

• An observation: e.g. crude extracts of a particular species are found to have antibacterial properties.

• The hypothesis: the crude extracts contain several compounds, therefore one, several or all of them are responsible for the antibacterial properties.

• The question: what is the answer to the hypothesis?

• Conduct a literature search: to see what has been done before.

• Testing of the hypothesis: an experiment is constructed to test the hypothesis. All details of the experiment, e.g. material, preparation and process of the experiment, should be included in the experimental description. It is important that the methodology is reproducible; ‘one-off’ experiments are not scientifically valid.

• Presentation of results: quite often tabulated for quick reference.

• Discussion: what conclusions can be drawn e.g. certain groups of compounds in the plant in isolation have an antibacterial effect.

General Comments

The paper should state:

• Why there might be flaws in the research.

• If there is any particular bias: e.g. does the research have any affiliations with an interested group, or was funding derived from an interested party.

• Statistics: are these relevant? A full appreciation of a paper will obviously be enhanced by a proper understanding of statistics.

Tags: Pharmacology A Handbook for Complementary Healthcare Professional

Jul 22, 2016 | Posted by admin in PHARMACY | Comments Off

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