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| ADA's Response to Misinformation |
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- Show me the science!
- ADA believes that research is THE foundation of the profession. Research provides the basis for our practice, educational outreach, and nutrition policy. |
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| - Investigation and analysis focused on a better or fuller understanding of a subject or basic law. |
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| Research: A Systematic Process |
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| - process of collecting, analyzing, and interpreting information (data) in order to increase understanding of a phenomenon |
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| Characteristics of Research |
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- Originates with a question or problem
- Requires clear articulation of a goal/s
- Requires planning which is guided by the hypothesis
- Accepts certain critical assumptions
- Requires collection and interpretation of data |
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| The Research Process is Cyclical |
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| What are the two Basic Types of Research? |
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1. Qualitative Research
2. Quantitative Research |
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-Collection of non-numerical data to explore a phenomena of interest
- Data collection methods include questionnaires, interviews, focus groups, surveys, etc.
- Study design is not completely determined prior to data collection – as the study proceeds, investigator determines additional information that needs to be collected
- Data analysis occurs throughout the data collection process
- Data-gathering technique that generates open-ended, narrative data
- Purpose= describe and understand the participant's point of view
- Perspective= inside out |
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- Collection of numerical data to describe, explain, control, and/or predict a phenomena of interest
- WORDS may be expressed as numbers
- Based on principles of scientific method
- Methods are completely planned prior to initiation of the study
- Data collection methods are dependent on the type of research – clinical, food sensory research, field research, bench research, etc.
- Answers questions about relationships among measured variables
- Experimental Research
- Epidemiology Research
- Perspective = outside in |
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| What Parties are Involved in Research? |
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Definition
1. Investigator or Principal Investigator
2. Institutional Review Board |
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| Investigator or Principal Investigator |
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| - Scientist with primary responsibility for the design, funding, and conduct or a research project |
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| Institutional Review Board (IRB) |
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| - Review body established at each university, medical center, or research entity designated to protect the welfare of human participants recruited to participate in biomedical or behavioral research |
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- Formally designated committee responsible for approving, monitoring, and reviewing research that involves living subjects
- Each research institution or organization must establish their own IRB |
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| What are the 3 Principles of the Belmont Report? |
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1. Respect for Persons
2. Beneficence
3. Justice |
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- Individuals should be treated as autonomous agents
- Individuals with diminished autonomy are entitled to additional protections |
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- Do no harm
- Maximize possible benefits and minimize potential harms/risks |
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| - Benefits and risks of research must be distributed fairly |
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| - process of information exchange that takes place between the prospective subjects and the investigator – before, during, and after the study |
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| - participatory agreement of the subject or the subject’s legally authorized representative based on information regarding the study (given in understandable language) |
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| - child’s affirmative agreement to participate in research |
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| What are the 2 sources of Data? |
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| - Gathers data that does not already exist |
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| - Uses data previously gathered for other studies. |
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- Degree to which a measure assess what it is supposed to measure
- Validity implies reliability |
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- Percentage accounting for dropouts in a study
- Different from “intent to treat” which accounts for total number of recruited participants expected to complete the study |
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- Probability of an event happening
- Number of ways it can happen/Total number of outcomes.
~ Toss 1 die 6 outcomes
~ Probability of throwing any of those numbers
- Don't want your results to be by chance |
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| P-Value/ Statistical Significance |
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- P-value conveys the probability that a difference or an association is due to chance
- Higher the p-value the more likely the finding is due to chance
- P < 0.05 |
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| - the consistency of a set of measurements or of a measuring instrument |
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- Conditions of the experiment that are systematically manipulated or controlled by the investigator
- Variable that impacts the dependent variable |
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- Variable that is altered by the impact of the independent variable
- Value “depends” on the independent variable
- Observed outcome resulting from intervention or implementation of the independent variable |
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- Arithmetic average.
- The individual scores are added and divided by the total number of scores.
- Example: Average number of pounds lost during a month following a weight loss program: 5, 9, 3, 2, 6/5 = 25/5 = 5 |
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- Difference from the mean
- Example:
(5-5)2 + (9-5)2, (3-5)2, (2-5)2, (6-5)2/5 = 5
0 + 16 +4 + 9 + 1 = 30
30/5 = 6 |
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-Shows how much variation there is from the mean.
-Square root of the variance
- Example: 2.44
- A low standard deviation indicates less variation in data points. |
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- The point at the 50th percentile of the range of values where half the values are lower and half are higher.
- Central Tendency |
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| Qualitative Research in Nutrition |
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Definition
| - Purpose= To investigate occurrences of interest, generate ideas, gain insight, or develop a research question for future investigations |
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Qualitative Research in Nutrition
Why do it? |
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- Allows observations in the natural setting
- Open-ended exploration
- Obtain data from patient/client POV, social context, and interactions among participants |
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| Limitations of Qualitative Research |
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Definition
- Generalizations are not possible
- Difficult to compare to other qualitative studies due to contextual differences
- Data collection is dependent upon training of personnel
- Lengthy data analysis and publications |
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| Data Collection Methods of Qualitative Research |
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Definition
- In-depth interviews
- Focus groups
- Content Analysis
- Free elicitation
- Sampling |
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- Effective way of obtaining information for devising hypotheses and proposing associations
- Cannot test or verify, but rather illustrates a non-quantifiable topic
- Involves a well-focused research question |
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- study of the distribution and determinants of disease frequency
- Provide conceptual framework for describing the distribution of the disease
~ Quantifying the extent & location of disease or nutritional problems associated with disease
- Provide rationale for testing the etiologic hypothesis for a disease or health outcome
~ Suggest associations between diet and disease that can be evaluated by experimental research |
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| What are the 2 types of Epidemiology Studies? |
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1. Descriptive Epidemiology
2. Analytic Epidemiology |
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| - Studies the frequency, distribution, and pattern of health-related states or events |
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| - Examines whether a factor is a source of risk or directly causes a health or disease effect |
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| Issues in Analytic Nutrition Epidemiology Studies |
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- Defining the “representative” question
- Diet and/or nutrient exposure
- Choice of exposure variables
- Exposure measurements
- Potential for bias
- Potential for confounding variables
- Multivariate relationship |
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- Analytical research evaluating hypotheses and the determination of causal relationships
- Involves investigator-controlled interventions
- Experimental design determines statistical power
- most common type= randomized control |
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| What are the 2 Experimental Study Components? |
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1. Experimental Group
2. Placebo |
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- The group in an experimental design study receiving treatment in the form of the independent variable or intervention
- Group compared to the control group for assessing differences |
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- Chemically inert substance used in clinical trials for administration to the control group
- Used to determine the possibility of improvement and/or side effects based on imagination or anticipation rather than the actual intervention
- Serves as the “control group” in medical trials |
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| What are the 6 Experimental Research Designs? |
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1. Parallel RCT
2. Crossover RCT
3. Factorical Design RCT
4. Free-Living Studies
5. Postprandial Studies
6. Dose-Response Studies |
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- Participants are randomly assigned to a treatment group and remain on this treatment throughout the study
- Requires large sample sizes due to degree of variance among participants in each group |
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- Each participant receives the treatment and the control
- Individuals serve as their own control
- Wash out period typically separates different stages of study |
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| What are the advandages of Crossover RCT? |
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- Variability is reduced
- Decrease in variance allows for smaller sample sizes to be used |
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- Allows researchers to address multiple objectives within one study
- Simplest Design: 2 x 2 |
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- Participants self-select their diet based on advice from study personnel
- Often used in weight loss trials
- Less degree of control or precision than with a RCT
- Requires attentive participant monitoring |
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- Allows researchers to evaluate the acute effects of a specific nutrient, food, or mixed meal on specific end points of interest
- Postprandial time in a day can be as long as 12-14 hours |
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- Provides information about range of biological effects in response to different doses of nutrients evaluated
- Important in assessing maximum effective dose and establishing dietary intake levels |
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| What are the ADA Standards for Professional Practice? |
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- Locate and review research for application within specific area of practice
- Base practice on sound scientific principles, research, and theory
- Promote research & contribute to the development of knowledge through research
- Collect measurable data and document outcomes within the practice setting |
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- Journal of the American Dietetic Association
- Journal of Food Science
- Journal of Clinical Nutrition
Science
- New England Journal of Medicine |
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| What are the 2 types of Integrative Research? |
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1. Meta-Analysis
2. Systematic Reviews |
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- Seeks to merge the reported results of similar research studies to mathematically answer specific, quantitative questions
- Relies on statistical power of a larger, merged sample |
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- Organized narrative evaluation of a cohort of studies without a mathematical evaluation
- Synthesizes evidence relative to a specific practice question
- Review document represents a summary and synthesis of best available review data |
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