Methodological issues in the observational studies conducted in older population: a narrative review

Introduction Well-conducted observational studies may represent valuable tools for getting insight to disease etiology, detecting the effect of age-related changes, and providing an important perspective on health risk factors and disabilities in an aging population. Nevertheless, this kind of research poses several challenges for researchers. The main aim of this narrative review was to address the potential methodological issues in performing the observational studies in the elderly, the factors that influence their participation, and the possible solutions for overcoming the barriers to research in this population. Methods Comprehensive search for the papers published in the period from January 1st 1980 until 31st July 2016 in English or Italian was conducted through MEDLINE, Scopus and Web of Science electronic databases. Findings from the included papers were finally summarized. Results In cohort studies, the following barriers were addressed: sample size calculation, ascertainment of the target population, frequency of data collection, exposure determination, multifactorial loss to follow-up (drop-outs), cognitive impairment, definition of confounders, and ethical aspects. Case-control studies were reported to be prone to the issues like ascertainment of cases and controls, willingness to participate, data accuracy, recall bias, issues related to patients’ multimorbidity, and cognitive impairment. Conclusions Important factors to consider in research in elderly people include: precise definition of the study population, well conducted recruitment process, engagement with family and home care staff, cognitive impairment assessment and the consequent relevant ethical and legal issues, relief of participant burden in order to minimize withdrawal, and engagement with the media

Six concerns about the data in aid debates: applying an epidemiological perspective to the analysis of aid effectiveness in health and development.

Is aid helping, hindering, or having no effect on development and health? The answer to this question is highly contested, with proponents on all sides adhering strongly to their competing interpretations. We ask how it is possible for those who are often using the same data to hold such divergent views. Here, we employ an epidemiological perspective and find that, in many cases, the arguments are characterised by methodological weaknesses. There may be selective citation of results and failure to account for bias and confounding, such as where an extraneous factor influencing the outcome is correlated with increased aid or, in confounding by indication, where increased aid is a consequence of a country being in an especially adverse situation. Studies may also lack external validity, whereby lack of data (a widespread problem) or similar considerations mean that analyses are undertaken on an unrepresentative subset of countries. Multiple outcome measures can also be problematic, where the main outcome of interest is not specified in advance. Many studies fail to account for differential time lags between changes in aid and the outcomes being studied. Some studies may also be underpowered to detect an association where one exists. Although, ideally, this debate should be informed by large scale randomised controlled trials, this will often be unfeasible. Given this limitation, it is essential that those engaged in it are cognisant of the many methodological issues that face any observational study

Do diagnostic delays in cancer matter?

background: The United Kingdom has poorer cancer outcomes than many other countries due partly to delays in diagnosing symptomatic cancer, leading to more advanced stage at diagnosis. Delays can occur at the level of patients, primary care, systems and secondary care. There is considerable potential for interventions to minimise delays and lead to earlier-stage diagnosis. methods: Scoping review of the published studies, with a focus on methodological issues. results: Trial data in this area are lacking and observational studies often show no association or negative ones. This review offers methodological explanations for these counter-intuitive findings. conclusion: While diagnostic delays do matter, their importance is uncertain and must be determined through more sophisticated methods

Propensity Scoring after Multiple Imputation in a Retrospective Study on Adjuvant Radiation Therapy in Lymph-Node Positive Vulvar Cancer

Propensity scoring (PS) is an established tool to account for measured confounding in non-randomized studies. These methods are sensitive to missing values, which are a common problem in observational data. The combination of multiple imputation of missing values and different propensity scoring techniques is addressed in this work. For a sample of lymph node-positive vulvar cancer patients, we re-analyze associations between the application of radiotherapy and disease-related and non-related survival. Inverse-probability-of-treatment-weighting (IPTW) and PS stratification are applied after multiple imputation by chained equation (MICE). Methodological issues are described in detail. Interpretation of the results and methodological limitations are discussed

Corpus linguistics: A guide to the methodology

Corpora are widely used in linguistics, but not always wisely. This book attempts to frame corpus linguistics systematically as a variant of the observational method. The first part introduces the reader to the general methodological discussions surrounding corpus data as well as the practice of doing corpus linguistics, including issues such as the scientific research cycle, research design, extraction of corpus data and statistical evaluation. The second part consists of a number of case studies from the main areas of corpus linguistics (lexical associations, morphology, grammar, text and metaphor), surveying the range of issues studied in corpus linguistics while at the same time showing how they fit into the methodology outlined in the first part

Corpus linguistics: A guide to the methodology

Corpora are widely used in linguistics, but not always wisely. This book attempts to frame corpus linguistics systematically as a variant of the observational method. The first part introduces the reader to the general methodological discussions surrounding corpus data as well as the practice of doing corpus linguistics, including issues such as the scientific research cycle, research design, extraction of corpus data and statistical evaluation. The second part consists of a number of case studies from the main areas of corpus linguistics (lexical associations, morphology, grammar, text and metaphor), surveying the range of issues studied in corpus linguistics while at the same time showing how they fit into the methodology outlined in the first part

Corpus linguistics: A guide to the methodology

Corpora are widely used in linguistics, but not always wisely. This book attempts to frame corpus linguistics systematically as a variant of the observational method. The first part introduces the reader to the general methodological discussions surrounding corpus data as well as the practice of doing corpus linguistics, including issues such as the scientific research cycle, research design, extraction of corpus data and statistical evaluation. The second part consists of a number of case studies from the main areas of corpus linguistics (lexical associations, morphology, grammar, text and metaphor), surveying the range of issues studied in corpus linguistics while at the same time showing how they fit into the methodology outlined in the first part

Corpus linguistics: A guide to the methodology

Corpora are widely used in linguistics, but not always wisely. This book attempts to frame corpus linguistics systematically as a variant of the observational method. The first part introduces the reader to the general methodological discussions surrounding corpus data as well as the practice of doing corpus linguistics, including issues such as the scientific research cycle, research design, extraction of corpus data and statistical evaluation. The second part consists of a number of case studies from the main areas of corpus linguistics (lexical associations, morphology, grammar, text and metaphor), surveying the range of issues studied in corpus linguistics while at the same time showing how they fit into the methodology outlined in the first part

Corpus linguistics: A guide to the methodology

Corpora are widely used in linguistics, but not always wisely. This book attempts to frame corpus linguistics systematically as a variant of the observational method. The first part introduces the reader to the general methodological discussions surrounding corpus data as well as the practice of doing corpus linguistics, including issues such as the scientific research cycle, research design, extraction of corpus data and statistical evaluation. The second part consists of a number of case studies from the main areas of corpus linguistics (lexical associations, morphology, grammar, text and metaphor), surveying the range of issues studied in corpus linguistics while at the same time showing how they fit into the methodology outlined in the first part