Samenva'ng methodologie masterjaar 1
1
,Inhoudsopgave
Samenva'ng methodologie masterjaar 1 ........................................................................................... 1
Kwan6ta6ef onderzoek .................................................................................................................... 4
Therapeu(sch onderzoek – trials ......................................................................................................... 5
Wat is therapeu,sch onderzoek? ..................................................................................................... 5
Nadelen observa,onele studies....................................................................................................... 6
Waarom gerandomiseerde trials? .................................................................................................... 6
Doel van randomisa,e ................................................................................................................... 6
Doel controlegroep ........................................................................................................................ 7
Doel blinderen .............................................................................................................................. 7
Gerandomiseerde trials - kenmerken ............................................................................................... 7
Baseline tabellen ......................................................................................................................... 10
Analyse ...................................................................................................................................... 10
Limita,es.................................................................................................................................... 11
Opmerkelijke designs ................................................................................................................... 11
Confounding en effectmodifica(e ...................................................................................................... 15
Confounding ............................................................................................................................... 16
Kenmerken ................................................................................................................................. 16
De 3 pilaren van confounding ........................................................................................................ 16
Methoden om met confounding om te gaan ................................................................................... 17
Selec,e van confounders .............................................................................................................. 17
Confounding by indica,on ............................................................................................................ 21
Confounding by contra-indica,on .................................................................................................. 21
Bijwerkingen ............................................................................................................................... 21
Effect modifica,e ......................................................................................................................... 24
Verschil interac,e en effectmodifica,e ........................................................................................... 26
Predic(emodellen ........................................................................................................................... 30
Wat is een predic,emodel? .......................................................................................................... 30
Ontwikkelen predictiemodel ....................................................................................................... 32
Discriminatie van een diagnostische test .................................................................................... 38
Sensitiviteit (Se) ......................................................................................................................... 38
Specificiteit (Sp) ......................................................................................................................... 38
Positief voorspellende waarde (PPV) ........................................................................................... 38
Negatief voorspellende waarde (NPV) ......................................................................................... 39
Calibratie van een predictie model .............................................................................................. 49
Validatie predictiemodel............................................................................................................. 51
Missing data .................................................................................................................................. 52
Soorten missende waarden........................................................................................................... 54
Last observation carried forward (LOCF) ..................................................................................... 59
Mean imputation ........................................................................................................................ 60
Single imputation (SI) ................................................................................................................. 61
Multiple imputation (MI) ............................................................................................................. 63
Doelma(gheidsonderzoek ................................................................................................................ 68
Opzet ........................................................................................................................................ 69
De Quality Adjusted Life-Year (QALY) ........................................................................................... 71
Kosten-eXectiviteit ICER............................................................................................................. 77
Doelmatigheidsonderzoek & beslissingen ................................................................................... 80
Kwalita6ef onderzoek .....................................................................................................................83
Grounded theory, fenomenologie en etnografie .................................................................................. 84
Welke onderzoeksvragen welke stroming? ................................................................................... 84
2
, Studieproces ............................................................................................................................. 85
Sampling ................................................................................................................................... 86
Dataverzameling ........................................................................................................................ 86
Wanneer stopt sampling? ........................................................................................................... 87
Data-analyse ............................................................................................................................. 87
Theoretische sensitiviteit ............................................................................................................ 88
Dataverzameling............................................................................................................................. 91
Focusgroepen ............................................................................................................................ 92
Data-analyse .................................................................................................................................. 96
Coderen .................................................................................................................................... 96
Constant comparison ................................................................................................................ 97
A theoretical thematic analyses .................................................................................................. 98
Topical survey ............................................................................................................................. 98
Conceptual/thema,c descrip,on................................................................................................... 98
No finding................................................................................................................................... 98
Thema,c survey .......................................................................................................................... 98
Interpreta,ve explana,on ............................................................................................................ 98
Content analyse ......................................................................................................................... 99
Conventioneel ........................................................................................................................... 99
Directional ................................................................................................................................. 99
Mixed methods ..............................................................................................................................102
Wanneer mixed methods? ........................................................................................................ 102
Belangrijkste redenen mixed methods op een rij: ....................................................................... 103
Drie core mixed methods designs ............................................................................................. 104
Convergent design ................................................................................................................... 105
Explanatory sequential design .................................................................................................. 106
Exploratory sequential design ................................................................................................... 107
Sterktes en uitdagingen ............................................................................................................ 108
Voorbeelden mixed methods .................................................................................................... 108
Mee6nstrumenten ....................................................................................................................... 109
Volgorde van belangrijkheid van eigenschappen PROM’s ........................................................... 110
Cosmin-taxonomie .................................................................................................................. 111
Face en content validiteit ......................................................................................................... 111
Structuur validiteit ................................................................................................................... 111
Criterium validiteit ................................................................................................................... 112
Cross-culturele validiteit .......................................................................................................... 112
Construct validiteit................................................................................................................... 112
Responsitiviteit (longitudinale validiteit) .................................................................................... 113
Betrouwbaarheid – interne consistentie 1 (Cronbach’s alpha) .................................................... 114
Betrouwbaarheid - interne consistentie 2 .................................................................................. 114
Betrouwbaarheid – reproduceerbaarheid 1 ................................................................................ 115
Betrouwbaarheid – reproduceerbaarheid 2 ................................................................................ 115
Betrouwbaarheid – meetfouten 2 .............................................................................................. 115
3
, Kwan6ta6ef onderzoek
- Therapeu6sch onderzoek
- Confounding en effectmodifica6e
- Predic6emodellen
- Missing data
- Doelma6gheidsonderzoek
4
1
,Inhoudsopgave
Samenva'ng methodologie masterjaar 1 ........................................................................................... 1
Kwan6ta6ef onderzoek .................................................................................................................... 4
Therapeu(sch onderzoek – trials ......................................................................................................... 5
Wat is therapeu,sch onderzoek? ..................................................................................................... 5
Nadelen observa,onele studies....................................................................................................... 6
Waarom gerandomiseerde trials? .................................................................................................... 6
Doel van randomisa,e ................................................................................................................... 6
Doel controlegroep ........................................................................................................................ 7
Doel blinderen .............................................................................................................................. 7
Gerandomiseerde trials - kenmerken ............................................................................................... 7
Baseline tabellen ......................................................................................................................... 10
Analyse ...................................................................................................................................... 10
Limita,es.................................................................................................................................... 11
Opmerkelijke designs ................................................................................................................... 11
Confounding en effectmodifica(e ...................................................................................................... 15
Confounding ............................................................................................................................... 16
Kenmerken ................................................................................................................................. 16
De 3 pilaren van confounding ........................................................................................................ 16
Methoden om met confounding om te gaan ................................................................................... 17
Selec,e van confounders .............................................................................................................. 17
Confounding by indica,on ............................................................................................................ 21
Confounding by contra-indica,on .................................................................................................. 21
Bijwerkingen ............................................................................................................................... 21
Effect modifica,e ......................................................................................................................... 24
Verschil interac,e en effectmodifica,e ........................................................................................... 26
Predic(emodellen ........................................................................................................................... 30
Wat is een predic,emodel? .......................................................................................................... 30
Ontwikkelen predictiemodel ....................................................................................................... 32
Discriminatie van een diagnostische test .................................................................................... 38
Sensitiviteit (Se) ......................................................................................................................... 38
Specificiteit (Sp) ......................................................................................................................... 38
Positief voorspellende waarde (PPV) ........................................................................................... 38
Negatief voorspellende waarde (NPV) ......................................................................................... 39
Calibratie van een predictie model .............................................................................................. 49
Validatie predictiemodel............................................................................................................. 51
Missing data .................................................................................................................................. 52
Soorten missende waarden........................................................................................................... 54
Last observation carried forward (LOCF) ..................................................................................... 59
Mean imputation ........................................................................................................................ 60
Single imputation (SI) ................................................................................................................. 61
Multiple imputation (MI) ............................................................................................................. 63
Doelma(gheidsonderzoek ................................................................................................................ 68
Opzet ........................................................................................................................................ 69
De Quality Adjusted Life-Year (QALY) ........................................................................................... 71
Kosten-eXectiviteit ICER............................................................................................................. 77
Doelmatigheidsonderzoek & beslissingen ................................................................................... 80
Kwalita6ef onderzoek .....................................................................................................................83
Grounded theory, fenomenologie en etnografie .................................................................................. 84
Welke onderzoeksvragen welke stroming? ................................................................................... 84
2
, Studieproces ............................................................................................................................. 85
Sampling ................................................................................................................................... 86
Dataverzameling ........................................................................................................................ 86
Wanneer stopt sampling? ........................................................................................................... 87
Data-analyse ............................................................................................................................. 87
Theoretische sensitiviteit ............................................................................................................ 88
Dataverzameling............................................................................................................................. 91
Focusgroepen ............................................................................................................................ 92
Data-analyse .................................................................................................................................. 96
Coderen .................................................................................................................................... 96
Constant comparison ................................................................................................................ 97
A theoretical thematic analyses .................................................................................................. 98
Topical survey ............................................................................................................................. 98
Conceptual/thema,c descrip,on................................................................................................... 98
No finding................................................................................................................................... 98
Thema,c survey .......................................................................................................................... 98
Interpreta,ve explana,on ............................................................................................................ 98
Content analyse ......................................................................................................................... 99
Conventioneel ........................................................................................................................... 99
Directional ................................................................................................................................. 99
Mixed methods ..............................................................................................................................102
Wanneer mixed methods? ........................................................................................................ 102
Belangrijkste redenen mixed methods op een rij: ....................................................................... 103
Drie core mixed methods designs ............................................................................................. 104
Convergent design ................................................................................................................... 105
Explanatory sequential design .................................................................................................. 106
Exploratory sequential design ................................................................................................... 107
Sterktes en uitdagingen ............................................................................................................ 108
Voorbeelden mixed methods .................................................................................................... 108
Mee6nstrumenten ....................................................................................................................... 109
Volgorde van belangrijkheid van eigenschappen PROM’s ........................................................... 110
Cosmin-taxonomie .................................................................................................................. 111
Face en content validiteit ......................................................................................................... 111
Structuur validiteit ................................................................................................................... 111
Criterium validiteit ................................................................................................................... 112
Cross-culturele validiteit .......................................................................................................... 112
Construct validiteit................................................................................................................... 112
Responsitiviteit (longitudinale validiteit) .................................................................................... 113
Betrouwbaarheid – interne consistentie 1 (Cronbach’s alpha) .................................................... 114
Betrouwbaarheid - interne consistentie 2 .................................................................................. 114
Betrouwbaarheid – reproduceerbaarheid 1 ................................................................................ 115
Betrouwbaarheid – reproduceerbaarheid 2 ................................................................................ 115
Betrouwbaarheid – meetfouten 2 .............................................................................................. 115
3
, Kwan6ta6ef onderzoek
- Therapeu6sch onderzoek
- Confounding en effectmodifica6e
- Predic6emodellen
- Missing data
- Doelma6gheidsonderzoek
4
