Why would outcomes research use an entire database, rather than ...

[j.rubin]

Why would outcomes research use an entire database, rather than merely selecting a sample? (Select all that apply.)
 
  a. Use of the whole database provides an analysis that addresses the entire patient population.
  b. Permission to use an entire data base implies that the entire data base must be studied.
  c. Small effect sizes and multiple variables demand huge samples, if statistical significance is to be achieved.
  d. Accurate determination of risk throughout the system is the focus of outcomes research.
  e. Cost is not an issue.

Question 2

Outcomes research differs from traditional quantitative research in which of the following ways? (Select all that apply.)
 
  a. Outcomes research measures the effects of interventions; quantitative research measures the theory underlying the effects of interventions.
  b. Quantitative research identifies variables before the study onset. Outcomes research may or may not identify variables before the study onset.
  c. Quantitative research may use a number of appropriate theoretical frameworks; outcomes research's theoretical and philosophical bases are all nested within Donabedian's paradigm.
  d. Outcomes research focuses on medical practice; quantitative research focuses on nursing practice.
  e. At the outset, the researcher selects a traditional quantitative research sample according to strict inclusion and exclusion criteria. Outcomes research initially uses all available data and then focuses on specifics.

[Jadwiga9]

Answer to Question 1

ANS: A, C, D
Outcome design strategies tend to have less control than traditional research designs and, except for the clinical trial, seldom use random samples; rather, they use large representative samples. Rather than using sampling criteria that restrict subjects included in the study to decrease possible biases and that reduce the variance and increase the possibility of identifying a statistically significant difference, outcomes researchers seek large heterogeneous samples that reflect, as much as possible, all patients who would be receiving care in the real world. One source of samples used for outcomes studies is large databases. Two broad categories of databases emerge from patient care encounters: clinical databases and administrative. A prospective cohort study is an epidemiological study in which the researcher identifies a group of people who are at risk for experiencing a particular event; they are optimally identified and followed through use of a database.

Answer to Question 2

ANS: B, C, E
Quality is the overriding construct of the theory; however, Donabedian never defined this concept himself. Outcomes research may focus on any potential input to quality of care, regardless of which discipline owns it. Research strategies for outcomes studies have emerged from a variety of disciplines, and innovative new strategies continue to appear in the literature. One source of samples for outcomes studies is large databases. Strategies for outcomes studies tend to employ fewer controls than traditional research designs and cannot be as easily categorized. The research strategies described in this section are only a sampling from the outcomes research literature and include: consensus knowledge building, practice pattern profiling, prospective cohort studies, retrospective cohort studies, population-based studies, geographical analyses, economic studies, and ethical studies.