--- Franklin Valier <[EMAIL PROTECTED]> wrote: > However when an individual reads a > case study and comes to the > conclusion that this is a major contribution to the > development of knowledge > about the subject in question, it needs to be > pointed out that it is just a > case study and where case studies fall within the > scope of scientific > investigations. This is a matter of the critical reading of all literature. There is precious little we can do if the reader is taken up with whatever appears in a journal, irresespective of the quality and standing of the journal in the community.
Within the limitations, all observational studies have their uses, and in the abscense of the double blind controlled trials, may indeed be all we can go, alas. Nandalal > > ----- Original Message ----- > From: "Tim Churches" <[EMAIL PROTECTED]> > To: <[email protected]> > Sent: Friday, May 20, 2005 7:22 PM > Subject: Re: Attitudes of hospital workers towards > electronic medical > records > > > > > > Franklin Valier wrote: > >> In science this type of study only has value as > to its scientifically > >> agreed upon use. Its ability to be relied upon > to make reliable > >> conclusions from the methodology has to be taken > into perspective when > >> reading the study. It has value, but in science > you don't take it too > >> seriously. We rely on empirical studies for > serious evaluation of a > >> phenomena. If they haven't been done, all you > can say is this is all > >> have and this is all we know right now. Not > much. I wouldn't get too > >> upset about this. > > > > I think that you are being overly dismissive of > observational studies. > > Controlled experiments are great, but a) they can > be hard to arrange > > when the thing being tested is a hospital-wide > information system which > > costs tens of millions of dollars to implement and > b) controlled trials > > can introduce their own sets of biases and limit > generalisability due to > > overly tight selection criteria. And how practical > is it to randomise > > whole hospitals to "get teh computer system" or > "stay with paper"? > > OPolitically that is rather hard to do. > > > > Certainly in the case of evaluations of > implementations of hospital and > > other clinical infromations systems it is best to > use a before-and-after > > study design, in which the hospital acts as its > own matched control, and > > the same survey instruments and methods are used > before and after the > > implementation of the system. It is easy to say > that in retrospect, but > > getting money from management to commission an > expensive evaluation > > study of a new information system BEFORE the > system has even begun to be > > installed can be a challenge, I suspect. > > > > Tim C > > > > > > __________________________________________________ Do You Yahoo!? Tired of spam? Yahoo! Mail has the best spam protection around http://mail.yahoo.com
