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Research Design | Step-by-Step Guide with Examples

Published on 5 May 2022 by Shona McCombes . Revised on 20 March 2023.

A research design is a strategy for answering your research question  using empirical data. Creating a research design means making decisions about:

• Your overall aims and approach
• The type of research design you’ll use
• Your sampling methods or criteria for selecting subjects
• Your data collection methods
• The procedures you’ll follow to collect data
• Your data analysis methods

A well-planned research design helps ensure that your methods match your research aims and that you use the right kind of analysis for your data.

Table of contents

Step 1: consider your aims and approach, step 2: choose a type of research design, step 3: identify your population and sampling method, step 4: choose your data collection methods, step 5: plan your data collection procedures, step 6: decide on your data analysis strategies, frequently asked questions.

• Introduction

Before you can start designing your research, you should already have a clear idea of the research question you want to investigate.

There are many different ways you could go about answering this question. Your research design choices should be driven by your aims and priorities – start by thinking carefully about what you want to achieve.

The first choice you need to make is whether you’ll take a qualitative or quantitative approach.

Qualitative research designs tend to be more flexible and inductive , allowing you to adjust your approach based on what you find throughout the research process.

Quantitative research designs tend to be more fixed and deductive , with variables and hypotheses clearly defined in advance of data collection.

It’s also possible to use a mixed methods design that integrates aspects of both approaches. By combining qualitative and quantitative insights, you can gain a more complete picture of the problem you’re studying and strengthen the credibility of your conclusions.

Practical and ethical considerations when designing research

As well as scientific considerations, you need to think practically when designing your research. If your research involves people or animals, you also need to consider research ethics .

• How much time do you have to collect data and write up the research?
• Will you be able to gain access to the data you need (e.g., by travelling to a specific location or contacting specific people)?
• Do you have the necessary research skills (e.g., statistical analysis or interview techniques)?
• Will you need ethical approval ?

At each stage of the research design process, make sure that your choices are practically feasible.

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Within both qualitative and quantitative approaches, there are several types of research design to choose from. Each type provides a framework for the overall shape of your research.

Types of quantitative research designs

Quantitative designs can be split into four main types. Experimental and   quasi-experimental designs allow you to test cause-and-effect relationships, while descriptive and correlational designs allow you to measure variables and describe relationships between them.

With descriptive and correlational designs, you can get a clear picture of characteristics, trends, and relationships as they exist in the real world. However, you can’t draw conclusions about cause and effect (because correlation doesn’t imply causation ).

Experiments are the strongest way to test cause-and-effect relationships without the risk of other variables influencing the results. However, their controlled conditions may not always reflect how things work in the real world. They’re often also more difficult and expensive to implement.

Types of qualitative research designs

Qualitative designs are less strictly defined. This approach is about gaining a rich, detailed understanding of a specific context or phenomenon, and you can often be more creative and flexible in designing your research.

The table below shows some common types of qualitative design. They often have similar approaches in terms of data collection, but focus on different aspects when analysing the data.

Your research design should clearly define who or what your research will focus on, and how you’ll go about choosing your participants or subjects.

In research, a population is the entire group that you want to draw conclusions about, while a sample is the smaller group of individuals you’ll actually collect data from.

Defining the population

A population can be made up of anything you want to study – plants, animals, organisations, texts, countries, etc. In the social sciences, it most often refers to a group of people.

For example, will you focus on people from a specific demographic, region, or background? Are you interested in people with a certain job or medical condition, or users of a particular product?

The more precisely you define your population, the easier it will be to gather a representative sample.

Sampling methods

Even with a narrowly defined population, it’s rarely possible to collect data from every individual. Instead, you’ll collect data from a sample.

To select a sample, there are two main approaches: probability sampling and non-probability sampling . The sampling method you use affects how confidently you can generalise your results to the population as a whole.

Probability sampling is the most statistically valid option, but it’s often difficult to achieve unless you’re dealing with a very small and accessible population.

For practical reasons, many studies use non-probability sampling, but it’s important to be aware of the limitations and carefully consider potential biases. You should always make an effort to gather a sample that’s as representative as possible of the population.

Case selection in qualitative research

In some types of qualitative designs, sampling may not be relevant.

For example, in an ethnography or a case study, your aim is to deeply understand a specific context, not to generalise to a population. Instead of sampling, you may simply aim to collect as much data as possible about the context you are studying.

In these types of design, you still have to carefully consider your choice of case or community. You should have a clear rationale for why this particular case is suitable for answering your research question.

For example, you might choose a case study that reveals an unusual or neglected aspect of your research problem, or you might choose several very similar or very different cases in order to compare them.

Data collection methods are ways of directly measuring variables and gathering information. They allow you to gain first-hand knowledge and original insights into your research problem.

You can choose just one data collection method, or use several methods in the same study.

Survey methods

Surveys allow you to collect data about opinions, behaviours, experiences, and characteristics by asking people directly. There are two main survey methods to choose from: questionnaires and interviews.

Observation methods

Observations allow you to collect data unobtrusively, observing characteristics, behaviours, or social interactions without relying on self-reporting.

Observations may be conducted in real time, taking notes as you observe, or you might make audiovisual recordings for later analysis. They can be qualitative or quantitative.

Other methods of data collection

There are many other ways you might collect data depending on your field and topic.

If you’re not sure which methods will work best for your research design, try reading some papers in your field to see what data collection methods they used.

Secondary data

If you don’t have the time or resources to collect data from the population you’re interested in, you can also choose to use secondary data that other researchers already collected – for example, datasets from government surveys or previous studies on your topic.

With this raw data, you can do your own analysis to answer new research questions that weren’t addressed by the original study.

Using secondary data can expand the scope of your research, as you may be able to access much larger and more varied samples than you could collect yourself.

However, it also means you don’t have any control over which variables to measure or how to measure them, so the conclusions you can draw may be limited.

As well as deciding on your methods, you need to plan exactly how you’ll use these methods to collect data that’s consistent, accurate, and unbiased.

Planning systematic procedures is especially important in quantitative research, where you need to precisely define your variables and ensure your measurements are reliable and valid.

Operationalisation

Some variables, like height or age, are easily measured. But often you’ll be dealing with more abstract concepts, like satisfaction, anxiety, or competence. Operationalisation means turning these fuzzy ideas into measurable indicators.

If you’re using observations , which events or actions will you count?

If you’re using surveys , which questions will you ask and what range of responses will be offered?

You may also choose to use or adapt existing materials designed to measure the concept you’re interested in – for example, questionnaires or inventories whose reliability and validity has already been established.

Reliability and validity

Reliability means your results can be consistently reproduced , while validity means that you’re actually measuring the concept you’re interested in.

For valid and reliable results, your measurement materials should be thoroughly researched and carefully designed. Plan your procedures to make sure you carry out the same steps in the same way for each participant.

If you’re developing a new questionnaire or other instrument to measure a specific concept, running a pilot study allows you to check its validity and reliability in advance.

Sampling procedures

As well as choosing an appropriate sampling method, you need a concrete plan for how you’ll actually contact and recruit your selected sample.

That means making decisions about things like:

• How many participants do you need for an adequate sample size?
• What inclusion and exclusion criteria will you use to identify eligible participants?
• How will you contact your sample – by mail, online, by phone, or in person?

If you’re using a probability sampling method, it’s important that everyone who is randomly selected actually participates in the study. How will you ensure a high response rate?

If you’re using a non-probability method, how will you avoid bias and ensure a representative sample?

Data management

It’s also important to create a data management plan for organising and storing your data.

Will you need to transcribe interviews or perform data entry for observations? You should anonymise and safeguard any sensitive data, and make sure it’s backed up regularly.

Keeping your data well organised will save time when it comes to analysing them. It can also help other researchers validate and add to your findings.

On their own, raw data can’t answer your research question. The last step of designing your research is planning how you’ll analyse the data.

Quantitative data analysis

In quantitative research, you’ll most likely use some form of statistical analysis . With statistics, you can summarise your sample data, make estimates, and test hypotheses.

Using descriptive statistics , you can summarise your sample data in terms of:

• The distribution of the data (e.g., the frequency of each score on a test)
• The central tendency of the data (e.g., the mean to describe the average score)
• The variability of the data (e.g., the standard deviation to describe how spread out the scores are)

The specific calculations you can do depend on the level of measurement of your variables.

Using inferential statistics , you can:

• Make estimates about the population based on your sample data.
• Test hypotheses about a relationship between variables.

Regression and correlation tests look for associations between two or more variables, while comparison tests (such as t tests and ANOVAs ) look for differences in the outcomes of different groups.

Your choice of statistical test depends on various aspects of your research design, including the types of variables you’re dealing with and the distribution of your data.

Qualitative data analysis

In qualitative research, your data will usually be very dense with information and ideas. Instead of summing it up in numbers, you’ll need to comb through the data in detail, interpret its meanings, identify patterns, and extract the parts that are most relevant to your research question.

Two of the most common approaches to doing this are thematic analysis and discourse analysis .

There are many other ways of analysing qualitative data depending on the aims of your research. To get a sense of potential approaches, try reading some qualitative research papers in your field.

A sample is a subset of individuals from a larger population. Sampling means selecting the group that you will actually collect data from in your research.

For example, if you are researching the opinions of students in your university, you could survey a sample of 100 students.

Statistical sampling allows you to test a hypothesis about the characteristics of a population. There are various sampling methods you can use to ensure that your sample is representative of the population as a whole.

Operationalisation means turning abstract conceptual ideas into measurable observations.

For example, the concept of social anxiety isn’t directly observable, but it can be operationally defined in terms of self-rating scores, behavioural avoidance of crowded places, or physical anxiety symptoms in social situations.

Before collecting data , it’s important to consider how you will operationalise the variables that you want to measure.

The research methods you use depend on the type of data you need to answer your research question .

• If you want to measure something or test a hypothesis , use quantitative methods . If you want to explore ideas, thoughts, and meanings, use qualitative methods .
• If you want to analyse a large amount of readily available data, use secondary data. If you want data specific to your purposes with control over how they are generated, collect primary data.
• If you want to establish cause-and-effect relationships between variables , use experimental methods. If you want to understand the characteristics of a research subject, use descriptive methods.

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Research Design 101

Everything You Need To Get Started (With Examples)

By: Derek Jansen (MBA) | Reviewers: Eunice Rautenbach (DTech) & Kerryn Warren (PhD) | April 2023

Navigating the world of research can be daunting, especially if you’re a first-time researcher. One concept you’re bound to run into fairly early in your research journey is that of “ research design ”. Here, we’ll guide you through the basics using practical examples , so that you can approach your research with confidence.

Overview: Research Design 101

What is research design.

• Research design types for quantitative studies
• Video explainer : quantitative research design
• Research design types for qualitative studies
• Video explainer : qualitative research design
• How to choose a research design
• Key takeaways

Research design refers to the overall plan, structure or strategy that guides a research project , from its conception to the final data analysis. A good research design serves as the blueprint for how you, as the researcher, will collect and analyse data while ensuring consistency, reliability and validity throughout your study.

Understanding different types of research designs is essential as helps ensure that your approach is suitable  given your research aims, objectives and questions , as well as the resources you have available to you. Without a clear big-picture view of how you’ll design your research, you run the risk of potentially making misaligned choices in terms of your methodology – especially your sampling , data collection and data analysis decisions.

The problem with defining research design…

One of the reasons students struggle with a clear definition of research design is because the term is used very loosely across the internet, and even within academia.

Some sources claim that the three research design types are qualitative, quantitative and mixed methods , which isn’t quite accurate (these just refer to the type of data that you’ll collect and analyse). Other sources state that research design refers to the sum of all your design choices, suggesting it’s more like a research methodology . Others run off on other less common tangents. No wonder there’s confusion!

In this article, we’ll clear up the confusion. We’ll explain the most common research design types for both qualitative and quantitative research projects, whether that is for a full dissertation or thesis, or a smaller research paper or article.

Research Design: Quantitative Studies

Quantitative research involves collecting and analysing data in a numerical form. Broadly speaking, there are four types of quantitative research designs: descriptive , correlational , experimental , and quasi-experimental . 

Descriptive Research Design

As the name suggests, descriptive research design focuses on describing existing conditions, behaviours, or characteristics by systematically gathering information without manipulating any variables. In other words, there is no intervention on the researcher’s part – only data collection.

For example, if you’re studying smartphone addiction among adolescents in your community, you could deploy a survey to a sample of teens asking them to rate their agreement with certain statements that relate to smartphone addiction. The collected data would then provide insight regarding how widespread the issue may be – in other words, it would describe the situation.

The key defining attribute of this type of research design is that it purely describes the situation . In other words, descriptive research design does not explore potential relationships between different variables or the causes that may underlie those relationships. Therefore, descriptive research is useful for generating insight into a research problem by describing its characteristics . By doing so, it can provide valuable insights and is often used as a precursor to other research design types.

Correlational Research Design

Correlational design is a popular choice for researchers aiming to identify and measure the relationship between two or more variables without manipulating them . In other words, this type of research design is useful when you want to know whether a change in one thing tends to be accompanied by a change in another thing.

For example, if you wanted to explore the relationship between exercise frequency and overall health, you could use a correlational design to help you achieve this. In this case, you might gather data on participants’ exercise habits, as well as records of their health indicators like blood pressure, heart rate, or body mass index. Thereafter, you’d use a statistical test to assess whether there’s a relationship between the two variables (exercise frequency and health).

As you can see, correlational research design is useful when you want to explore potential relationships between variables that cannot be manipulated or controlled for ethical, practical, or logistical reasons. It is particularly helpful in terms of developing predictions , and given that it doesn’t involve the manipulation of variables, it can be implemented at a large scale more easily than experimental designs (which will look at next).

That said, it’s important to keep in mind that correlational research design has limitations – most notably that it cannot be used to establish causality . In other words, correlation does not equal causation . To establish causality, you’ll need to move into the realm of experimental design, coming up next…

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Experimental Research Design

Experimental research design is used to determine if there is a causal relationship between two or more variables . With this type of research design, you, as the researcher, manipulate one variable (the independent variable) while controlling others (dependent variables). Doing so allows you to observe the effect of the former on the latter and draw conclusions about potential causality.

For example, if you wanted to measure if/how different types of fertiliser affect plant growth, you could set up several groups of plants, with each group receiving a different type of fertiliser, as well as one with no fertiliser at all. You could then measure how much each plant group grew (on average) over time and compare the results from the different groups to see which fertiliser was most effective.

Overall, experimental research design provides researchers with a powerful way to identify and measure causal relationships (and the direction of causality) between variables. However, developing a rigorous experimental design can be challenging as it’s not always easy to control all the variables in a study. This often results in smaller sample sizes , which can reduce the statistical power and generalisability of the results.

Moreover, experimental research design requires random assignment . This means that the researcher needs to assign participants to different groups or conditions in a way that each participant has an equal chance of being assigned to any group (note that this is not the same as random sampling ). Doing so helps reduce the potential for bias and confounding variables . This need for random assignment can lead to ethics-related issues . For example, withholding a potentially beneficial medical treatment from a control group may be considered unethical in certain situations.

Quasi-Experimental Research Design

Quasi-experimental research design is used when the research aims involve identifying causal relations , but one cannot (or doesn’t want to) randomly assign participants to different groups (for practical or ethical reasons). Instead, with a quasi-experimental research design, the researcher relies on existing groups or pre-existing conditions to form groups for comparison.

For example, if you were studying the effects of a new teaching method on student achievement in a particular school district, you may be unable to randomly assign students to either group and instead have to choose classes or schools that already use different teaching methods. This way, you still achieve separate groups, without having to assign participants to specific groups yourself.

Naturally, quasi-experimental research designs have limitations when compared to experimental designs. Given that participant assignment is not random, it’s more difficult to confidently establish causality between variables, and, as a researcher, you have less control over other variables that may impact findings.

All that said, quasi-experimental designs can still be valuable in research contexts where random assignment is not possible and can often be undertaken on a much larger scale than experimental research, thus increasing the statistical power of the results. What’s important is that you, as the researcher, understand the limitations of the design and conduct your quasi-experiment as rigorously as possible, paying careful attention to any potential confounding variables .

Research Design: Qualitative Studies

There are many different research design types when it comes to qualitative studies, but here we’ll narrow our focus to explore the “Big 4”. Specifically, we’ll look at phenomenological design, grounded theory design, ethnographic design, and case study design.

Phenomenological Research Design

Phenomenological design involves exploring the meaning of lived experiences and how they are perceived by individuals. This type of research design seeks to understand people’s perspectives , emotions, and behaviours in specific situations. Here, the aim for researchers is to uncover the essence of human experience without making any assumptions or imposing preconceived ideas on their subjects.

For example, you could adopt a phenomenological design to study why cancer survivors have such varied perceptions of their lives after overcoming their disease. This could be achieved by interviewing survivors and then analysing the data using a qualitative analysis method such as thematic analysis to identify commonalities and differences.

Phenomenological research design typically involves in-depth interviews or open-ended questionnaires to collect rich, detailed data about participants’ subjective experiences. This richness is one of the key strengths of phenomenological research design but, naturally, it also has limitations. These include potential biases in data collection and interpretation and the lack of generalisability of findings to broader populations.

Grounded Theory Research Design

Grounded theory (also referred to as “GT”) aims to develop theories by continuously and iteratively analysing and comparing data collected from a relatively large number of participants in a study. It takes an inductive (bottom-up) approach, with a focus on letting the data “speak for itself”, without being influenced by preexisting theories or the researcher’s preconceptions.

As an example, let’s assume your research aims involved understanding how people cope with chronic pain from a specific medical condition, with a view to developing a theory around this. In this case, grounded theory design would allow you to explore this concept thoroughly without preconceptions about what coping mechanisms might exist. You may find that some patients prefer cognitive-behavioural therapy (CBT) while others prefer to rely on herbal remedies. Based on multiple, iterative rounds of analysis, you could then develop a theory in this regard, derived directly from the data (as opposed to other preexisting theories and models).

Grounded theory typically involves collecting data through interviews or observations and then analysing it to identify patterns and themes that emerge from the data. These emerging ideas are then validated by collecting more data until a saturation point is reached (i.e., no new information can be squeezed from the data). From that base, a theory can then be developed .

As you can see, grounded theory is ideally suited to studies where the research aims involve theory generation , especially in under-researched areas. Keep in mind though that this type of research design can be quite time-intensive , given the need for multiple rounds of data collection and analysis.

Ethnographic Research Design

Ethnographic design involves observing and studying a culture-sharing group of people in their natural setting to gain insight into their behaviours, beliefs, and values. The focus here is on observing participants in their natural environment (as opposed to a controlled environment). This typically involves the researcher spending an extended period of time with the participants in their environment, carefully observing and taking field notes .

All of this is not to say that ethnographic research design relies purely on observation. On the contrary, this design typically also involves in-depth interviews to explore participants’ views, beliefs, etc. However, unobtrusive observation is a core component of the ethnographic approach.

As an example, an ethnographer may study how different communities celebrate traditional festivals or how individuals from different generations interact with technology differently. This may involve a lengthy period of observation, combined with in-depth interviews to further explore specific areas of interest that emerge as a result of the observations that the researcher has made.

As you can probably imagine, ethnographic research design has the ability to provide rich, contextually embedded insights into the socio-cultural dynamics of human behaviour within a natural, uncontrived setting. Naturally, however, it does come with its own set of challenges, including researcher bias (since the researcher can become quite immersed in the group), participant confidentiality and, predictably, ethical complexities . All of these need to be carefully managed if you choose to adopt this type of research design.

Case Study Design

With case study research design, you, as the researcher, investigate a single individual (or a single group of individuals) to gain an in-depth understanding of their experiences, behaviours or outcomes. Unlike other research designs that are aimed at larger sample sizes, case studies offer a deep dive into the specific circumstances surrounding a person, group of people, event or phenomenon, generally within a bounded setting or context .

As an example, a case study design could be used to explore the factors influencing the success of a specific small business. This would involve diving deeply into the organisation to explore and understand what makes it tick – from marketing to HR to finance. In terms of data collection, this could include interviews with staff and management, review of policy documents and financial statements, surveying customers, etc.

While the above example is focused squarely on one organisation, it’s worth noting that case study research designs can have different variation s, including single-case, multiple-case and longitudinal designs. As you can see in the example, a single-case design involves intensely examining a single entity to understand its unique characteristics and complexities. Conversely, in a multiple-case design , multiple cases are compared and contrasted to identify patterns and commonalities. Lastly, in a longitudinal case design , a single case or multiple cases are studied over an extended period of time to understand how factors develop over time.

As you can see, a case study research design is particularly useful where a deep and contextualised understanding of a specific phenomenon or issue is desired. However, this strength is also its weakness. In other words, you can’t generalise the findings from a case study to the broader population. So, keep this in mind if you’re considering going the case study route.

How To Choose A Research Design

Having worked through all of these potential research designs, you’d be forgiven for feeling a little overwhelmed and wondering, “ But how do I decide which research design to use? ”. While we could write an entire post covering that alone, here are a few factors to consider that will help you choose a suitable research design for your study.

Data type: The first determining factor is naturally the type of data you plan to be collecting – i.e., qualitative or quantitative. This may sound obvious, but we have to be clear about this – don’t try to use a quantitative research design on qualitative data (or vice versa)!

Research aim(s) and question(s): As with all methodological decisions, your research aim and research questions will heavily influence your research design. For example, if your research aims involve developing a theory from qualitative data, grounded theory would be a strong option. Similarly, if your research aims involve identifying and measuring relationships between variables, one of the experimental designs would likely be a better option.

Time: It’s essential that you consider any time constraints you have, as this will impact the type of research design you can choose. For example, if you’ve only got a month to complete your project, a lengthy design such as ethnography wouldn’t be a good fit.

Resources: Take into account the resources realistically available to you, as these need to factor into your research design choice. For example, if you require highly specialised lab equipment to execute an experimental design, you need to be sure that you’ll have access to that before you make a decision.

Keep in mind that when it comes to research, it’s important to manage your risks and play as conservatively as possible. If your entire project relies on you achieving a huge sample, having access to niche equipment or holding interviews with very difficult-to-reach participants, you’re creating risks that could kill your project. So, be sure to think through your choices carefully and make sure that you have backup plans for any existential risks. Remember that a relatively simple methodology executed well generally will typically earn better marks than a highly-complex methodology executed poorly.

Recap: Key Takeaways

We’ve covered a lot of ground here. Let’s recap by looking at the key takeaways:

• Research design refers to the overall plan, structure or strategy that guides a research project, from its conception to the final analysis of data.
• Research designs for quantitative studies include descriptive , correlational , experimental and quasi-experimenta l designs.
• Research designs for qualitative studies include phenomenological , grounded theory , ethnographic and case study designs.
• When choosing a research design, you need to consider a variety of factors, including the type of data you’ll be working with, your research aims and questions, your time and the resources available to you.

If you need a helping hand with your research design (or any other aspect of your research), check out our private coaching services .

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10 Comments

Is there any blog article explaining more on Case study research design? Is there a Case study write-up template? Thank you.

Thanks this was quite valuable to clarify such an important concept.

Thanks for this simplified explanations. it is quite very helpful.

This was really helpful. thanks

Thank you for your explanation. I think case study research design and the use of secondary data in researches needs to be talked about more in your videos and articles because there a lot of case studies research design tailored projects out there.

Please is there any template for a case study research design whose data type is a secondary data on your repository?

This post is very clear, comprehensive and has been very helpful to me. It has cleared the confusion I had in regard to research design and methodology.

This post is helpful, easy to understand, and deconstructs what a research design is. Thanks

how to cite this page

Thank you very much for the post. It is wonderful and has cleared many worries in my mind regarding research designs. I really appreciate .

how can I put this blog as my reference(APA style) in bibliography part?

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An introduction to different types of study design

Posted on 6th April 2021 by Hadi Abbas

Study designs are the set of methods and procedures used to collect and analyze data in a study.

Broadly speaking, there are 2 types of study designs: descriptive studies and analytical studies.

Descriptive studies

• Describes specific characteristics in a population of interest
• The most common forms are case reports and case series
• In a case report, we discuss our experience with the patient’s symptoms, signs, diagnosis, and treatment
• In a case series, several patients with similar experiences are grouped.

Analytical Studies

Analytical studies are of 2 types: observational and experimental.

Observational studies are studies that we conduct without any intervention or experiment. In those studies, we purely observe the outcomes.  On the other hand, in experimental studies, we conduct experiments and interventions.

Observational studies

Observational studies include many subtypes. Below, I will discuss the most common designs.

Cross-sectional study:

• This design is transverse where we take a specific sample at a specific time without any follow-up
• It allows us to calculate the frequency of disease ( p revalence ) or the frequency of a risk factor
• This design is easy to conduct
• For example – if we want to know the prevalence of migraine in a population, we can conduct a cross-sectional study whereby we take a sample from the population and calculate the number of patients with migraine headaches.

Cohort study:

• We conduct this study by comparing two samples from the population: one sample with a risk factor while the other lacks this risk factor
• It shows us the risk of developing the disease in individuals with the risk factor compared to those without the risk factor ( RR = relative risk )
• Prospective : we follow the individuals in the future to know who will develop the disease
• Retrospective : we look to the past to know who developed the disease (e.g. using medical records)
• This design is the strongest among the observational studies
• For example – to find out the relative risk of developing chronic obstructive pulmonary disease (COPD) among smokers, we take a sample including smokers and non-smokers. Then, we calculate the number of individuals with COPD among both.

Case-Control Study:

• We conduct this study by comparing 2 groups: one group with the disease (cases) and another group without the disease (controls)
• This design is always retrospective
•  We aim to find out the odds of having a risk factor or an exposure if an individual has a specific disease (Odds ratio)
•  Relatively easy to conduct
• For example – we want to study the odds of being a smoker among hypertensive patients compared to normotensive ones. To do so, we choose a group of patients diagnosed with hypertension and another group that serves as the control (normal blood pressure). Then we study their smoking history to find out if there is a correlation.

Experimental Studies

• Also known as interventional studies
• Can involve animals and humans
• Pre-clinical trials involve animals
• Clinical trials are experimental studies involving humans
• In clinical trials, we study the effect of an intervention compared to another intervention or placebo. As an example, I have listed the four phases of a drug trial:

I:  We aim to assess the safety of the drug ( is it safe ? )

II: We aim to assess the efficacy of the drug ( does it work ? )

III: We want to know if this drug is better than the old treatment ( is it better ? )

IV: We follow-up to detect long-term side effects ( can it stay in the market ? )

• In randomized controlled trials, one group of participants receives the control, while the other receives the tested drug/intervention. Those studies are the best way to evaluate the efficacy of a treatment.

Finally, the figure below will help you with your understanding of different types of study designs.

References (pdf)

You may also be interested in the following blogs for further reading:

An introduction to randomized controlled trials

Case-control and cohort studies: a brief overview

Cohort studies: prospective and retrospective designs

Prevalence vs Incidence: what is the difference?

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you are amazing one!! if I get you I’m working with you! I’m student from Ethiopian higher education. health sciences student

Very informative and easy understandable

You are my kind of doctor. Do not lose sight of your objective.

Wow very erll explained and easy to understand

I’m Khamisu Habibu community health officer student from Abubakar Tafawa Balewa university teaching hospital Bauchi, Nigeria, I really appreciate your write up and you have make it clear for the learner. thank you

well understood,thank you so much

Well understood…thanks

Simply explained. Thank You.

Thanks a lot for this nice informative article which help me to understand different study designs that I felt difficult before

That’s lovely to hear, Mona, thank you for letting the author know how useful this was. If there are any other particular topics you think would be useful to you, and are not already on the website, please do let us know.

it is very informative and useful.

thank you statistician

Fabulous to hear, thank you John.

Thanks for this information

Thanks so much for this information….I have clearly known the types of study design Thanks

That’s so good to hear, Mirembe, thank you for letting the author know.

Very helpful article!! U have simplified everything for easy understanding

I’m a health science major currently taking statistics for health care workers…this is a challenging class…thanks for the simified feedback.

That’s good to hear this has helped you. Hopefully you will find some of the other blogs useful too. If you see any topics that are missing from the website, please do let us know!

Hello. I liked your presentation, the fact that you ranked them clearly is very helpful to understand for people like me who is a novelist researcher. However, I was expecting to read much more about the Experimental studies. So please direct me if you already have or will one day. Thank you

Dear Ay. My sincere apologies for not responding to your comment sooner. You may find it useful to filter the blogs by the topic of ‘Study design and research methods’ – here is a link to that filter: https://s4be.cochrane.org/blog/topic/study-design/ This will cover more detail about experimental studies. Or have a look on our library page for further resources there – you’ll find that on the ‘Resources’ drop down from the home page.

However, if there are specific things you feel you would like to learn about experimental studies, that are missing from the website, it would be great if you could let me know too. Thank you, and best of luck. Emma

Great job Mr Hadi. I advise you to prepare and study for the Australian Medical Board Exams as soon as you finish your undergrad study in Lebanon. Good luck and hope we can meet sometime in the future. Regards ;)

You have give a good explaination of what am looking for. However, references am not sure of where to get them from.

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Organizing Your Social Sciences Research Paper

• Types of Research Designs
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Introduction

Before beginning your paper, you need to decide how you plan to design the study .

The research design refers to the overall strategy and analytical approach that you have chosen in order to integrate, in a coherent and logical way, the different components of the study, thus ensuring that the research problem will be thoroughly investigated. It constitutes the blueprint for the collection, measurement, and interpretation of information and data. Note that the research problem determines the type of design you choose, not the other way around!

De Vaus, D. A. Research Design in Social Research . London: SAGE, 2001; Trochim, William M.K. Research Methods Knowledge Base. 2006.

General Structure and Writing Style

The function of a research design is to ensure that the evidence obtained enables you to effectively address the research problem logically and as unambiguously as possible . In social sciences research, obtaining information relevant to the research problem generally entails specifying the type of evidence needed to test the underlying assumptions of a theory, to evaluate a program, or to accurately describe and assess meaning related to an observable phenomenon.

With this in mind, a common mistake made by researchers is that they begin their investigations before they have thought critically about what information is required to address the research problem. Without attending to these design issues beforehand, the overall research problem will not be adequately addressed and any conclusions drawn will run the risk of being weak and unconvincing. As a consequence, the overall validity of the study will be undermined.

The length and complexity of describing the research design in your paper can vary considerably, but any well-developed description will achieve the following :

• Identify the research problem clearly and justify its selection, particularly in relation to any valid alternative designs that could have been used,
• Review and synthesize previously published literature associated with the research problem,
• Clearly and explicitly specify hypotheses [i.e., research questions] central to the problem,
• Effectively describe the information and/or data which will be necessary for an adequate testing of the hypotheses and explain how such information and/or data will be obtained, and
• Describe the methods of analysis to be applied to the data in determining whether or not the hypotheses are true or false.

The research design is usually incorporated into the introduction of your paper . You can obtain an overall sense of what to do by reviewing studies that have utilized the same research design [e.g., using a case study approach]. This can help you develop an outline to follow for your own paper.

NOTE: Use the SAGE Research Methods Online and Cases and the SAGE Research Methods Videos databases to search for scholarly resources on how to apply specific research designs and methods . The Research Methods Online database contains links to more than 175,000 pages of SAGE publisher's book, journal, and reference content on quantitative, qualitative, and mixed research methodologies. Also included is a collection of case studies of social research projects that can be used to help you better understand abstract or complex methodological concepts. The Research Methods Videos database contains hours of tutorials, interviews, video case studies, and mini-documentaries covering the entire research process.

Creswell, John W. and J. David Creswell. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches . 5th edition. Thousand Oaks, CA: Sage, 2018; De Vaus, D. A. Research Design in Social Research . London: SAGE, 2001; Gorard, Stephen. Research Design: Creating Robust Approaches for the Social Sciences . Thousand Oaks, CA: Sage, 2013; Leedy, Paul D. and Jeanne Ellis Ormrod. Practical Research: Planning and Design . Tenth edition. Boston, MA: Pearson, 2013; Vogt, W. Paul, Dianna C. Gardner, and Lynne M. Haeffele. When to Use What Research Design . New York: Guilford, 2012.

Action Research Design

Definition and Purpose

The essentials of action research design follow a characteristic cycle whereby initially an exploratory stance is adopted, where an understanding of a problem is developed and plans are made for some form of interventionary strategy. Then the intervention is carried out [the "action" in action research] during which time, pertinent observations are collected in various forms. The new interventional strategies are carried out, and this cyclic process repeats, continuing until a sufficient understanding of [or a valid implementation solution for] the problem is achieved. The protocol is iterative or cyclical in nature and is intended to foster deeper understanding of a given situation, starting with conceptualizing and particularizing the problem and moving through several interventions and evaluations.

What do these studies tell you ?

• This is a collaborative and adaptive research design that lends itself to use in work or community situations.
• Design focuses on pragmatic and solution-driven research outcomes rather than testing theories.
• When practitioners use action research, it has the potential to increase the amount they learn consciously from their experience; the action research cycle can be regarded as a learning cycle.
• Action research studies often have direct and obvious relevance to improving practice and advocating for change.
• There are no hidden controls or preemption of direction by the researcher.

What these studies don't tell you ?

• It is harder to do than conducting conventional research because the researcher takes on responsibilities of advocating for change as well as for researching the topic.
• Action research is much harder to write up because it is less likely that you can use a standard format to report your findings effectively [i.e., data is often in the form of stories or observation].
• Personal over-involvement of the researcher may bias research results.
• The cyclic nature of action research to achieve its twin outcomes of action [e.g. change] and research [e.g. understanding] is time-consuming and complex to conduct.
• Advocating for change usually requires buy-in from study participants.

Coghlan, David and Mary Brydon-Miller. The Sage Encyclopedia of Action Research . Thousand Oaks, CA:  Sage, 2014; Efron, Sara Efrat and Ruth Ravid. Action Research in Education: A Practical Guide . New York: Guilford, 2013; Gall, Meredith. Educational Research: An Introduction . Chapter 18, Action Research. 8th ed. Boston, MA: Pearson/Allyn and Bacon, 2007; Gorard, Stephen. Research Design: Creating Robust Approaches for the Social Sciences . Thousand Oaks, CA: Sage, 2013; Kemmis, Stephen and Robin McTaggart. “Participatory Action Research.” In Handbook of Qualitative Research . Norman Denzin and Yvonna S. Lincoln, eds. 2nd ed. (Thousand Oaks, CA: SAGE, 2000), pp. 567-605; McNiff, Jean. Writing and Doing Action Research . London: Sage, 2014; Reason, Peter and Hilary Bradbury. Handbook of Action Research: Participative Inquiry and Practice . Thousand Oaks, CA: SAGE, 2001.

Case Study Design

A case study is an in-depth study of a particular research problem rather than a sweeping statistical survey or comprehensive comparative inquiry. It is often used to narrow down a very broad field of research into one or a few easily researchable examples. The case study research design is also useful for testing whether a specific theory and model actually applies to phenomena in the real world. It is a useful design when not much is known about an issue or phenomenon.

• Approach excels at bringing us to an understanding of a complex issue through detailed contextual analysis of a limited number of events or conditions and their relationships.
• A researcher using a case study design can apply a variety of methodologies and rely on a variety of sources to investigate a research problem.
• Design can extend experience or add strength to what is already known through previous research.
• Social scientists, in particular, make wide use of this research design to examine contemporary real-life situations and provide the basis for the application of concepts and theories and the extension of methodologies.
• The design can provide detailed descriptions of specific and rare cases.
• A single or small number of cases offers little basis for establishing reliability or to generalize the findings to a wider population of people, places, or things.
• Intense exposure to the study of a case may bias a researcher's interpretation of the findings.
• Design does not facilitate assessment of cause and effect relationships.
• Vital information may be missing, making the case hard to interpret.
• The case may not be representative or typical of the larger problem being investigated.
• If the criteria for selecting a case is because it represents a very unusual or unique phenomenon or problem for study, then your interpretation of the findings can only apply to that particular case.

Case Studies. Writing@CSU. Colorado State University; Anastas, Jeane W. Research Design for Social Work and the Human Services . Chapter 4, Flexible Methods: Case Study Design. 2nd ed. New York: Columbia University Press, 1999; Gerring, John. “What Is a Case Study and What Is It Good for?” American Political Science Review 98 (May 2004): 341-354; Greenhalgh, Trisha, editor. Case Study Evaluation: Past, Present and Future Challenges . Bingley, UK: Emerald Group Publishing, 2015; Mills, Albert J. , Gabrielle Durepos, and Eiden Wiebe, editors. Encyclopedia of Case Study Research . Thousand Oaks, CA: SAGE Publications, 2010; Stake, Robert E. The Art of Case Study Research . Thousand Oaks, CA: SAGE, 1995; Yin, Robert K. Case Study Research: Design and Theory . Applied Social Research Methods Series, no. 5. 3rd ed. Thousand Oaks, CA: SAGE, 2003.

Causal Design

Causality studies may be thought of as understanding a phenomenon in terms of conditional statements in the form, “If X, then Y.” This type of research is used to measure what impact a specific change will have on existing norms and assumptions. Most social scientists seek causal explanations that reflect tests of hypotheses. Causal effect (nomothetic perspective) occurs when variation in one phenomenon, an independent variable, leads to or results, on average, in variation in another phenomenon, the dependent variable.

Conditions necessary for determining causality:

• Empirical association -- a valid conclusion is based on finding an association between the independent variable and the dependent variable.
• Appropriate time order -- to conclude that causation was involved, one must see that cases were exposed to variation in the independent variable before variation in the dependent variable.
• Nonspuriousness -- a relationship between two variables that is not due to variation in a third variable.
• Causality research designs assist researchers in understanding why the world works the way it does through the process of proving a causal link between variables and by the process of eliminating other possibilities.
• Replication is possible.
• There is greater confidence the study has internal validity due to the systematic subject selection and equity of groups being compared.
• Not all relationships are causal! The possibility always exists that, by sheer coincidence, two unrelated events appear to be related [e.g., Punxatawney Phil could accurately predict the duration of Winter for five consecutive years but, the fact remains, he's just a big, furry rodent].
• Conclusions about causal relationships are difficult to determine due to a variety of extraneous and confounding variables that exist in a social environment. This means causality can only be inferred, never proven.
• If two variables are correlated, the cause must come before the effect. However, even though two variables might be causally related, it can sometimes be difficult to determine which variable comes first and, therefore, to establish which variable is the actual cause and which is the  actual effect.

Beach, Derek and Rasmus Brun Pedersen. Causal Case Study Methods: Foundations and Guidelines for Comparing, Matching, and Tracing . Ann Arbor, MI: University of Michigan Press, 2016; Bachman, Ronet. The Practice of Research in Criminology and Criminal Justice . Chapter 5, Causation and Research Designs. 3rd ed. Thousand Oaks, CA: Pine Forge Press, 2007; Brewer, Ernest W. and Jennifer Kubn. “Causal-Comparative Design.” In Encyclopedia of Research Design . Neil J. Salkind, editor. (Thousand Oaks, CA: Sage, 2010), pp. 125-132; Causal Research Design: Experimentation. Anonymous SlideShare Presentation; Gall, Meredith. Educational Research: An Introduction . Chapter 11, Nonexperimental Research: Correlational Designs. 8th ed. Boston, MA: Pearson/Allyn and Bacon, 2007; Trochim, William M.K. Research Methods Knowledge Base. 2006.

Cohort Design

Often used in the medical sciences, but also found in the applied social sciences, a cohort study generally refers to a study conducted over a period of time involving members of a population which the subject or representative member comes from, and who are united by some commonality or similarity. Using a quantitative framework, a cohort study makes note of statistical occurrence within a specialized subgroup, united by same or similar characteristics that are relevant to the research problem being investigated, rather than studying statistical occurrence within the general population. Using a qualitative framework, cohort studies generally gather data using methods of observation. Cohorts can be either "open" or "closed."

• Open Cohort Studies [dynamic populations, such as the population of Los Angeles] involve a population that is defined just by the state of being a part of the study in question (and being monitored for the outcome). Date of entry and exit from the study is individually defined, therefore, the size of the study population is not constant. In open cohort studies, researchers can only calculate rate based data, such as, incidence rates and variants thereof.
• Closed Cohort Studies [static populations, such as patients entered into a clinical trial] involve participants who enter into the study at one defining point in time and where it is presumed that no new participants can enter the cohort. Given this, the number of study participants remains constant (or can only decrease).
• The use of cohorts is often mandatory because a randomized control study may be unethical. For example, you cannot deliberately expose people to asbestos, you can only study its effects on those who have already been exposed. Research that measures risk factors often relies upon cohort designs.
• Because cohort studies measure potential causes before the outcome has occurred, they can demonstrate that these “causes” preceded the outcome, thereby avoiding the debate as to which is the cause and which is the effect.
• Cohort analysis is highly flexible and can provide insight into effects over time and related to a variety of different types of changes [e.g., social, cultural, political, economic, etc.].
• Either original data or secondary data can be used in this design.
• In cases where a comparative analysis of two cohorts is made [e.g., studying the effects of one group exposed to asbestos and one that has not], a researcher cannot control for all other factors that might differ between the two groups. These factors are known as confounding variables.
• Cohort studies can end up taking a long time to complete if the researcher must wait for the conditions of interest to develop within the group. This also increases the chance that key variables change during the course of the study, potentially impacting the validity of the findings.
• Due to the lack of randominization in the cohort design, its external validity is lower than that of study designs where the researcher randomly assigns participants.

Healy P, Devane D. “Methodological Considerations in Cohort Study Designs.” Nurse Researcher 18 (2011): 32-36; Glenn, Norval D, editor. Cohort Analysis . 2nd edition. Thousand Oaks, CA: Sage, 2005; Levin, Kate Ann. Study Design IV: Cohort Studies. Evidence-Based Dentistry 7 (2003): 51–52; Payne, Geoff. “Cohort Study.” In The SAGE Dictionary of Social Research Methods . Victor Jupp, editor. (Thousand Oaks, CA: Sage, 2006), pp. 31-33; Study Design 101. Himmelfarb Health Sciences Library. George Washington University, November 2011; Cohort Study. Wikipedia.

Cross-Sectional Design

Cross-sectional research designs have three distinctive features: no time dimension; a reliance on existing differences rather than change following intervention; and, groups are selected based on existing differences rather than random allocation. The cross-sectional design can only measure differences between or from among a variety of people, subjects, or phenomena rather than a process of change. As such, researchers using this design can only employ a relatively passive approach to making causal inferences based on findings.

• Cross-sectional studies provide a clear 'snapshot' of the outcome and the characteristics associated with it, at a specific point in time.
• Unlike an experimental design, where there is an active intervention by the researcher to produce and measure change or to create differences, cross-sectional designs focus on studying and drawing inferences from existing differences between people, subjects, or phenomena.
• Entails collecting data at and concerning one point in time. While longitudinal studies involve taking multiple measures over an extended period of time, cross-sectional research is focused on finding relationships between variables at one moment in time.
• Groups identified for study are purposely selected based upon existing differences in the sample rather than seeking random sampling.
• Cross-section studies are capable of using data from a large number of subjects and, unlike observational studies, is not geographically bound.
• Can estimate prevalence of an outcome of interest because the sample is usually taken from the whole population.
• Because cross-sectional designs generally use survey techniques to gather data, they are relatively inexpensive and take up little time to conduct.
• Finding people, subjects, or phenomena to study that are very similar except in one specific variable can be difficult.
• Results are static and time bound and, therefore, give no indication of a sequence of events or reveal historical or temporal contexts.
• Studies cannot be utilized to establish cause and effect relationships.
• This design only provides a snapshot of analysis so there is always the possibility that a study could have differing results if another time-frame had been chosen.
• There is no follow up to the findings.

Bethlehem, Jelke. "7: Cross-sectional Research." In Research Methodology in the Social, Behavioural and Life Sciences . Herman J Adèr and Gideon J Mellenbergh, editors. (London, England: Sage, 1999), pp. 110-43; Bourque, Linda B. “Cross-Sectional Design.” In  The SAGE Encyclopedia of Social Science Research Methods . Michael S. Lewis-Beck, Alan Bryman, and Tim Futing Liao. (Thousand Oaks, CA: 2004), pp. 230-231; Hall, John. “Cross-Sectional Survey Design.” In Encyclopedia of Survey Research Methods . Paul J. Lavrakas, ed. (Thousand Oaks, CA: Sage, 2008), pp. 173-174; Helen Barratt, Maria Kirwan. Cross-Sectional Studies: Design Application, Strengths and Weaknesses of Cross-Sectional Studies. Healthknowledge, 2009. Cross-Sectional Study. Wikipedia.

Descriptive Design

Descriptive research designs help provide answers to the questions of who, what, when, where, and how associated with a particular research problem; a descriptive study cannot conclusively ascertain answers to why. Descriptive research is used to obtain information concerning the current status of the phenomena and to describe "what exists" with respect to variables or conditions in a situation.

• The subject is being observed in a completely natural and unchanged natural environment. True experiments, whilst giving analyzable data, often adversely influence the normal behavior of the subject [a.k.a., the Heisenberg effect whereby measurements of certain systems cannot be made without affecting the systems].
• Descriptive research is often used as a pre-cursor to more quantitative research designs with the general overview giving some valuable pointers as to what variables are worth testing quantitatively.
• If the limitations are understood, they can be a useful tool in developing a more focused study.
• Descriptive studies can yield rich data that lead to important recommendations in practice.
• Appoach collects a large amount of data for detailed analysis.
• The results from a descriptive research cannot be used to discover a definitive answer or to disprove a hypothesis.
• Because descriptive designs often utilize observational methods [as opposed to quantitative methods], the results cannot be replicated.
• The descriptive function of research is heavily dependent on instrumentation for measurement and observation.

Anastas, Jeane W. Research Design for Social Work and the Human Services . Chapter 5, Flexible Methods: Descriptive Research. 2nd ed. New York: Columbia University Press, 1999; Given, Lisa M. "Descriptive Research." In Encyclopedia of Measurement and Statistics . Neil J. Salkind and Kristin Rasmussen, editors. (Thousand Oaks, CA: Sage, 2007), pp. 251-254; McNabb, Connie. Descriptive Research Methodologies. Powerpoint Presentation; Shuttleworth, Martyn. Descriptive Research Design, September 26, 2008; Erickson, G. Scott. "Descriptive Research Design." In New Methods of Market Research and Analysis . (Northampton, MA: Edward Elgar Publishing, 2017), pp. 51-77; Sahin, Sagufta, and Jayanta Mete. "A Brief Study on Descriptive Research: Its Nature and Application in Social Science." International Journal of Research and Analysis in Humanities 1 (2021): 11; K. Swatzell and P. Jennings. “Descriptive Research: The Nuts and Bolts.” Journal of the American Academy of Physician Assistants 20 (2007), pp. 55-56; Kane, E. Doing Your Own Research: Basic Descriptive Research in the Social Sciences and Humanities . London: Marion Boyars, 1985.

Experimental Design

A blueprint of the procedure that enables the researcher to maintain control over all factors that may affect the result of an experiment. In doing this, the researcher attempts to determine or predict what may occur. Experimental research is often used where there is time priority in a causal relationship (cause precedes effect), there is consistency in a causal relationship (a cause will always lead to the same effect), and the magnitude of the correlation is great. The classic experimental design specifies an experimental group and a control group. The independent variable is administered to the experimental group and not to the control group, and both groups are measured on the same dependent variable. Subsequent experimental designs have used more groups and more measurements over longer periods. True experiments must have control, randomization, and manipulation.

• Experimental research allows the researcher to control the situation. In so doing, it allows researchers to answer the question, “What causes something to occur?”
• Permits the researcher to identify cause and effect relationships between variables and to distinguish placebo effects from treatment effects.
• Experimental research designs support the ability to limit alternative explanations and to infer direct causal relationships in the study.
• Approach provides the highest level of evidence for single studies.
• The design is artificial, and results may not generalize well to the real world.
• The artificial settings of experiments may alter the behaviors or responses of participants.
• Experimental designs can be costly if special equipment or facilities are needed.
• Some research problems cannot be studied using an experiment because of ethical or technical reasons.
• Difficult to apply ethnographic and other qualitative methods to experimentally designed studies.

Anastas, Jeane W. Research Design for Social Work and the Human Services . Chapter 7, Flexible Methods: Experimental Research. 2nd ed. New York: Columbia University Press, 1999; Chapter 2: Research Design, Experimental Designs. School of Psychology, University of New England, 2000; Chow, Siu L. "Experimental Design." In Encyclopedia of Research Design . Neil J. Salkind, editor. (Thousand Oaks, CA: Sage, 2010), pp. 448-453; "Experimental Design." In Social Research Methods . Nicholas Walliman, editor. (London, England: Sage, 2006), pp, 101-110; Experimental Research. Research Methods by Dummies. Department of Psychology. California State University, Fresno, 2006; Kirk, Roger E. Experimental Design: Procedures for the Behavioral Sciences . 4th edition. Thousand Oaks, CA: Sage, 2013; Trochim, William M.K. Experimental Design. Research Methods Knowledge Base. 2006; Rasool, Shafqat. Experimental Research. Slideshare presentation.

Exploratory Design

An exploratory design is conducted about a research problem when there are few or no earlier studies to refer to or rely upon to predict an outcome . The focus is on gaining insights and familiarity for later investigation or undertaken when research problems are in a preliminary stage of investigation. Exploratory designs are often used to establish an understanding of how best to proceed in studying an issue or what methodology would effectively apply to gathering information about the issue.

The goals of exploratory research are intended to produce the following possible insights:

• Familiarity with basic details, settings, and concerns.
• Well grounded picture of the situation being developed.
• Generation of new ideas and assumptions.
• Development of tentative theories or hypotheses.
• Determination about whether a study is feasible in the future.
• Issues get refined for more systematic investigation and formulation of new research questions.
• Direction for future research and techniques get developed.
• Design is a useful approach for gaining background information on a particular topic.
• Exploratory research is flexible and can address research questions of all types (what, why, how).
• Provides an opportunity to define new terms and clarify existing concepts.
• Exploratory research is often used to generate formal hypotheses and develop more precise research problems.
• In the policy arena or applied to practice, exploratory studies help establish research priorities and where resources should be allocated.
• Exploratory research generally utilizes small sample sizes and, thus, findings are typically not generalizable to the population at large.
• The exploratory nature of the research inhibits an ability to make definitive conclusions about the findings. They provide insight but not definitive conclusions.
• The research process underpinning exploratory studies is flexible but often unstructured, leading to only tentative results that have limited value to decision-makers.
• Design lacks rigorous standards applied to methods of data gathering and analysis because one of the areas for exploration could be to determine what method or methodologies could best fit the research problem.

Cuthill, Michael. “Exploratory Research: Citizen Participation, Local Government, and Sustainable Development in Australia.” Sustainable Development 10 (2002): 79-89; Streb, Christoph K. "Exploratory Case Study." In Encyclopedia of Case Study Research . Albert J. Mills, Gabrielle Durepos and Eiden Wiebe, editors. (Thousand Oaks, CA: Sage, 2010), pp. 372-374; Taylor, P. J., G. Catalano, and D.R.F. Walker. “Exploratory Analysis of the World City Network.” Urban Studies 39 (December 2002): 2377-2394; Exploratory Research. Wikipedia.

Field Research Design

Sometimes referred to as ethnography or participant observation, designs around field research encompass a variety of interpretative procedures [e.g., observation and interviews] rooted in qualitative approaches to studying people individually or in groups while inhabiting their natural environment as opposed to using survey instruments or other forms of impersonal methods of data gathering. Information acquired from observational research takes the form of “ field notes ” that involves documenting what the researcher actually sees and hears while in the field. Findings do not consist of conclusive statements derived from numbers and statistics because field research involves analysis of words and observations of behavior. Conclusions, therefore, are developed from an interpretation of findings that reveal overriding themes, concepts, and ideas. More information can be found HERE .

• Field research is often necessary to fill gaps in understanding the research problem applied to local conditions or to specific groups of people that cannot be ascertained from existing data.
• The research helps contextualize already known information about a research problem, thereby facilitating ways to assess the origins, scope, and scale of a problem and to gage the causes, consequences, and means to resolve an issue based on deliberate interaction with people in their natural inhabited spaces.
• Enables the researcher to corroborate or confirm data by gathering additional information that supports or refutes findings reported in prior studies of the topic.
• Because the researcher in embedded in the field, they are better able to make observations or ask questions that reflect the specific cultural context of the setting being investigated.
• Observing the local reality offers the opportunity to gain new perspectives or obtain unique data that challenges existing theoretical propositions or long-standing assumptions found in the literature.

What these studies don't tell you

• A field research study requires extensive time and resources to carry out the multiple steps involved with preparing for the gathering of information, including for example, examining background information about the study site, obtaining permission to access the study site, and building trust and rapport with subjects.
• Requires a commitment to staying engaged in the field to ensure that you can adequately document events and behaviors as they unfold.
• The unpredictable nature of fieldwork means that researchers can never fully control the process of data gathering. They must maintain a flexible approach to studying the setting because events and circumstances can change quickly or unexpectedly.
• Findings can be difficult to interpret and verify without access to documents and other source materials that help to enhance the credibility of information obtained from the field  [i.e., the act of triangulating the data].
• Linking the research problem to the selection of study participants inhabiting their natural environment is critical. However, this specificity limits the ability to generalize findings to different situations or in other contexts or to infer courses of action applied to other settings or groups of people.
• The reporting of findings must take into account how the researcher themselves may have inadvertently affected respondents and their behaviors.

Historical Design

The purpose of a historical research design is to collect, verify, and synthesize evidence from the past to establish facts that defend or refute a hypothesis. It uses secondary sources and a variety of primary documentary evidence, such as, diaries, official records, reports, archives, and non-textual information [maps, pictures, audio and visual recordings]. The limitation is that the sources must be both authentic and valid.

• The historical research design is unobtrusive; the act of research does not affect the results of the study.
• The historical approach is well suited for trend analysis.
• Historical records can add important contextual background required to more fully understand and interpret a research problem.
• There is often no possibility of researcher-subject interaction that could affect the findings.
• Historical sources can be used over and over to study different research problems or to replicate a previous study.
• The ability to fulfill the aims of your research are directly related to the amount and quality of documentation available to understand the research problem.
• Since historical research relies on data from the past, there is no way to manipulate it to control for contemporary contexts.
• Interpreting historical sources can be very time consuming.
• The sources of historical materials must be archived consistently to ensure access. This may especially challenging for digital or online-only sources.
• Original authors bring their own perspectives and biases to the interpretation of past events and these biases are more difficult to ascertain in historical resources.
• Due to the lack of control over external variables, historical research is very weak with regard to the demands of internal validity.
• It is rare that the entirety of historical documentation needed to fully address a research problem is available for interpretation, therefore, gaps need to be acknowledged.

Howell, Martha C. and Walter Prevenier. From Reliable Sources: An Introduction to Historical Methods . Ithaca, NY: Cornell University Press, 2001; Lundy, Karen Saucier. "Historical Research." In The Sage Encyclopedia of Qualitative Research Methods . Lisa M. Given, editor. (Thousand Oaks, CA: Sage, 2008), pp. 396-400; Marius, Richard. and Melvin E. Page. A Short Guide to Writing about History . 9th edition. Boston, MA: Pearson, 2015; Savitt, Ronald. “Historical Research in Marketing.” Journal of Marketing 44 (Autumn, 1980): 52-58;  Gall, Meredith. Educational Research: An Introduction . Chapter 16, Historical Research. 8th ed. Boston, MA: Pearson/Allyn and Bacon, 2007.

Longitudinal Design

A longitudinal study follows the same sample over time and makes repeated observations. For example, with longitudinal surveys, the same group of people is interviewed at regular intervals, enabling researchers to track changes over time and to relate them to variables that might explain why the changes occur. Longitudinal research designs describe patterns of change and help establish the direction and magnitude of causal relationships. Measurements are taken on each variable over two or more distinct time periods. This allows the researcher to measure change in variables over time. It is a type of observational study sometimes referred to as a panel study.

• Longitudinal data facilitate the analysis of the duration of a particular phenomenon.
• Enables survey researchers to get close to the kinds of causal explanations usually attainable only with experiments.
• The design permits the measurement of differences or change in a variable from one period to another [i.e., the description of patterns of change over time].
• Longitudinal studies facilitate the prediction of future outcomes based upon earlier factors.
• The data collection method may change over time.
• Maintaining the integrity of the original sample can be difficult over an extended period of time.
• It can be difficult to show more than one variable at a time.
• This design often needs qualitative research data to explain fluctuations in the results.
• A longitudinal research design assumes present trends will continue unchanged.
• It can take a long period of time to gather results.
• There is a need to have a large sample size and accurate sampling to reach representativness.

Anastas, Jeane W. Research Design for Social Work and the Human Services . Chapter 6, Flexible Methods: Relational and Longitudinal Research. 2nd ed. New York: Columbia University Press, 1999; Forgues, Bernard, and Isabelle Vandangeon-Derumez. "Longitudinal Analyses." In Doing Management Research . Raymond-Alain Thiétart and Samantha Wauchope, editors. (London, England: Sage, 2001), pp. 332-351; Kalaian, Sema A. and Rafa M. Kasim. "Longitudinal Studies." In Encyclopedia of Survey Research Methods . Paul J. Lavrakas, ed. (Thousand Oaks, CA: Sage, 2008), pp. 440-441; Menard, Scott, editor. Longitudinal Research . Thousand Oaks, CA: Sage, 2002; Ployhart, Robert E. and Robert J. Vandenberg. "Longitudinal Research: The Theory, Design, and Analysis of Change.” Journal of Management 36 (January 2010): 94-120; Longitudinal Study. Wikipedia.

Meta-Analysis Design

Meta-analysis is an analytical methodology designed to systematically evaluate and summarize the results from a number of individual studies, thereby, increasing the overall sample size and the ability of the researcher to study effects of interest. The purpose is to not simply summarize existing knowledge, but to develop a new understanding of a research problem using synoptic reasoning. The main objectives of meta-analysis include analyzing differences in the results among studies and increasing the precision by which effects are estimated. A well-designed meta-analysis depends upon strict adherence to the criteria used for selecting studies and the availability of information in each study to properly analyze their findings. Lack of information can severely limit the type of analyzes and conclusions that can be reached. In addition, the more dissimilarity there is in the results among individual studies [heterogeneity], the more difficult it is to justify interpretations that govern a valid synopsis of results. A meta-analysis needs to fulfill the following requirements to ensure the validity of your findings:

• Clearly defined description of objectives, including precise definitions of the variables and outcomes that are being evaluated;
• A well-reasoned and well-documented justification for identification and selection of the studies;
• Assessment and explicit acknowledgment of any researcher bias in the identification and selection of those studies;
• Description and evaluation of the degree of heterogeneity among the sample size of studies reviewed; and,
• Justification of the techniques used to evaluate the studies.
• Can be an effective strategy for determining gaps in the literature.
• Provides a means of reviewing research published about a particular topic over an extended period of time and from a variety of sources.
• Is useful in clarifying what policy or programmatic actions can be justified on the basis of analyzing research results from multiple studies.
• Provides a method for overcoming small sample sizes in individual studies that previously may have had little relationship to each other.
• Can be used to generate new hypotheses or highlight research problems for future studies.
• Small violations in defining the criteria used for content analysis can lead to difficult to interpret and/or meaningless findings.
• A large sample size can yield reliable, but not necessarily valid, results.
• A lack of uniformity regarding, for example, the type of literature reviewed, how methods are applied, and how findings are measured within the sample of studies you are analyzing, can make the process of synthesis difficult to perform.
• Depending on the sample size, the process of reviewing and synthesizing multiple studies can be very time consuming.

Beck, Lewis W. "The Synoptic Method." The Journal of Philosophy 36 (1939): 337-345; Cooper, Harris, Larry V. Hedges, and Jeffrey C. Valentine, eds. The Handbook of Research Synthesis and Meta-Analysis . 2nd edition. New York: Russell Sage Foundation, 2009; Guzzo, Richard A., Susan E. Jackson and Raymond A. Katzell. “Meta-Analysis Analysis.” In Research in Organizational Behavior , Volume 9. (Greenwich, CT: JAI Press, 1987), pp 407-442; Lipsey, Mark W. and David B. Wilson. Practical Meta-Analysis . Thousand Oaks, CA: Sage Publications, 2001; Study Design 101. Meta-Analysis. The Himmelfarb Health Sciences Library, George Washington University; Timulak, Ladislav. “Qualitative Meta-Analysis.” In The SAGE Handbook of Qualitative Data Analysis . Uwe Flick, editor. (Los Angeles, CA: Sage, 2013), pp. 481-495; Walker, Esteban, Adrian V. Hernandez, and Micheal W. Kattan. "Meta-Analysis: It's Strengths and Limitations." Cleveland Clinic Journal of Medicine 75 (June 2008): 431-439.

Mixed-Method Design

• Narrative and non-textual information can add meaning to numeric data, while numeric data can add precision to narrative and non-textual information.
• Can utilize existing data while at the same time generating and testing a grounded theory approach to describe and explain the phenomenon under study.
• A broader, more complex research problem can be investigated because the researcher is not constrained by using only one method.
• The strengths of one method can be used to overcome the inherent weaknesses of another method.
• Can provide stronger, more robust evidence to support a conclusion or set of recommendations.
• May generate new knowledge new insights or uncover hidden insights, patterns, or relationships that a single methodological approach might not reveal.
• Produces more complete knowledge and understanding of the research problem that can be used to increase the generalizability of findings applied to theory or practice.
• A researcher must be proficient in understanding how to apply multiple methods to investigating a research problem as well as be proficient in optimizing how to design a study that coherently melds them together.
• Can increase the likelihood of conflicting results or ambiguous findings that inhibit drawing a valid conclusion or setting forth a recommended course of action [e.g., sample interview responses do not support existing statistical data].
• Because the research design can be very complex, reporting the findings requires a well-organized narrative, clear writing style, and precise word choice.
• Design invites collaboration among experts. However, merging different investigative approaches and writing styles requires more attention to the overall research process than studies conducted using only one methodological paradigm.
• Concurrent merging of quantitative and qualitative research requires greater attention to having adequate sample sizes, using comparable samples, and applying a consistent unit of analysis. For sequential designs where one phase of qualitative research builds on the quantitative phase or vice versa, decisions about what results from the first phase to use in the next phase, the choice of samples and estimating reasonable sample sizes for both phases, and the interpretation of results from both phases can be difficult.
• Due to multiple forms of data being collected and analyzed, this design requires extensive time and resources to carry out the multiple steps involved in data gathering and interpretation.

Burch, Patricia and Carolyn J. Heinrich. Mixed Methods for Policy Research and Program Evaluation . Thousand Oaks, CA: Sage, 2016; Creswell, John w. et al. Best Practices for Mixed Methods Research in the Health Sciences . Bethesda, MD: Office of Behavioral and Social Sciences Research, National Institutes of Health, 2010Creswell, John W. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches . 4th edition. Thousand Oaks, CA: Sage Publications, 2014; Domínguez, Silvia, editor. Mixed Methods Social Networks Research . Cambridge, UK: Cambridge University Press, 2014; Hesse-Biber, Sharlene Nagy. Mixed Methods Research: Merging Theory with Practice . New York: Guilford Press, 2010; Niglas, Katrin. “How the Novice Researcher Can Make Sense of Mixed Methods Designs.” International Journal of Multiple Research Approaches 3 (2009): 34-46; Onwuegbuzie, Anthony J. and Nancy L. Leech. “Linking Research Questions to Mixed Methods Data Analysis Procedures.” The Qualitative Report 11 (September 2006): 474-498; Tashakorri, Abbas and John W. Creswell. “The New Era of Mixed Methods.” Journal of Mixed Methods Research 1 (January 2007): 3-7; Zhanga, Wanqing. “Mixed Methods Application in Health Intervention Research: A Multiple Case Study.” International Journal of Multiple Research Approaches 8 (2014): 24-35 .

Observational Design

This type of research design draws a conclusion by comparing subjects against a control group, in cases where the researcher has no control over the experiment. There are two general types of observational designs. In direct observations, people know that you are watching them. Unobtrusive measures involve any method for studying behavior where individuals do not know they are being observed. An observational study allows a useful insight into a phenomenon and avoids the ethical and practical difficulties of setting up a large and cumbersome research project.

• Observational studies are usually flexible and do not necessarily need to be structured around a hypothesis about what you expect to observe [data is emergent rather than pre-existing].
• The researcher is able to collect in-depth information about a particular behavior.
• Can reveal interrelationships among multifaceted dimensions of group interactions.
• You can generalize your results to real life situations.
• Observational research is useful for discovering what variables may be important before applying other methods like experiments.
• Observation research designs account for the complexity of group behaviors.
• Reliability of data is low because seeing behaviors occur over and over again may be a time consuming task and are difficult to replicate.
• In observational research, findings may only reflect a unique sample population and, thus, cannot be generalized to other groups.
• There can be problems with bias as the researcher may only "see what they want to see."
• There is no possibility to determine "cause and effect" relationships since nothing is manipulated.
• Sources or subjects may not all be equally credible.
• Any group that is knowingly studied is altered to some degree by the presence of the researcher, therefore, potentially skewing any data collected.

Atkinson, Paul and Martyn Hammersley. “Ethnography and Participant Observation.” In Handbook of Qualitative Research . Norman K. Denzin and Yvonna S. Lincoln, eds. (Thousand Oaks, CA: Sage, 1994), pp. 248-261; Observational Research. Research Methods by Dummies. Department of Psychology. California State University, Fresno, 2006; Patton Michael Quinn. Qualitiative Research and Evaluation Methods . Chapter 6, Fieldwork Strategies and Observational Methods. 3rd ed. Thousand Oaks, CA: Sage, 2002; Payne, Geoff and Judy Payne. "Observation." In Key Concepts in Social Research . The SAGE Key Concepts series. (London, England: Sage, 2004), pp. 158-162; Rosenbaum, Paul R. Design of Observational Studies . New York: Springer, 2010;Williams, J. Patrick. "Nonparticipant Observation." In The Sage Encyclopedia of Qualitative Research Methods . Lisa M. Given, editor.(Thousand Oaks, CA: Sage, 2008), pp. 562-563.

Philosophical Design

Understood more as an broad approach to examining a research problem than a methodological design, philosophical analysis and argumentation is intended to challenge deeply embedded, often intractable, assumptions underpinning an area of study. This approach uses the tools of argumentation derived from philosophical traditions, concepts, models, and theories to critically explore and challenge, for example, the relevance of logic and evidence in academic debates, to analyze arguments about fundamental issues, or to discuss the root of existing discourse about a research problem. These overarching tools of analysis can be framed in three ways:

• Ontology -- the study that describes the nature of reality; for example, what is real and what is not, what is fundamental and what is derivative?
• Epistemology -- the study that explores the nature of knowledge; for example, by what means does knowledge and understanding depend upon and how can we be certain of what we know?
• Axiology -- the study of values; for example, what values does an individual or group hold and why? How are values related to interest, desire, will, experience, and means-to-end? And, what is the difference between a matter of fact and a matter of value?
• Can provide a basis for applying ethical decision-making to practice.
• Functions as a means of gaining greater self-understanding and self-knowledge about the purposes of research.
• Brings clarity to general guiding practices and principles of an individual or group.
• Philosophy informs methodology.
• Refine concepts and theories that are invoked in relatively unreflective modes of thought and discourse.
• Beyond methodology, philosophy also informs critical thinking about epistemology and the structure of reality (metaphysics).
• Offers clarity and definition to the practical and theoretical uses of terms, concepts, and ideas.
• Limited application to specific research problems [answering the "So What?" question in social science research].
• Analysis can be abstract, argumentative, and limited in its practical application to real-life issues.
• While a philosophical analysis may render problematic that which was once simple or taken-for-granted, the writing can be dense and subject to unnecessary jargon, overstatement, and/or excessive quotation and documentation.
• There are limitations in the use of metaphor as a vehicle of philosophical analysis.
• There can be analytical difficulties in moving from philosophy to advocacy and between abstract thought and application to the phenomenal world.

Burton, Dawn. "Part I, Philosophy of the Social Sciences." In Research Training for Social Scientists . (London, England: Sage, 2000), pp. 1-5; Chapter 4, Research Methodology and Design. Unisa Institutional Repository (UnisaIR), University of South Africa; Jarvie, Ian C., and Jesús Zamora-Bonilla, editors. The SAGE Handbook of the Philosophy of Social Sciences . London: Sage, 2011; Labaree, Robert V. and Ross Scimeca. “The Philosophical Problem of Truth in Librarianship.” The Library Quarterly 78 (January 2008): 43-70; Maykut, Pamela S. Beginning Qualitative Research: A Philosophic and Practical Guide . Washington, DC: Falmer Press, 1994; McLaughlin, Hugh. "The Philosophy of Social Research." In Understanding Social Work Research . 2nd edition. (London: SAGE Publications Ltd., 2012), pp. 24-47; Stanford Encyclopedia of Philosophy . Metaphysics Research Lab, CSLI, Stanford University, 2013.

Sequential Design

• The researcher has a limitless option when it comes to sample size and the sampling schedule.
• Due to the repetitive nature of this research design, minor changes and adjustments can be done during the initial parts of the study to correct and hone the research method.
• This is a useful design for exploratory studies.
• There is very little effort on the part of the researcher when performing this technique. It is generally not expensive, time consuming, or workforce intensive.
• Because the study is conducted serially, the results of one sample are known before the next sample is taken and analyzed. This provides opportunities for continuous improvement of sampling and methods of analysis.
• The sampling method is not representative of the entire population. The only possibility of approaching representativeness is when the researcher chooses to use a very large sample size significant enough to represent a significant portion of the entire population. In this case, moving on to study a second or more specific sample can be difficult.
• The design cannot be used to create conclusions and interpretations that pertain to an entire population because the sampling technique is not randomized. Generalizability from findings is, therefore, limited.
• Difficult to account for and interpret variation from one sample to another over time, particularly when using qualitative methods of data collection.

Betensky, Rebecca. Harvard University, Course Lecture Note slides; Bovaird, James A. and Kevin A. Kupzyk. "Sequential Design." In Encyclopedia of Research Design . Neil J. Salkind, editor. (Thousand Oaks, CA: Sage, 2010), pp. 1347-1352; Cresswell, John W. Et al. “Advanced Mixed-Methods Research Designs.” In Handbook of Mixed Methods in Social and Behavioral Research . Abbas Tashakkori and Charles Teddle, eds. (Thousand Oaks, CA: Sage, 2003), pp. 209-240; Henry, Gary T. "Sequential Sampling." In The SAGE Encyclopedia of Social Science Research Methods . Michael S. Lewis-Beck, Alan Bryman and Tim Futing Liao, editors. (Thousand Oaks, CA: Sage, 2004), pp. 1027-1028; Nataliya V. Ivankova. “Using Mixed-Methods Sequential Explanatory Design: From Theory to Practice.” Field Methods 18 (February 2006): 3-20; Bovaird, James A. and Kevin A. Kupzyk. “Sequential Design.” In Encyclopedia of Research Design . Neil J. Salkind, ed. Thousand Oaks, CA: Sage, 2010; Sequential Analysis. Wikipedia.

Systematic Review

• A systematic review synthesizes the findings of multiple studies related to each other by incorporating strategies of analysis and interpretation intended to reduce biases and random errors.
• The application of critical exploration, evaluation, and synthesis methods separates insignificant, unsound, or redundant research from the most salient and relevant studies worthy of reflection.
• They can be use to identify, justify, and refine hypotheses, recognize and avoid hidden problems in prior studies, and explain data inconsistencies and conflicts in data.
• Systematic reviews can be used to help policy makers formulate evidence-based guidelines and regulations.
• The use of strict, explicit, and pre-determined methods of synthesis, when applied appropriately, provide reliable estimates about the effects of interventions, evaluations, and effects related to the overarching research problem investigated by each study under review.
• Systematic reviews illuminate where knowledge or thorough understanding of a research problem is lacking and, therefore, can then be used to guide future research.
• The accepted inclusion of unpublished studies [i.e., grey literature] ensures the broadest possible way to analyze and interpret research on a topic.
• Results of the synthesis can be generalized and the findings extrapolated into the general population with more validity than most other types of studies .
• Systematic reviews do not create new knowledge per se; they are a method for synthesizing existing studies about a research problem in order to gain new insights and determine gaps in the literature.
• The way researchers have carried out their investigations [e.g., the period of time covered, number of participants, sources of data analyzed, etc.] can make it difficult to effectively synthesize studies.
• The inclusion of unpublished studies can introduce bias into the review because they may not have undergone a rigorous peer-review process prior to publication. Examples may include conference presentations or proceedings, publications from government agencies, white papers, working papers, and internal documents from organizations, and doctoral dissertations and Master's theses.

Denyer, David and David Tranfield. "Producing a Systematic Review." In The Sage Handbook of Organizational Research Methods .  David A. Buchanan and Alan Bryman, editors. ( Thousand Oaks, CA: Sage Publications, 2009), pp. 671-689; Foster, Margaret J. and Sarah T. Jewell, editors. Assembling the Pieces of a Systematic Review: A Guide for Librarians . Lanham, MD: Rowman and Littlefield, 2017; Gough, David, Sandy Oliver, James Thomas, editors. Introduction to Systematic Reviews . 2nd edition. Los Angeles, CA: Sage Publications, 2017; Gopalakrishnan, S. and P. Ganeshkumar. “Systematic Reviews and Meta-analysis: Understanding the Best Evidence in Primary Healthcare.” Journal of Family Medicine and Primary Care 2 (2013): 9-14; Gough, David, James Thomas, and Sandy Oliver. "Clarifying Differences between Review Designs and Methods." Systematic Reviews 1 (2012): 1-9; Khan, Khalid S., Regina Kunz, Jos Kleijnen, and Gerd Antes. “Five Steps to Conducting a Systematic Review.” Journal of the Royal Society of Medicine 96 (2003): 118-121; Mulrow, C. D. “Systematic Reviews: Rationale for Systematic Reviews.” BMJ 309:597 (September 1994); O'Dwyer, Linda C., and Q. Eileen Wafford. "Addressing Challenges with Systematic Review Teams through Effective Communication: A Case Report." Journal of the Medical Library Association 109 (October 2021): 643-647; Okoli, Chitu, and Kira Schabram. "A Guide to Conducting a Systematic Literature Review of Information Systems Research."  Sprouts: Working Papers on Information Systems 10 (2010); Siddaway, Andy P., Alex M. Wood, and Larry V. Hedges. "How to Do a Systematic Review: A Best Practice Guide for Conducting and Reporting Narrative Reviews, Meta-analyses, and Meta-syntheses." Annual Review of Psychology 70 (2019): 747-770; Torgerson, Carole J. “Publication Bias: The Achilles’ Heel of Systematic Reviews?” British Journal of Educational Studies 54 (March 2006): 89-102; Torgerson, Carole. Systematic Reviews . New York: Continuum, 2003.

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Study designs: Part 1 - An overview and classification

Affiliations.

• 1 Department of Anaesthesiology, Tata Memorial Centre, Mumbai, Maharashtra, India.
• 2 Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
• PMID: 30319950
• PMCID: PMC6176693
• DOI: 10.4103/picr.PICR_124_18

There are several types of research study designs, each with its inherent strengths and flaws. The study design used to answer a particular research question depends on the nature of the question and the availability of resources. In this article, which is the first part of a series on "study designs," we provide an overview of research study designs and their classification. The subsequent articles will focus on individual designs.

Keywords: Epidemiologic methods; research design; research methodology.

Organizing Academic Research Papers: Types of Research Designs

• Purpose of Guide
• Design Flaws to Avoid
• Glossary of Research Terms
• Narrowing a Topic Idea
• Broadening a Topic Idea
• Extending the Timeliness of a Topic Idea
• Academic Writing Style
• Choosing a Title
• Making an Outline
• Paragraph Development
• Executive Summary
• Background Information
• The Research Problem/Question
• Theoretical Framework
• Citation Tracking
• Content Alert Services
• Evaluating Sources
• Primary Sources
• Secondary Sources
• Tertiary Sources
• What Is Scholarly vs. Popular?
• Qualitative Methods
• Quantitative Methods
• Using Non-Textual Elements
• Limitations of the Study
• Common Grammar Mistakes
• Avoiding Plagiarism
• Footnotes or Endnotes?
• Further Readings
• Annotated Bibliography
• Dealing with Nervousness
• Using Visual Aids
• Grading Someone Else's Paper
• How to Manage Group Projects
• Multiple Book Review Essay
• Reviewing Collected Essays
• About Informed Consent
• Writing Field Notes
• Writing a Policy Memo
• Writing a Research Proposal
• Acknowledgements

Introduction

Before beginning your paper, you need to decide how you plan to design the study .

The research design refers to the overall strategy that you choose to integrate the different components of the study in a coherent and logical way, thereby, ensuring you will effectively address the research problem; it constitutes the blueprint for the collection, measurement, and analysis of data. Note that your research problem determines the type of design you can use, not the other way around!

General Structure and Writing Style

Action research design, case study design, causal design, cohort design, cross-sectional design, descriptive design, experimental design, exploratory design, historical design, longitudinal design, observational design, philosophical design, sequential design.

Kirshenblatt-Gimblett, Barbara. Part 1, What Is Research Design? The Context of Design. Performance Studies Methods Course syllabus . New York University, Spring 2006; Trochim, William M.K. Research Methods Knowledge Base . 2006.

The function of a research design is to ensure that the evidence obtained enables you to effectively address the research problem as unambiguously as possible. In social sciences research, obtaining evidence relevant to the research problem generally entails specifying the type of evidence needed to test a theory, to evaluate a program, or to accurately describe a phenomenon. However, researchers can often begin their investigations far too early, before they have thought critically about about what information is required to answer the study's research questions. Without attending to these design issues beforehand, the conclusions drawn risk being weak and unconvincing and, consequently, will fail to adequate address the overall research problem.

 Given this, the length and complexity of research designs can vary considerably, but any sound design will do the following things:

• Identify the research problem clearly and justify its selection,
• Review previously published literature associated with the problem area,
• Clearly and explicitly specify hypotheses [i.e., research questions] central to the problem selected,
• Effectively describe the data which will be necessary for an adequate test of the hypotheses and explain how such data will be obtained, and
• Describe the methods of analysis which will be applied to the data in determining whether or not the hypotheses are true or false.

Kirshenblatt-Gimblett, Barbara. Part 1, What Is Research Design? The Context of Design. Performance Studies Methods Course syllabus . New Yortk University, Spring 2006.

Definition and Purpose

The essentials of action research design follow a characteristic cycle whereby initially an exploratory stance is adopted, where an understanding of a problem is developed and plans are made for some form of interventionary strategy. Then the intervention is carried out (the action in Action Research) during which time, pertinent observations are collected in various forms. The new interventional strategies are carried out, and the cyclic process repeats, continuing until a sufficient understanding of (or implement able solution for) the problem is achieved. The protocol is iterative or cyclical in nature and is intended to foster deeper understanding of a given situation, starting with conceptualizing and particularizing the problem and moving through several interventions and evaluations.

What do these studies tell you?

• A collaborative and adaptive research design that lends itself to use in work or community situations.
• Design focuses on pragmatic and solution-driven research rather than testing theories.
• When practitioners use action research it has the potential to increase the amount they learn consciously from their experience. The action research cycle can also be regarded as a learning cycle.
• Action search studies often have direct and obvious relevance to practice.
• There are no hidden controls or preemption of direction by the researcher.

What these studies don't tell you?

• It is harder to do than conducting conventional studies because the researcher takes on responsibilities for encouraging change as well as for research.
• Action research is much harder to write up because you probably can’t use a standard format to report your findings effectively.
• Personal over-involvement of the researcher may bias research results.
• The cyclic nature of action research to achieve its twin outcomes of action (e.g. change) and research (e.g. understanding) is time-consuming and complex to conduct.

Gall, Meredith. Educational Research: An Introduction . Chapter 18, Action Research. 8th ed. Boston, MA: Pearson/Allyn and Bacon, 2007; Kemmis, Stephen and Robin McTaggart. “Participatory Action Research.” In Handbook of Qualitative Research . Norman Denzin and Yvonna S. Locoln, eds. 2nd ed. (Thousand Oaks, CA: SAGE, 2000), pp. 567-605.; Reason, Peter and Hilary Bradbury. Handbook of Action Research: Participative Inquiry and Practice . Thousand Oaks, CA: SAGE, 2001.

A case study is an in-depth study of a particular research problem rather than a sweeping statistical survey. It is often used to narrow down a very broad field of research into one or a few easily researchable examples. The case study research design is also useful for testing whether a specific theory and model actually applies to phenomena in the real world. It is a useful design when not much is known about a phenomenon.

• Approach excels at bringing us to an understanding of a complex issue through detailed contextual analysis of a limited number of events or conditions and their relationships.
• A researcher using a case study design can apply a vaiety of methodologies and rely on a variety of sources to investigate a research problem.
• Design can extend experience or add strength to what is already known through previous research.
• Social scientists, in particular, make wide use of this research design to examine contemporary real-life situations and provide the basis for the application of concepts and theories and extension of methods.
• The design can provide detailed descriptions of specific and rare cases.
• A single or small number of cases offers little basis for establishing reliability or to generalize the findings to a wider population of people, places, or things.
• The intense exposure to study of the case may bias a researcher's interpretation of the findings.
• Design does not facilitate assessment of cause and effect relationships.
• Vital information may be missing, making the case hard to interpret.
• The case may not be representative or typical of the larger problem being investigated.
• If the criteria for selecting a case is because it represents a very unusual or unique phenomenon or problem for study, then your intepretation of the findings can only apply to that particular case.

Anastas, Jeane W. Research Design for Social Work and the Human Services . Chapter 4, Flexible Methods: Case Study Design. 2nd ed. New York: Columbia University Press, 1999; Stake, Robert E. The Art of Case Study Research . Thousand Oaks, CA: SAGE, 1995; Yin, Robert K. Case Study Research: Design and Theory . Applied Social Research Methods Series, no. 5. 3rd ed. Thousand Oaks, CA: SAGE, 2003.

Causality studies may be thought of as understanding a phenomenon in terms of conditional statements in the form, “If X, then Y.” This type of research is used to measure what impact a specific change will have on existing norms and assumptions. Most social scientists seek causal explanations that reflect tests of hypotheses. Causal effect (nomothetic perspective) occurs when variation in one phenomenon, an independent variable, leads to or results, on average, in variation in another phenomenon, the dependent variable.

Conditions necessary for determining causality:

• Empirical association--a valid conclusion is based on finding an association between the independent variable and the dependent variable.
• Appropriate time order--to conclude that causation was involved, one must see that cases were exposed to variation in the independent variable before variation in the dependent variable.
• Nonspuriousness--a relationship between two variables that is not due to variation in a third variable.
• Causality research designs helps researchers understand why the world works the way it does through the process of proving a causal link between variables and eliminating other possibilities.
• Replication is possible.
• There is greater confidence the study has internal validity due to the systematic subject selection and equity of groups being compared.
• Not all relationships are casual! The possibility always exists that, by sheer coincidence, two unrelated events appear to be related [e.g., Punxatawney Phil could accurately predict the duration of Winter for five consecutive years but, the fact remains, he's just a big, furry rodent].
• Conclusions about causal relationships are difficult to determine due to a variety of extraneous and confounding variables that exist in a social environment. This means causality can only be inferred, never proven.
• If two variables are correlated, the cause must come before the effect. However, even though two variables might be causally related, it can sometimes be difficult to determine which variable comes first and therefore to establish which variable is the actual cause and which is the  actual effect.

Bachman, Ronet. The Practice of Research in Criminology and Criminal Justice . Chapter 5, Causation and Research Designs. 3rd ed.  Thousand Oaks, CA: Pine Forge Press, 2007; Causal Research Design: Experimentation. Anonymous SlideShare Presentation ; Gall, Meredith. Educational Research: An Introduction . Chapter 11, Nonexperimental Research: Correlational Designs. 8th ed. Boston, MA: Pearson/Allyn and Bacon, 2007; Trochim, William M.K. Research Methods Knowledge Base . 2006.

Often used in the medical sciences, but also found in the applied social sciences, a cohort study generally refers to a study conducted over a period of time involving members of a population which the subject or representative member comes from, and who are united by some commonality or similarity. Using a quantitative framework, a cohort study makes note of statistical occurrence within a specialized subgroup, united by same or similar characteristics that are relevant to the research problem being investigated, r ather than studying statistical occurrence within the general population. Using a qualitative framework, cohort studies generally gather data using methods of observation. Cohorts can be either "open" or "closed."

• Open Cohort Studies [dynamic populations, such as the population of Los Angeles] involve a population that is defined just by the state of being a part of the study in question (and being monitored for the outcome). Date of entry and exit from the study is individually defined, therefore, the size of the study population is not constant. In open cohort studies, researchers can only calculate rate based data, such as, incidence rates and variants thereof.
• Closed Cohort Studies [static populations, such as patients entered into a clinical trial] involve participants who enter into the study at one defining point in time and where it is presumed that no new participants can enter the cohort. Given this, the number of study participants remains constant (or can only decrease).
• The use of cohorts is often mandatory because a randomized control study may be unethical. For example, you cannot deliberately expose people to asbestos, you can only study its effects on those who have already been exposed. Research that measures risk factors  often relies on cohort designs.
• Because cohort studies measure potential causes before the outcome has occurred, they can demonstrate that these “causes” preceded the outcome, thereby avoiding the debate as to which is the cause and which is the effect.
• Cohort analysis is highly flexible and can provide insight into effects over time and related to a variety of different types of changes [e.g., social, cultural, political, economic, etc.].
• Either original data or secondary data can be used in this design.
• In cases where a comparative analysis of two cohorts is made [e.g., studying the effects of one group exposed to asbestos and one that has not], a researcher cannot control for all other factors that might differ between the two groups. These factors are known as confounding variables.
• Cohort studies can end up taking a long time to complete if the researcher must wait for the conditions of interest to develop within the group. This also increases the chance that key variables change during the course of the study, potentially impacting the validity of the findings.
• Because of the lack of randominization in the cohort design, its external validity is lower than that of study designs where the researcher randomly assigns participants.

Healy P, Devane D. “Methodological Considerations in Cohort Study Designs.” Nurse Researcher 18 (2011): 32-36;  Levin, Kate Ann. Study Design IV: Cohort Studies. Evidence-Based Dentistry 7 (2003): 51–52; Study Design 101 . Himmelfarb Health Sciences Library. George Washington University, November 2011; Cohort Study . Wikipedia.

Cross-sectional research designs have three distinctive features: no time dimension, a reliance on existing differences rather than change following intervention; and, groups are selected based on existing differences rather than random allocation. The cross-sectional design can only measure diffrerences between or from among a variety of people, subjects, or phenomena rather than change. As such, researchers using this design can only employ a relative passive approach to making causal inferences based on findings.

• Cross-sectional studies provide a 'snapshot' of the outcome and the characteristics associated with it, at a specific point in time.
• Unlike the experimental design where there is an active intervention by the researcher to produce and measure change or to create differences, cross-sectional designs focus on studying and drawing inferences from existing differences between people, subjects, or phenomena.
• Entails collecting data at and concerning one point in time. While longitudinal studies involve taking multiple measures over an extended period of time, cross-sectional research is focused on finding relationships between variables at one moment in time.
• Groups identified for study are purposely selected based upon existing differences in the sample rather than seeking random sampling.
• Cross-section studies are capable of using data from a large number of subjects and, unlike observational studies, is not geographically bound.
• Can estimate prevalence of an outcome of interest because the sample is usually taken from the whole population.
• Because cross-sectional designs generally use survey techniques to gather data, they are relatively inexpensive and take up little time to conduct.
• Finding people, subjects, or phenomena to study that are very similar except in one specific variable can be difficult.
• Results are static and time bound and, therefore, give no indication of a sequence of events or reveal historical contexts.
• Studies cannot be utilized to establish cause and effect relationships.
• Provide only a snapshot of analysis so there is always the possibility that a study could have differing results if another time-frame had been chosen.
• There is no follow up to the findings.

Hall, John. “Cross-Sectional Survey Design.” In Encyclopedia of Survey Research Methods. Paul J. Lavrakas, ed. (Thousand Oaks, CA: Sage, 2008), pp. 173-174; Helen Barratt, Maria Kirwan. Cross-Sectional Studies: Design, Application, Strengths and Weaknesses of Cross-Sectional Studies . Healthknowledge, 2009. Cross-Sectional Study . Wikipedia.

Descriptive research designs help provide answers to the questions of who, what, when, where, and how associated with a particular research problem; a descriptive study cannot conclusively ascertain answers to why. Descriptive research is used to obtain information concerning the current status of the phenomena and to describe "what exists" with respect to variables or conditions in a situation.

• The subject is being observed in a completely natural and unchanged natural environment. True experiments, whilst giving analyzable data, often adversely influence the normal behavior of the subject.
• Descriptive research is often used as a pre-cursor to more quantitatively research designs, the general overview giving some valuable pointers as to what variables are worth testing quantitatively.
• If the limitations are understood, they can be a useful tool in developing a more focused study.
• Descriptive studies can yield rich data that lead to important recommendations.
• Appoach collects a large amount of data for detailed analysis.
• The results from a descriptive research can not be used to discover a definitive answer or to disprove a hypothesis.
• Because descriptive designs often utilize observational methods [as opposed to quantitative methods], the results cannot be replicated.
• The descriptive function of research is heavily dependent on instrumentation for measurement and observation.

Anastas, Jeane W. Research Design for Social Work and the Human Services . Chapter 5, Flexible Methods: Descriptive Research. 2nd ed. New York: Columbia University Press, 1999;  McNabb, Connie. Descriptive Research Methodologies . Powerpoint Presentation; Shuttleworth, Martyn. Descriptive Research Design , September 26, 2008. Explorable.com website.

A blueprint of the procedure that enables the researcher to maintain control over all factors that may affect the result of an experiment. In doing this, the researcher attempts to determine or predict what may occur. Experimental Research is often used where there is time priority in a causal relationship (cause precedes effect), there is consistency in a causal relationship (a cause will always lead to the same effect), and the magnitude of the correlation is great. The classic experimental design specifies an experimental group and a control group. The independent variable is administered to the experimental group and not to the control group, and both groups are measured on the same dependent variable. Subsequent experimental designs have used more groups and more measurements over longer periods. True experiments must have control, randomization, and manipulation.

• Experimental research allows the researcher to control the situation. In so doing, it allows researchers to answer the question, “what causes something to occur?”
• Permits the researcher to identify cause and effect relationships between variables and to distinguish placebo effects from treatment effects.
• Experimental research designs support the ability to limit alternative explanations and to infer direct causal relationships in the study.
• Approach provides the highest level of evidence for single studies.
• The design is artificial, and results may not generalize well to the real world.
• The artificial settings of experiments may alter subject behaviors or responses.
• Experimental designs can be costly if special equipment or facilities are needed.
• Some research problems cannot be studied using an experiment because of ethical or technical reasons.
• Difficult to apply ethnographic and other qualitative methods to  experimental designed research studies.

Anastas, Jeane W. Research Design for Social Work and the Human Services . Chapter 7, Flexible Methods: Experimental Research. 2nd ed. New York: Columbia University Press, 1999; Chapter 2: Research Design, Experimental Designs . School of Psychology, University of New England, 2000; Experimental Research. Research Methods by Dummies. Department of Psychology. California State University, Fresno, 2006; Trochim, William M.K. Experimental Design . Research Methods Knowledge Base. 2006; Rasool, Shafqat. Experimental Research . Slideshare presentation.

An exploratory design is conducted about a research problem when there are few or no earlier studies to refer to. The focus is on gaining insights and familiarity for later investigation or undertaken when problems are in a preliminary stage of investigation.

The goals of exploratory research are intended to produce the following possible insights:

• Familiarity with basic details, settings and concerns.
• Well grounded picture of the situation being developed.
• Generation of new ideas and assumption, development of tentative theories or hypotheses.
• Determination about whether a study is feasible in the future.
• Issues get refined for more systematic investigation and formulation of new research questions.
• Direction for future research and techniques get developed.
• Design is a useful approach for gaining background information on a particular topic.
• Exploratory research is flexible and can address research questions of all types (what, why, how).
• Provides an opportunity to define new terms and clarify existing concepts.
• Exploratory research is often used to generate formal hypotheses and develop more precise research problems.
• Exploratory studies help establish research priorities.
• Exploratory research generally utilizes small sample sizes and, thus, findings are typically not generalizable to the population at large.
• The exploratory nature of the research inhibits an ability to make definitive conclusions about the findings.
• The research process underpinning exploratory studies is flexible but often unstructured, leading to only tentative results that have limited value in decision-making.
• Design lacks rigorous standards applied to methods of data gathering and analysis because one of the areas for exploration could be to determine what method or methodologies could best fit the research problem.

Cuthill, Michael. “Exploratory Research: Citizen Participation, Local Government, and Sustainable Development in Australia.” Sustainable Development 10 (2002): 79-89; Taylor, P. J., G. Catalano, and D.R.F. Walker. “Exploratory Analysis of the World City Network.” Urban Studies 39 (December 2002): 2377-2394; Exploratory Research . Wikipedia.

The purpose of a historical research design is to collect, verify, and synthesize evidence from the past to establish facts that defend or refute your hypothesis. It uses secondary sources and a variety of primary documentary evidence, such as, logs, diaries, official records, reports, archives, and non-textual information [maps, pictures, audio and visual recordings]. The limitation is that the sources must be both authentic and valid.

• The historical research design is unobtrusive; the act of research does not affect the results of the study.
• The historical approach is well suited for trend analysis.
• Historical records can add important contextual background required to more fully understand and interpret a research problem.
• There is no possibility of researcher-subject interaction that could affect the findings.
• Historical sources can be used over and over to study different research problems or to replicate a previous study.
• The ability to fulfill the aims of your research are directly related to the amount and quality of documentation available to understand the research problem.
• Since historical research relies on data from the past, there is no way to manipulate it to control for contemporary contexts.
• Interpreting historical sources can be very time consuming.
• The sources of historical materials must be archived consistentally to ensure access.
• Original authors bring their own perspectives and biases to the interpretation of past events and these biases are more difficult to ascertain in historical resources.
• Due to the lack of control over external variables, historical research is very weak with regard to the demands of internal validity.
• It rare that the entirety of historical documentation needed to fully address a research problem is available for interpretation, therefore, gaps need to be acknowledged.

Savitt, Ronald. “Historical Research in Marketing.” Journal of Marketing 44 (Autumn, 1980): 52-58;  Gall, Meredith. Educational Research: An Introduction . Chapter 16, Historical Research. 8th ed. Boston, MA: Pearson/Allyn and Bacon, 2007.

A longitudinal study follows the same sample over time and makes repeated observations. With longitudinal surveys, for example, the same group of people is interviewed at regular intervals, enabling researchers to track changes over time and to relate them to variables that might explain why the changes occur. Longitudinal research designs describe patterns of change and help establish the direction and magnitude of causal relationships. Measurements are taken on each variable over two or more distinct time periods. This allows the researcher to measure change in variables over time. It is a type of observational study and is sometimes referred to as a panel study.

• Longitudinal data allow the analysis of duration of a particular phenomenon.
• Enables survey researchers to get close to the kinds of causal explanations usually attainable only with experiments.
• The design permits the measurement of differences or change in a variable from one period to another [i.e., the description of patterns of change over time].
• Longitudinal studies facilitate the prediction of future outcomes based upon earlier factors.
• The data collection method may change over time.
• Maintaining the integrity of the original sample can be difficult over an extended period of time.
• It can be difficult to show more than one variable at a time.
• This design often needs qualitative research to explain fluctuations in the data.
• A longitudinal research design assumes present trends will continue unchanged.
• It can take a long period of time to gather results.
• There is a need to have a large sample size and accurate sampling to reach representativness.

Anastas, Jeane W. Research Design for Social Work and the Human Services . Chapter 6, Flexible Methods: Relational and Longitudinal Research. 2nd ed. New York: Columbia University Press, 1999; Kalaian, Sema A. and Rafa M. Kasim. "Longitudinal Studies." In Encyclopedia of Survey Research Methods . Paul J. Lavrakas, ed. (Thousand Oaks, CA: Sage, 2008), pp. 440-441; Ployhart, Robert E. and Robert J. Vandenberg. "Longitudinal Research: The Theory, Design, and Analysis of Change.” Journal of Management 36 (January 2010): 94-120; Longitudinal Study . Wikipedia.

This type of research design draws a conclusion by comparing subjects against a control group, in cases where the researcher has no control over the experiment. There are two general types of observational designs. In direct observations, people know that you are watching them. Unobtrusive measures involve any method for studying behavior where individuals do not know they are being observed. An observational study allows a useful insight into a phenomenon and avoids the ethical and practical difficulties of setting up a large and cumbersome research project.

• Observational studies are usually flexible and do not necessarily need to be structured around a hypothesis about what you expect to observe (data is emergent rather than pre-existing).
• The researcher is able to collect a depth of information about a particular behavior.
• Can reveal interrelationships among multifaceted dimensions of group interactions.
• You can generalize your results to real life situations.
• Observational research is useful for discovering what variables may be important before applying other methods like experiments.
• Observation researchd esigns account for the complexity of group behaviors.
• Reliability of data is low because seeing behaviors occur over and over again may be a time consuming task and difficult to replicate.
• In observational research, findings may only reflect a unique sample population and, thus, cannot be generalized to other groups.
• There can be problems with bias as the researcher may only "see what they want to see."
• There is no possiblility to determine "cause and effect" relationships since nothing is manipulated.
• Sources or subjects may not all be equally credible.
• Any group that is studied is altered to some degree by the very presence of the researcher, therefore, skewing to some degree any data collected (the Heisenburg Uncertainty Principle).

Atkinson, Paul and Martyn Hammersley. “Ethnography and Participant Observation.” In Handbook of Qualitative Research . Norman K. Denzin and Yvonna S. Lincoln, eds. (Thousand Oaks, CA: Sage, 1994), pp. 248-261; Observational Research. Research Methods by Dummies. Department of Psychology. California State University, Fresno, 2006; Patton Michael Quinn. Qualitiative Research and Evaluation Methods . Chapter 6, Fieldwork Strategies and Observational Methods. 3rd ed. Thousand Oaks, CA: Sage, 2002; Rosenbaum, Paul R. Design of Observational Studies . New York: Springer, 2010.

Understood more as an broad approach to examining a research problem than a methodological design, philosophical analysis and argumentation is intended to challenge deeply embedded, often intractable, assumptions underpinning an area of study. This approach uses the tools of argumentation derived from philosophical traditions, concepts, models, and theories to critically explore and challenge, for example, the relevance of logic and evidence in academic debates, to analyze arguments about fundamental issues, or to discuss the root of existing discourse about a research problem. These overarching tools of analysis can be framed in three ways:

• Ontology -- the study that describes the nature of reality; for example, what is real and what is not, what is fundamental and what is derivative?
• Epistemology -- the study that explores the nature of knowledge; for example, on what does knowledge and understanding depend upon and how can we be certain of what we know?
• Axiology -- the study of values; for example, what values does an individual or group hold and why? How are values related to interest, desire, will, experience, and means-to-end? And, what is the difference between a matter of fact and a matter of value?
• Can provide a basis for applying ethical decision-making to practice.
• Functions as a means of gaining greater self-understanding and self-knowledge about the purposes of research.
• Brings clarity to general guiding practices and principles of an individual or group.
• Philosophy informs methodology.
• Refine concepts and theories that are invoked in relatively unreflective modes of thought and discourse.
• Beyond methodology, philosophy also informs critical thinking about epistemology and the structure of reality (metaphysics).
• Offers clarity and definition to the practical and theoretical uses of terms, concepts, and ideas.
• Limited application to specific research problems [answering the "So What?" question in social science research].
• Analysis can be abstract, argumentative, and limited in its practical application to real-life issues.
• While a philosophical analysis may render problematic that which was once simple or taken-for-granted, the writing can be dense and subject to unnecessary jargon, overstatement, and/or excessive quotation and documentation.
• There are limitations in the use of metaphor as a vehicle of philosophical analysis.
• There can be analytical difficulties in moving from philosophy to advocacy and between abstract thought and application to the phenomenal world.

Chapter 4, Research Methodology and Design . Unisa Institutional Repository (UnisaIR), University of South Africa;  Labaree, Robert V. and Ross Scimeca. “The Philosophical Problem of Truth in Librarianship.” The Library Quarterly 78 (January 2008): 43-70; Maykut, Pamela S. Beginning Qualitative Research: A Philosophic and Practical Guide . Washington, D.C.: Falmer Press, 1994; Stanford Encyclopedia of Philosophy . Metaphysics Research Lab, CSLI, Stanford University, 2013.

• The researcher has a limitless option when it comes to sample size and the sampling schedule.
• Due to the repetitive nature of this research design, minor changes and adjustments can be done during the initial parts of the study to correct and hone the research method. Useful design for exploratory studies.
• There is very little effort on the part of the researcher when performing this technique. It is generally not expensive, time consuming, or workforce extensive.
• Because the study is conducted serially, the results of one sample are known before the next sample is taken and analyzed.
• The sampling method is not representative of the entire population. The only possibility of approaching representativeness is when the researcher chooses to use a very large sample size significant enough to represent a significant portion of the entire population. In this case, moving on to study a second or more sample can be difficult.
• Because the sampling technique is not randomized, the design cannot be used to create conclusions and interpretations that pertain to an entire population. Generalizability from findings is limited.
• Difficult to account for and interpret variation from one sample to another over time, particularly when using qualitative methods of data collection.

Rebecca Betensky, Harvard University, Course Lecture Note slides ; Cresswell, John W. Et al. “Advanced Mixed-Methods Research Designs.” In Handbook of Mixed Methods in Social and Behavioral Research . Abbas Tashakkori and Charles Teddle, eds. (Thousand Oaks, CA: Sage, 2003), pp. 209-240; Nataliya V. Ivankova. “Using Mixed-Methods Sequential Explanatory Design: From Theory to Practice.” Field Methods 18 (February 2006): 3-20; Bovaird, James A. and Kevin A. Kupzyk. “Sequential Design.” In Encyclopedia of Research Design . Neil J. Salkind, ed. Thousand Oaks, CA: Sage, 2010; Sequential Analysis . Wikipedia.  

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Course details

• Mon 25 Nov 2024 to 29 Nov 2024
• Mon 03 Mar 2025 to 07 Mar 2025
• Mon 19 May 2025 to 23 May 2025

Introduction to Study Design and Research Methods

Choosing and designing the most appropriate study to address your clinical research problem is paramount in generating the best evidence.

This module will introduce some of the more advanced concepts and skills of research design, emphasising how they relate to evidence-based health care. Choosing and designing the most appropriate study to address a clinical question is paramount in generating the best evidence. As students learn to identify the strengths and weaknesses of 6 key study designs, they will also learn how to design a research protocol. Participants will design data collection and analysis, to include appropriate statistical tests. They will also learn strategies to manage bias and assess the quality of published research.

Students will apply their learning in small groups to develop a protocol for an allocated research question, for which they will receive constructive and academic feedback.

The last date for receipt of complete applications is 5pm Friday 10th November 2023. Regrettably, late applications cannot be accepted.

This course will enable students to:

• Describe in detail different types of research methodologies;
• Identify the strengths and weaknesses of the different study designs;
• Assess whether research studies are using the most appropriate study design;
• Discuss why various approaches may be appropriate/ inappropriate for their work-based research question.

Statistical Analysis

• Describe methodologies that are used to investigate the effects of health care interventions;
• Have a basic understanding of the approaches to statistical analysis that can be used with these methodologies;
• Develop an understanding of the types of approaches that can be used for statistical analysis in each type of study design.

Protocol Development

• Identify various facets that form a successful research protocol, for different types of health research;
• List some of the challenges of preparing a research protocol, and develop strategies for addressing them.

Core Reading

• Epidemiological Studies: A Practical Guide - by Alan J. Silman and Gary J. Macfarlane

Comments from previous participants:

"This is a good course for bringing together a wide range of practical and theoretical expertise for dealing with research related topics."

Programme details

This module is run over an eight week cycle where the first week is spent working on introductory activities using a Virtual Learning Environment, the second week is spent in Oxford for the face to face teaching week (this takes place on the dates advertised), there are then four Post-Oxford activities (delivered through the VLE) which are designed to help you write your assignment. You then have a week of personal study and you will be required to submit your assignment electronically the following week (usually on a Tuesday at 14:00 UK Local Time).

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If you are an employee of the University of Oxford and have a valid University staff card you may be eligible to receive a 10% discount on the full stand-alone fee. To take advantage of this offer please submit a scan/photocopy of your staff card along with your application. Your card should be valid for a further six months after attending the course.

Prof Clare Bankhead

Module coordinator.

Clare Bankhead is a Professor at the Nuffield Department for Primary Care Health Sciences, University of Oxford.

Dr Susannah Fleming

Co module coordinator.

Susannah Fleming is a Senior Quantatitive Researcher at the Nuffield Department for Primary Care Health Sciences, University of Oxford

Dr Subhashisa Swain

Subhashisa Swain  is a Quantitative Researcher.

Assessment methods

Assessment will be based on submission of a written assignment which should not exceed 4,000 words.

Academic Credit

Applicants may take this course for academic credit. The University of Oxford Department for Continuing Education offers Credit Accumulation and Transfer Scheme (CATS) points for this course. Participants attending at least 80% of the taught course and successfully completing assessed assignments are eligible to earn credit equivalent to 20 CATS points which may be counted towards a postgraduate qualification.

Applicants can choose not to take the course for academic credit and will therefore not be eligible to undertake the academic assignment offered to students taking the course for credit. Applicants cannot receive CATS (Credit Accumulation and Transfer Scheme) points or equivalence. Credit cannot be attributed retrospectively. CATS accreditation is required if you wish for the course to count towards a further qualification in the future.

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Admissions Criteria: To apply for the course you should:

• Be a graduate or have successfully completed a professional training course
• Have professional work experience in the health service or a health-related field
• Be able to combine intensive classroom learning with the application of the principles and practices of evidence-based health care within the work place
• Have a good working knowledge of email, internet, word processing and Windows applications (for communications with course members, course team and administration)
• Show evidence of the ability to commit time to study and an employer's commitment to make time available to study, complete course work and attend course and university events and modules.
• Be able to demonstrate English Language proficiency at the University’s higher level . 

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• MSc in Evidence-Based Health Care
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• Volume 3, Issue 1
• Regular use of fish oil supplements and course of cardiovascular diseases: prospective cohort study
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• Ge Chen 1 ,
• Zhengmin (Min) Qian 2 ,
• Junguo Zhang 1 ,
• Shiyu Zhang 1 ,
• http://orcid.org/0000-0002-7003-6565 Zilong Zhang 1 ,
• Michael G Vaughn 3 ,
• Hannah E Aaron 2 ,
• Chuangshi Wang 4 ,
• Gregory YH Lip 5 , 6 and
• http://orcid.org/0000-0002-3643-9408 Hualiang Lin 1
• 1 Department of Epidemiology , Sun Yat-Sen University , Guangzhou , China
• 2 Department of Epidemiology and Biostatistics, College for Public Health and Social Justice , Saint Louis University , Saint Louis , Missouri , USA
• 3 School of Social Work, College for Public Health and Social Justice , Saint Louis University , Saint Louis , Missouri , USA
• 4 Medical Research and Biometrics Centre , Fuwai Hospital, National Centre for Cardiovascular Diseases, Peking Union Medical College , Beijing , China
• 5 Liverpool Centre for Cardiovascular Science , University of Liverpool and Liverpool Heart and Chest Hospital , Liverpool , UK
• 6 Department of Clinical Medicine , Aalborg University , Aalborg , Denmark
• Correspondence to Dr Hualiang Lin, Department of Epidemiology, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China; linhualiang{at}mail.sysu.edu.cn

Objective To examine the effects of fish oil supplements on the clinical course of cardiovascular disease, from a healthy state to atrial fibrillation, major adverse cardiovascular events, and subsequently death.

Design Prospective cohort study.

Setting UK Biobank study, 1 January 2006 to 31 December 2010, with follow-up to 31 March 2021 (median follow-up 11.9 years).

Participants 415 737 participants, aged 40-69 years, enrolled in the UK Biobank study.

Main outcome measures Incident cases of atrial fibrillation, major adverse cardiovascular events, and death, identified by linkage to hospital inpatient records and death registries. Role of fish oil supplements in different progressive stages of cardiovascular diseases, from healthy status (primary stage), to atrial fibrillation (secondary stage), major adverse cardiovascular events (tertiary stage), and death (end stage).

Results Among 415 737 participants free of cardiovascular diseases, 18 367 patients with incident atrial fibrillation, 22 636 with major adverse cardiovascular events, and 22 140 deaths during follow-up were identified. Regular use of fish oil supplements had different roles in the transitions from healthy status to atrial fibrillation, to major adverse cardiovascular events, and then to death. For people without cardiovascular disease, hazard ratios were 1.13 (95% confidence interval 1.10 to 1.17) for the transition from healthy status to atrial fibrillation and 1.05 (1.00 to 1.11) from healthy status to stroke. For participants with a diagnosis of a known cardiovascular disease, regular use of fish oil supplements was beneficial for transitions from atrial fibrillation to major adverse cardiovascular events (hazard ratio 0.92, 0.87 to 0.98), atrial fibrillation to myocardial infarction (0.85, 0.76 to 0.96), and heart failure to death (0.91, 0.84 to 0.99).

Conclusions Regular use of fish oil supplements might be a risk factor for atrial fibrillation and stroke among the general population but could be beneficial for progression of cardiovascular disease from atrial fibrillation to major adverse cardiovascular events, and from atrial fibrillation to death. Further studies are needed to determine the precise mechanisms for the development and prognosis of cardiovascular disease events with regular use of fish oil supplements.

• Health policy
• Nutritional sciences
• Public health

Data availability statement

Data are available upon reasonable request. UK Biobank is an open access resource. Bona fide researchers can apply to use the UK Biobank dataset by registering and applying at http://ukbiobank.ac.uk/register-apply/ .

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:  https://creativecommons.org/licenses/by/4.0/ .

https://doi.org/10.1136/bmjmed-2022-000451

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WHAT IS ALREADY KNOWN ON THIS TOPIC

Findings of the effects of omega 3 fatty acids or fish oil on the risk of cardiovascular disease are controversial

Most previous studies focused on one health outcome and did not characterise specific cardiovascular disease outcomes (eg, atrial fibrillation, myocardial infarction, stroke, heart failure, and major adverse cardiovascular events)

Whether fish oil could differentially affect the dynamic course of cardiovascular diseases, from atrial fibrillation to major adverse cardiovascular events, to other specific cardiovascular disease outcomes, or even to death, is unclear

WHAT THIS STUDY ADDS

In people with no known cardiovascular disease, regular use of fish oil supplements was associated with an increased relative risk of atrial fibrillation and stroke

In people with known cardiovascular disease, the beneficial effects of fish oil supplements were seen on transitions from atrial fibrillation to major adverse cardiovascular events, atrial fibrillation to myocardial infarction, and heart failure to death

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE, OR POLICY

Regular use of fish oil supplements might have different roles in the progression of cardiovascular disease

Further studies are needed to determine the precise mechanisms for the development and prognosis of cardiovascular disease events with regular use of fish oil supplements

Introduction

Cardiovascular disease is the leading cause of death worldwide, accounting for about one sixth of overall mortality in the UK. 1 2 Fish oil, a rich source of omega 3 fatty acids, containing eicosapentaenoic acid and docosahexaenoic acid, has been recommended as a dietary measure to prevent cardiovascular disease. 3 The UK National Institute for Health and Care Excellence recommends that people with or at high risk of cardiovascular disease consume at least one portion of oily fish a week, and the use of fish oil supplements has become popular in the UK and other western countries in recent years. 4 5

Although some epidemiological and clinical studies have assessed the effect of omega 3 fatty acids or fish oil on cardiovascular disease and its risk factors, the findings are controversial. The Agency for Healthcare Research and Quality systematically reviewed 37 observational studies and 61 randomised controlled trials, and found evidence indicating the beneficial effects of higher consumption of fish oil supplements on ischaemic stroke, whereas no beneficial effect was found for atrial fibrillation, major adverse cardiovascular events, myocardial infarction, total stroke, or all cause death. 6 In contrast, the Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial (REDUCE-IT) reported a decreased risk of major adverse cardiovascular events with icosapent ethyl in patients with raised levels of triglycerides, regardless of the use of statins. 7 Most of these findings, however, tended to assess the role of fish oil at a certain stage of cardiovascular disease. For example, some studies restricted the study population to people with a specific cardiovascular disease or at a high risk of cardiovascular disease, 8 9 whereas others evaluated databases of generally healthy populations. 10 All of these factors might preclude direct comparison of the effects of omega 3 fatty acids on atrial fibrillation events or on further deterioration of cardiovascular disease. Few studies have fully characterised specific cardiovascular disease outcomes or accounted for differential effects based on the complex disease characteristics of participants. Hence, in this study, we hypothesised that fish oil supplements might have harmful, beneficial, or no effect on different cardiovascular disease events in patients with varying health conditions.

Most previous studies on the association between fish oil and cardiovascular diseases generally focused on one health outcome. Also, no study highlighted the dynamic progressive course of cardiovascular diseases, from healthy status (primary stage), to atrial fibrillation (secondary stage), major adverse cardiovascular events (tertiary stage), and death (end stage). Clarifying this complex pathway in relation to the detailed progression of cardiovascular diseases would provide substantial insights into the prevention or treatment of future disease at critical stages. Whether fish oil could differentially affect the dynamic course of cardiovascular disease (ie, from atrial fibrillation to major adverse cardiovascular events, to other specific cardiovascular disease outcomes, or even to death) is unclear.

To deal with this evidence gap, we conducted a longitudinal cohort study to estimate the associations between fish oil supplements and specific clinical cardiovascular disease outcomes, including atrial fibrillation, major adverse cardiovascular events, and all cause death in people with no known cardiovascular disease or at high risk of cardiovascular disease for the purpose of primary prevention. We also assessed the modifying effects of fish oil supplements on the disease process, from atrial fibrillation to other outcomes, in people with known cardiovascular disease for the purpose of secondary prevention.

The UK Biobank is a community based cohort study with more than half a million UK inhabitants aged 40-69 years at recruitment. 11–13 Participants were invited to participate in this study if they were registered with the NHS and lived within 35 km of one of 22 Biobank assessment centres. Between 1 March 2006 and 31 July 2010, a baseline survey was conducted, based on a touch screen questionnaire and face-to-face interviews, to collect detailed personal, socioeconomic, and lifestyle characteristics, and information on diseases. 11–13

We excluded patients who had a diagnosis of atrial fibrillation (n=8326), heart failure (n=2748), myocardial infarction (n=11 949), stroke (n=7943), or cancer (n=48 624) at baseline; who withdrew from the study during follow-up (n=1299); or who had incomplete or outlier data for the main information (n=11 748). Because we focused only on a specific sequence of progression of cardiovascular disease (ie, from healthy status to atrial fibrillation, to major adverse cardiovascular events, and then to death), we excluded 1983 participants with other transition patterns. The remaining 415 737 participants were included in this analysis ( figure 1 ).

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Flowchart of selection of participants in study. The count of diagnosed diseases does not equate to the total number of individuals, because each person could have multiple diagnoses

Determining use of fish oil supplements

Information on regular use of fish oil supplements was collected from a self-reported touchscreen questionnaire during the baseline survey. 14 15 Each participant was asked whether they regularly used any fish oil supplement. Trained staff conducted a verbal interview with participants, asking if they were currently receiving treatments or taking any medicines, including omega 3 or fish oil supplements. Based on this information, we classified participants as regular users of fish oil supplements and non-users.

Follow-up and outcomes

Participants were followed up from the time of recruitment to death, loss to follow-up, or the end date of follow-up (31 March 2021), whichever came first. Incident cases of interest, including atrial fibrillation, heart failure, stroke, and myocardial infarction, were identified by linkage to death registries, primary care records, and hospital inpatient records. 11 Information on deaths was obtained from death registries of the NHS Information Centre, for participants in England and Wales, and from the NHS Central Register Scotland, for participants in Scotland. 11 Outcomes were defined by a three character ICD-10 (international classification of diseases, 10th revision) code. In this study, atrial fibrillation was defined by ICD-10 code I48, and major adverse cardiovascular events was determined by a combination of heart failure (I50, I11.0, I13.0, and I13.2), stroke (I60-I64), and myocardial infarction (I21, I22, I23, I24.1, and I25.2) codes.

We collected baseline data on age (<65 years and ≥65 years), sex (men and women), ethnic group (white and non-white), Townsend deprivation index (with a higher score indicating higher levels of deprivation), smoking status (never, previous, and current smokers), and alcohol consumption (never, previous, and current drinkers). Data for sex were taken from information in UK Biobank rather than from patient reported gender. Baseline dietary data were obtained from a dietary questionnaire completed by the patient or by an interviewer. The questionnaire was established for each nation (ie, England, Scotland, and Wales) to assess an individual's usual food intake (oily fish, non-oily fish, vegetables, fruit, and red meat). Diabetes mellitus was defined by ICD-10 codes E10-E14, self-reported physician's diagnosis, self-reported use of antidiabetic drugs, or haemoglobin A1c level ≥6.5% at baseline. Hypertension was defined by ICD-10 code I10 or I15, self-reported physician's diagnosis, self-reported use of antihypertensive drugs, or measured systolic and diastolic blood pressure ≥130/85 mm Hg at baseline. Information on other comorbidities (obesity (ICD-10 code E66), chronic obstructive pulmonary disease (J44), and chronic renal failure (N18)) was extracted from the first occurrence (UKB category ID 1712). Information on the use of drugs, including antihypertensive drugs, antidiabetic drug, and statins, was extracted from treatment and drug use records. Biochemistry markers were measured immediately at the central laboratory from serum samples collected at baseline. Binge drinking was defined as consumption of ≥6 standard drinks/day for women or ≥8 standard drinks/day for men. Detailed information on alcohol consumption and binge drinking in the UK Biobank was reported previously. 16

Statistical analysis

Characteristics of participants are summarised as number (percentages) for categorical variables and mean (standard deviation (SD)) for continuous variables. Comparisons between regular users of fish oil supplements and non-users were made with the χ 2 test or Student's t test.

We used a multi-state regression model to assess the role of regular use of fish oil supplements in the temporal disease progression from healthy status to atrial fibrillation, to major adverse cardiovascular events, and subsequently to death. The multi-state model is an extension of competing risks survival analysis. 17–19 The model allows simultaneous estimation of the role of risk factors in transitions from a healthy state to atrial fibrillation (transition A), healthy state to major adverse cardiovascular events (transition B), healthy state to death (transition C), atrial fibrillation to major adverse cardiovascular events (transition D), atrial fibrillation to death (transition E), and major adverse cardiovascular events to death (transition F) (transition pattern I, figure 2 ). The focus on these six transitions rather than on all possible health state transitions was preplanned and evidence based. If participants entered different states on the same date, we used the date of the theoretically previous state as the entry date of the latter state minus 0.5 days.

Numbers of participants in transition pattern I, from baseline to atrial fibrillation, major adverse cardiovascular events, and death

We further examined the effects of regular use of fish oil supplements on other pathways. For example, we divided major adverse cardiovascular events into three individual diseases (heart failure, stroke, and myocardial infarction), resulting in three independent pathways (transition patterns II, III, and IV, online supplemental figures S1–S3 ). All models were adjusted for age, sex, ethnic group, Townsend deprivation index, consumption of oily fish, consumption of non-oily fish, smoking status, alcohol consumption, obesity, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, chronic renal failure, and use of statins, antidiabetic drugs, and antihypertensive drugs.

Supplemental material

We conducted several sensitivity analyses for the multi-state analyses of transition pattern A: additionally adjusting for setting (urban and rural), body mass index (underweight, normal, overweight, and obese), and physical activity (low, moderate, and high) in the model; adjusting for binge drinking rather than alcohol consumption; additionally adjusting for other variables of dietary intake (consumption of vegetables, fruit, and red meat); calculating participants' entry date into the previous state with different time intervals (0.5 years, one year, and two years); excluding participants who entered different states on the same date; excluding events occurring in the first two years of follow-up; restricting the follow-up date to 31 March 2020 to evaluate the influence of the covid-19 pandemic; and the use of the inverse probability weighted method to deal with biases between the regular users and non-users of fish oil supplements. Also, we conducted grouped analyses for sex, age group, ethnic group, smoking status, consumption of oily fish, consumption of non-oily fish, hypertension, and drug use, to examine effect modification. The interactions were tested with the likelihood ratio test. All analyses were carried out with R software (version 4.0.3), and the multi-model analysis was performed with the mstate package. A two tailed P value <0.05 was considered significant.

Patient and public involvement

Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research. Participants were involved in developing the ethics and governance framework for UK Biobank and have been engaged in the progress of UK Biobank through follow-up questionnaires and additional assessment visits. UK Biobank keeps participants informed of all research output through the study website ( https://www.ukbiobank.ac.uk/explore-your-participation ), participant events, and newsletters.

A total of 415 737 participants (mean age 55.9 (SD 8.1) years; 55% women), aged 40-69 years, were analysed, and 31.4% (n=1 30 365) of participants reported regular use of fish oil supplements at baseline ( figure 1 ). Table 1 shows the characteristics of regular users (n=130 365) and non-users (n=285 372) of fish oil supplements. In the group of regular users of fish oil supplements, we found higher proportions of elderly people (22.6% v 13.9%), white people (95.1% v 94.2%), and women (57.6% v 53.9%), and higher consumption of alcohol (93.1% v 92.0%), oily fish (22.1% v 15.4%), and non-oily fish (18.0% v 15.4%) than non-users. The Townsend deprivation index (mean −1.5 (SD 3.0) v −1.3 (3.0)) and the proportion of current smokers (8.1% v 11.4%) were lower in regular users of fish oil supplements. Online supplemental table S1 provides more details on patient characteristics and online supplemental table S2 compares the basic characteristics of included and excluded people.

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Baseline characteristics of study participants grouped by use of fish oil supplements

Over a median follow-up time of of 11.9 years, 18 367 participants had atrial fibrillation (transition A) and 17 826 participants had major adverse cardiovascular events (transition B); 14 902 participants died without having atrial fibrillation or major adverse cardiovascular events (transition C). Among patients with incident atrial fibrillation, 4810 developed major adverse cardiovascular events (transition D) and 1653 died (transition E). Among patients with incident major adverse cardiovascular events, 5585 died during follow-up (transition F, figure 2 ). In separate analyses for individual diseases (transition patterns II, III, and IV, online supplemental figures S1–S3 ), in patients with atrial fibrillation, 3085 developed heart failure, 1180 had a stroke, and 1415 had a myocardial infarction. During follow-up, 2436, 2088, and 2098 deaths occurred in patients with heart failure, stroke, and myocardial infarction, respectively.

Multi-state regression results

Table 2 shows the different roles of regular use of fish oil supplements in transitions from healthy status to atrial fibrillation, to major adverse cardiovascular events, and then to death. For individuals in the primary stage (healthy status), we found that the use of fish oil supplements had a harmful effect on the transition from health to atrial fibrillation, with an adjusted hazard ratio of 1.13 (95% CI 1.10 to 1.17, transition A). The hazard ratio for transition B (from health to major adverse cardiovascular events) was 1.00 (95% CI 0.97 to 1.04) and for transition C (from health to death) was 0.98 (0.95 to 1.02).

Hazard ratios (95% confidence intervals) for each transition, for different transition patterns for progressive cardiovascular disease by regular use of fish oil supplements

For individuals in the secondary stage (atrial fibrillation) at the beginning of the study, regular use of fish oil supplements decreased the risk of major adverse cardiovascular events (transition D, hazard ratio 0.92, 95% CI 0.87 to 0.98), and had a borderline protective effect on the transition from atrial fibrillation to death (transition E, 0.91, 0.82 to 1.01). For transition F, from major adverse cardiovascular events to death, after adjusting for covariates, the hazard ratio was 0.99 (0.94 to 1.06, transition pattern I, table 2 ).

We divided major adverse cardiovascular events into three individual diseases (ie, heart failure, stroke, and myocardial infarction) and found that regular use of fish oil supplements was marginally associated with an increased risk of stroke in people with a healthy cardiovascular state (hazard ratio 1.05, 95% CI 1.00 to 1.11), whereas a protective effect was found in transitions from healthy cardiovascular states to heart failure (0.92, 0.86 to 0.98). For patients with atrial fibrillation, we found that the beneficial effects of regular use of fish oil supplements were for transitions from atrial fibrillation to myocardial infarction (0.85, 0.76 to 0.96), and from atrial fibrillation to death (0.88, 0.81 to 0.95) for transition pattern IV. For patients with heart failure, we found a protective effect of regular use of fish oil supplements on the risk of mortality (0.91, 0.84 to 0.99) (transition patterns II, III, and IV, table 2 ).

Stratified and sensitivity analyses

We found that age, sex, smoking, consumption of non-oily fish, prevalent hypertension, and use of statins and antihypertensive drugs modified the associations between regular use of fish oil supplements and the transition from healthy states to atrial fibrillation ( online supplemental figure S4 ). We found that the association between regular use of fish oil supplements and risk of transition from healthy states to major adverse cardiovascular events was greater in women (hazard ratio 1.06, 95% CI 1.00 to 1.11, P value for interaction=0.005) and non-smoking participants (1.06, 1.06 to 1.11, P value for interaction=0.001) ( online supplemental figure S4 ). The protective effect of regular use of fish oil supplements on the transition from healthy states to death was greater in men (hazard ratio 0.93, 95% CI 0.89 to 0.98, P value for interaction=0.003) and older participants (0.91, 0.86 to o 0.96, P value for interaction=0.002) ( online supplemental figures S5 and S6 ). The results were not substantially changed in the sensitivity analyses ( online supplemental table S3 ).

Principal findings

Our study characterised the regular use of fish oil supplements on the progressive course of cardiovascular disease, from a healthy state (primary stage), to atrial fibrillation (secondary stage), major adverse cardiovascular events (tertiary stage), and death (end stage). In this prospective analysis of more than 400 000 UK adults, we found that regular use of fish oil supplements could have a differential role in the progression of cardiovascular disease. For people with a healthy cardiovascular profile, regular use of fish oil supplements, a choice of primary prevention, was associated with an increased risk of atrial fibrillation. For participants with a diagnosis of atrial fibrillation, however, regular use of fish oil supplements, as secondary prevention, had a protective effect or no effect on transitions from atrial fibrillation to major adverse cardiovascular events, atrial fibrillation to death, and major adverse cardiovascular events to death. When we divided major adverse cardiovascular events into three individual diseases (ie, heart failure, stroke, and myocardial infarction), we found associations that could suggest a mildly harmful effect between regular use of fish oil supplements and transitions from a healthy cardiovascular state to stroke, whereas potential beneficial associations were found between regular use of fish oil supplements and transitions from atrial fibrillation to myocardial infarction, atrial fibrillation to death, and heart failure to death.

Comparison with other studies

Primary prevention.

The cardiovascular benefits of regular use of fish oil supplements have been examined in numerous studies but the results are controversial. Extending previous reports, our study estimated the associations between regular use of fish oil supplements and specific clinical cardiovascular disease outcomes in people with no known cardiovascular disease. Our findings are in agreement with the results of several previous randomised controlled trials and meta-analyses. The Long-Term Outcomes Study to Assess Statin Residual Risk with Epanova in High Cardiovascular Risk Patients with Hypertriglyceridaemia (STRENGTH) reported that consumption of 4 g/day of marine omega 3 fatty acids was associated with a 69% higher risk of new onset atrial fibrillation in people at high risk of cardiovascular disease. 20 A meta-analysis of seven randomised controlled trials showed that users of marine omega 3 fatty acids supplements had a higher risk of atrial fibrillation events, with a hazard ratio of 1.25 (95% CI 1.07 to 1.46, P=0.013). 21 The Vitamin D and Omega-3 Trial (VITAL Rhythm study), a large trial of omega 3 fatty acids for the primary prevention of cardiovascular disease in adults aged ≥50 years, however, found no effects on incident atrial fibrillation, major adverse cardiovascular events, or cardiovascular disease mortality among those treated with 840 mg/day of marine omega 3 fatty acids compared with placebo. 10 22

One possible explanation for the inconsistent results in these studies is that adverse effects might be related to dose and composition. Higher doses of omega 3 fatty acids used in previous studies might have had an important role in causing an adverse effect on atrial fibrillation. 21 One study found that high concentrations of fish oil altered cell membrane properties and inhibited Na-K-ATPase pump activity, whereas a low concentration of fish oil minimised peroxidation potential and optimised activity. 23 In another study, individuals with atrial fibrillation or flutter had higher percentages of total polyunsaturated fatty acids, and n-3 and n-6 polyunsaturated fatty acids, on red blood cell membranes than healthy controls. 24

In terms of composition of omega 3 fatty acids, a recent meta-analysis showed that eicosapentaenoic acid alone can be more effective at reducing the risk of cardiovascular disease than the combined effect of eicosapentaenoic acid and docosahexaenoic acid. 25 Similar outcomes were reported in the INSPIRE study, which showed that higher levels of docosahexaenoic acid reduced the cardiovascular benefits of eicosapentaenoic acid when given as a combination. 26 Another possible explanation is that age, sex, ethnic group, smoking status, dietary patterns, and use of statins and antidiabetic drugs by participants might modify the effects of regular use of fish oil supplements on cardiovascular disease events. Despite these differences in risk estimates, our findings do not support the use of fish oil or omega 3 fatty acid supplements for the primary prevention of incident atrial fibrillation or other specific clinical cardiovascular disease events in generally healthy individuals. Caution might be warranted when fish oil supplements are used for primary prevention because of the uncertain cardiovascular benefits.

Secondary prevention

Our large scale cohort study assessed the role of regular use of fish oil supplements on the disease process, from atrial fibrillation to more serious cardiovascular disease stages, to death, in people with known cardiovascular disease. Contrary to the observations for primary prevention, we found associations that could suggest beneficial effects between regular use of fish oil supplements and most cardiovascular disease transitions. No associations were found between regular use of fish oil supplements and transitions from atrial fibrillation to death, or from major adverse cardiovascular events to death.

Consistent with our hypothesis, the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI) Prevenzione study reported an association between administration of low dose prescriptions of n-3 polyunsaturated fatty acids and reduced cardiovascular events in patients with recent myocardial infarction. 27 A meta-analysis of 16 randomised controlled trials also reported a tendency towards a greater beneficial effect for secondary prevention in patients with cardiovascular disease. 28 Why patients with previous atrial fibrillation benefit is unclear. These findings indicate that triglyceride independent effects of omega 3 fatty acids might in part be responsible for the benefits in cardiovascular disease seen in previous trials. 29–31 No proven biological mechanism for this explanation exists, however, and the dose and formulation of omega 3 fatty acids used in clinical practice are not known.

For the disease process, from cardiovascular disease to death, our findings are consistent with the results of secondary prevention trials of omega 3 fatty acids, which have mostly shown a weak or neutral preventive effect in all cause mortality with oil fish supplements. The GISSI heart failure trial (GISSI-HF), conducted in 6975 patients with chronic heart failure, reported that supplemental omega 3 fatty acids reduced the risk of all cause mortality by 9% (hazard ratio 0.91, 95% CI 0.833 to 0.998, P=0.041). 32 Zelniker et al showed that omega 3 fatty acids were inversely associated with a lower incidence of sudden cardiac death in patients with non-ST segment elevation acute coronary syndrome. 33 A meta-analysis found that use of omega 3 supplements of ≤1 capsule/day was not associated with all cause mortality, but among participants with a risk of cardiovascular disease, taking a higher dose was associated with a reduction in cardiac death and sudden death. 28 Individuals who might benefit the most from fish oil or omega 3 fatty acid supplements are possibly more vulnerable individuals, such as those with previous cardiovascular diseases and those who can no longer live in the community. How fish oil supplements stop further deterioration of cardiovascular disease is unclear, but the theory that supplemental omega 3 fatty acids might protect the coronary artery is biologically plausible, suggesting that omega 3 fatty acids have anti-inflammatory and anti-hypertriglyceridaemia effects, contributing to a reduction in thrombosis and improvement in endothelial function. 34–41 Nevertheless, the effects of omega 3 fatty acids vary according to an individual's previous use of statins, which might partly explain the different effects of fish oil supplements in people with and without cardiovascular disease.

Many studies of omega 3 fatty acids, including large scale clinical trials and meta-analyses, have not produced entirely consistent results. 21 25 42 Our study mainly explored the varied potential effects of regular use of fish oil supplements on progression of cardiovascular disease, offering an initial overview of this ongoing discussion. Our findings suggest caution in the use of fish oil supplements for primary prevention because of the uncertain cardiovascular benefits and adverse effects. Further studies are needed to determine whether potential confounders modify the effects of oil fish supplements and the precise mechanisms related to the development and prognosis of cardiovascular disease events.

Strengths and limitations of this study

The strengths of our study were the large sample size, long follow-up period, which allowed us to analyse clinically diagnosed incident diseases, and complete data on health outcomes. Another strength was our analytical strategy. The multi-state model gives less biased estimates than the conventional Cox model, and distinguished the effect of regular use of fish oil supplements on each transition in the course of cardiovascular disease.

Our study had some limitations. Firstly, as an observational study, no causal relations can be drawn from our findings. Secondly, although we adjusted for multiple covariates, residual confounding could still exist. Thirdly, information on dose and formulation of the fish oil supplements was not available in this study, so we could not evaluate potential dose dependent effects or differentiate between the effects of different fish oil formulations. Fourthly, the use of hospital inpatient data for determining atrial fibrillation events could have excluded some events triggered by acute episodes, such as surgery, trauma, and similar conditions, resulting in underestimation of the true risk because undiagnosed atrial fibrillation is a common occurrence. 43 Fifthly, most of the participants in this study were from the white ethnic group and whether the findings can be generalised to other ethnic groups is not known. Finally, our study did not consider behavioural changes in populations with different cardiovascular profiles because of limited information, and variations in outcomes for different cardiovascular states merits further exploration.

Conclusions

This large scale prospective study of a UK cohort suggested that regular use of fish oil supplements might have differential roles in the course of cardiovascular diseases. Regular use of fish oil supplements might be a risk factor for atrial fibrillation and stroke among the general population but could be beneficial for disease progression, from atrial fibrillation to major adverse cardiovascular events, and from atrial fibrillation to death. Further studies are needed to determine whether potential confounders modify the effects of oil fish supplements and the precise mechanisms for the development and prognosis of cardiovascular disease events.

Ethics statements

Patient consent for publication.

Consent obtained directly from patients.

Ethics approval

The UK Biobank study obtained ethical approval from the North West Multicentre Research ethics committee, Information Advisory Group, and the Community Health Index Advisory Group (REC reference for UK Biobank 11/NW/0382). Participants gave informed consent to participate in the study before taking part.

Acknowledgments

This study was conducted with UK Biobank Resource (application No: 69550). We appreciate all participants and professionals contributing to UK Biobank.

• Mensah GA ,
• Johnson CO , et al
• Gao MM , et al
• Saravanan P ,
• Davidson NC ,
• Schmidt EB , et al
• National Institute for Health and Care Excellence
• Lichtenstein AH ,
• Vadiveloo M , et al
• Djuricic I ,
• Miller M , et al
• Kesse-Guyot E ,
• Czernichow S , et al
• Klemsdal TO ,
• Sandvik L , et al
• Manson JE ,
• Lee I-M , et al
• Gallacher J ,
• Allen N , et al
• Littlejohns TJ ,
• Sudlow C , et al
• Allen NE , et al
• Zhong W-F ,
• Liu S , et al
• Wu Z , et al
• Gallagher C ,
• Elliott AD , et al
• Qian SE , et al
• Nicholls SJ ,
• Lincoff AM ,
• Garcia M , et al
• Djousse L ,
• Al-Ramady OT , et al
• Bassuk SS ,
• Cook NR , et al
• Cazzola R ,
• Della Porta M ,
• Castiglioni S , et al
• Viviani Anselmi C ,
• Ferreri C ,
• Novelli V , et al
• Khan MS , et al
• Knowlton K , et al
• Marchioli R ,
• Bomba E , et al
• Olmastroni E ,
• Gazzotti M , et al
• Al Rifai M , et al
• Tavazzi L ,
• Maggioni AP ,
• Marchioli R , et al
• Zelniker TA ,
• Morrow DA ,
• Scirica BM , et al
• Limonte CP ,
• Zelnick LR ,
• Ruzinski J , et al
• Nelson JR ,
• Miller PE ,
• Van Elswyk M ,
• Alexander DD
• Mozaffarian D ,
• Bornfeldt KE
• Harris WS ,
• Ginsberg HN ,
• Arunakul N , et al
• Markozannes G ,
• Tsapas A , et al
• Svennberg E ,
• Engdahl J ,
• Al-Khalili F , et al

Supplementary materials

Supplementary data.

This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

• Data supplement 1
• Data supplement 2

GYL and HL are joint senior authors.

Contributors HL supervised the whole project and designed the work. GC and HL directly accessed and verified the underlying data reported in the manuscript. GC contributed to data interpretation and writing of the report. ZQ, SZ, JZ, ZZ, MGV, HEA, CW, and GYHL contributed to the discussion and data interpretation, and revised the manuscript. All authors had full access to all of the data in the study and had final responsibility for the decision to submit for publication. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. HL is the guarantor. Transparency: The lead author (guarantor) affirms that the manuscript is an honest, accurate, and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

Funding This work was supported by the Bill and Melinda Gates Foundation (grant No INV-016826). Under the grant conditions of the foundation, a creative commons attribution 4.0 generic license has already been assigned to the author accepted manuscript version that might arise from this submission. The funder had no role in considering the study design or in the collection, analysis, interpretation of data, writing of the report, or decision to submit the article for publication.

Competing interests All authors have completed the ICMJE uniform disclosure form at www.icmje.org/disclosure-of-interest/ and declare: support from Bill and Melinda Gates Foundation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Provenance and peer review Not commissioned; externally peer reviewed.

Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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Preventing Foodborne Illness Risk Factors in Schools

2023 FDA Science Forum

Food safety practices in foodservice and retail food establishments play a critical role in preventing foodborne illness. As part of FDA’s commitment to preventing foodborne illness, we conducted a quantitative observational study investigating the relationship between food safety management systems, certified food protection managers, and food safety behaviors and practices in 402 schools (K-12) from 2015-2016. Twenty-three FDA Food Specialist conducted site visits throughout the United States at randomly selected schools to perform the data collection. All specialist received customized training specific to the study data collection protocol and marking instructions for the standardized data collection tool. A Geographic Information System database containing a listing of U.S. schools was used as the establishment inventory. Schools were randomly selected to participate in the study from among all eligible establishments located within a 150-mile radius of the home locations of the twenty-three FDA specialist who conducted the data collection. The specialist conducted unannounced, non-regulatory visits to each school.

These previously unreleased data are part of a larger study conducted in four major facility segments of the foodservice and retail food establishment industries (restaurants, healthcare facilities, schools, and retail food stores). The results will show relationships affected by multiple variables, and the five risk factors identified as contributing to foodborne illness: improper holding temperatures, inadequate cooking, contaminated equipment, food from unsafe sources, and poor personal hygiene. Similar to findings in data analyzed for other facility segments: schools have the best control over No bare-hand contact with ready-to eat foods, in addition schools need better control over employee handwashing and holding foods requiring refrigeration at proper temperature (cold holding). The data provides valuable insights that FDA and other agencies can use to improve food safety practices in schools.

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Fate of Retired Research Chimps Still in Limbo

The National Institutes of Health, which owns the chimps at the Alamogordo Primate Facility in New Mexico, has no plans to move the animals to sanctuary, despite a ruling from a federal judge.

By Emily Anthes

It has been more than two decades since chimpanzee research came to a halt at the Alamogordo Primate Facility in New Mexico. And yet, some two dozen chimps still live there, despite a federal law that requires such retired research chimps to be moved to sanctuary.

In 2022, a judge ruled that the National Institutes of Health, which owns the chimps, was violating the law by refusing to move the animals to a wooded sanctuary in Louisiana. Earlier this year, the agency dropped its appeal of the ruling.

But the N.I.H. says it has no immediate plans to move the animals, citing concerns about the animals’ health — and a legal footnote that may exempt the agency from moving chimps that are “moribund,” a term that typically means near death.

As of last October, 28 chimps remained at Alamogordo, all of whom were moribund, the N.I.H. said in an email. It defined moribund as suffering from “life-threatening, systemic disease that poses a constant threat and could result in abrupt death.”

Some of the animals had previously been diagnosed with advanced cardiovascular disease, which is common in older chimps.

The N.I.H.’s refusal to transfer the chimps has drawn criticism from lawmakers, veterinarians and animal rights advocates.

The Humane Society of the United States, which sued the N.I.H. over its unwillingness to move the chimps, noted that the agency had been describing the chimps as “moribund” for years, making it unlikely that the animals were truly on the brink of death.

“They really need to stop making excuses,” said Kathleen Conlee, vice president of animal research issues at the Humane Society. “A lot of chimpanzees have moved to sanctuary with health conditions and thrived in their new environment.”

Independent veterinary experts, who had not examined the Alamogordo chimps personally, also wondered how animals could be moribund for years.

“‘Moribund’ in human or veterinary medicine is generally understood to mean death is imminent,” said Dr. Felicia Nutter, a wildlife veterinarian at Tufts University. “So any determination that chimps have been moribund for three years — there’s something not right with that.”

Transportation does pose risks, said Dr. Kathryn Gamble, the director of veterinary medicine at Lincoln Park Zoo in Chicago. But even significant cardiac disease does not make such moves impossible, she said.

“We have humans that have anything from mild to severe cardiac disease — many of them still travel,” Dr. Gamble said. And the risks of transport should be weighed against the potential benefits that might come from the change in environment, she said.

The Chimpanzee Health Improvement Maintenance Protection, or CHIMP, Act, which Congress passed in 2000, established a national chimpanzee sanctuary system and stipulated that federally owned chimps that were not needed for research be sent to sanctuary. Chimp Haven, a 200-acre sanctuary in Louisiana, serves as the designated retirement home.

In 2015, the N.I.H. announced that it would no longer support biomedical research on chimpanzees, and many Alamogordo chimps have since moved to Chimp Haven. But in 2019, the N.I.H. said that a veterinary panel had concluded that the 44 chimps remaining at Alamogordo were too sick to leave .

“The physiological and psychological stressors associated with transportation, quarantine, change in social structure and change in human care provider could trigger a fatal cardiac event,” the panel wrote in one case summary. The panel also expressed concern that chimps with disabilities, including cataracts and a leg amputation, might not integrate safely into new social groups and settings.

The Humane Society and other animal rights groups sued over the decision, accusing the N.I.H. of violating the CHIMP Act. In December 2022, a federal judge ruled in their favor, but added, in a footnote, “The parties appear to agree that N.I.H. is not obligated to transfer a ‘moribund’ chimpanzee to sanctuary.”

The Santa Fe New Mexican reported last month that the N.I.H. had no immediate plans to transfer the chimps.

“N.I.H. plans to conduct an annual evaluation of the chimpanzees at Alamogordo to determine if they are moribund, or if they are no longer moribund and can be safely transported to Chimp Haven,” the agency said in an email.

A plan for annual evaluations suggested that the chimps were not on the brink of death, said Rana Smith, the president of Chimp Haven.

Ms. Smith also objected to the agency’s interpretation of the law, noting that the CHIMP Act does not use the word “moribund” or make exceptions for chronically ill chimps. “We have found that chimpanzees are an incredibly resilient species and thrive in the sanctuary environment,” she said.

Several U.S. lawmakers have been urging the N.I.H. to transfer the remaining Alamogordo chimps for years. “I have been advocating for a humane and permanent solution for these chimpanzees, so they can live out the rest of their lives in a non-laboratory sanctuary environment,” Senator Martin Heinrich, Democrat of New Mexico, said in an emailed statement.

The agency’s refusal to move those chimps “stands in direct violation of federal law,” he added. “I am urging them to reconsider.”

Emily Anthes is a science reporter, writing primarily about animal health and science. She also covered the coronavirus pandemic. More about Emily Anthes

Explore the Animal Kingdom

A selection of quirky, intriguing and surprising discoveries about animal life..

The Lord Howe Island stick insect vanished from its home, but an effort at zoos in San Diego and Melbourne highlights the possibilities and challenges  of conserving invertebrate animals.

A genetic analysis of the German cockroach explained its rise in southern Asia millenniums ago, and how it eventually turned up in your kitchen .

Scientists say they have found an “alphabet” in the songs of sperm whales , raising the possibility that the animals are communicating in a complex language.

Indigenous rangers in Australia’s Western Desert got a rare close-up with the northern marsupial mole , which is tiny, light-colored and blind, and almost never comes to the surface.

For the first time, scientists observed a primate in the wild treating a wound  with a plant that has medicinal properties.

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Study designs: Part 7 – Systematic reviews

Priya ranganathan.

Department of Anaesthesiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India

Rakesh Aggarwal

1 Director, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

In this series on research study designs, we have so far looked at different types of primary research designs which attempt to answer a specific question. In this segment, we discuss systematic review, which is a study design used to summarize the results of several primary research studies. Systematic reviews often also use meta-analysis, which is a statistical tool to mathematically collate the results of various research studies to obtain a pooled estimate of treatment effect; this will be discussed in the next article.

In the previous six articles in this series on study designs, we have looked at different types of primary research study designs which are used to answer research questions. In this article, we describe the systematic review, a type of secondary research design that is used to summarize the results of prior primary research studies. Systematic reviews are considered the highest level of evidence for a particular research question.[ 1 ]

SYSTEMATIC REVIEWS

As defined in the Cochrane Handbook for Systematic Reviews of Interventions , “Systematic reviews seek to collate evidence that fits pre-specified eligibility criteria in order to answer a specific research question. They aim to minimize bias by using explicit, systematic methods documented in advance with a protocol.”[ 2 ]

NARRATIVE VERSUS SYSTEMATIC REVIEWS

Review of available data has been done since times immemorial. However, the traditional narrative reviews (“expert reviews”) do not involve a systematic search of the literature. Instead, the author of the review, usually an expert on the subject, used informal methods to identify (what he or she thinks are) the key studies on the topic. The final review thus is a summary of these “selected” studies. Since studies are chosen at will (haphazardly!) and without clearly defined criteria, such reviews preferentially include those studies that favor the author's views, leading to a potential for subjectivity or selection bias.

In contrast, systematic reviews involve a formal prespecified protocol with explicit, transparent criteria for the inclusion and exclusion of studies, thereby ensuring completeness of coverage of the available evidence, and providing a more objective, replicable, and comprehensive overview it.

META-ANALYSIS

Many systematic reviews use an additional tool, known as meta-analysis, which is a statistical technique for combining the results of multiple studies in a systematic review in a mathematically appropriate way, to create a single (pooled) and more precise estimate of treatment effect. The feasibility of performing a meta-analysis in a systematic review depends on the number of studies included in the final review and the degree of heterogeneity in the inclusion criteria as well as the results between the included studies. Meta-analysis will be discussed in detail in the next article in this series.

THE PROCESS OF A SYSTEMATIC REVIEW

The conduct of a systematic review involves several sequential key steps.[ 3 , 4 ] As in other research study designs, a clearly stated research question and a well-written research protocol are essential before commencing a systematic review.

Step 1: Stating the review question

Systematic reviews can be carried out in any field of medical research, e.g. efficacy or safety of interventions, diagnostics, screening or health economics. In this article, we focus on systematic reviews of studies looking at the efficacy of interventions. As for the other study designs, for a systematic review too, the question is best framed using the Population, Intervention, Comparator, and Outcome (PICO) format.

For example, Safi et al . carried out a systematic review on the effect of beta-blockers on the outcomes of patients with myocardial infarction.[ 5 ] In this review, the Population was patients with suspected or confirmed myocardial infarction, the Intervention was beta-blocker therapy, the Comparator was either placebo or no intervention, and the Outcomes were all-cause mortality and major adverse cardiovascular events. The review question was “ In patients with suspected or confirmed myocardial infarction, does the use of beta-blockers affect mortality or major adverse cardiovascular outcomes? ”

Step 2: Listing the eligibility criteria for studies to be included

It is essential to explicitly define a priori the criteria for selection of studies which will be included in the review. Besides the PICO components, some additional criteria used frequently for this purpose include language of publication (English versus non-English), publication status (published as full paper versus unpublished), study design (randomized versus quasi-experimental), age group (adults versus children), and publication year (e.g. in the last 5 years, or since a particular date). The PICO criteria used may not be very specific, e.g. it is possible to include studies that use one or the other drug belonging to the same group. For instance, the systematic review by Safi et al . included all randomized clinical trials, irrespective of setting, blinding, publication status, publication year, or language, and reported outcomes, that had used any beta-blocker and in a broad range of doses.[ 5 ]

Step 3: Comprehensive search for studies that meet the eligibility criteria

A thorough literature search is essential to identify all articles related to the research question and to ensure that no relevant article is left out. The search may include one or more electronic databases and trial registries; in addition, it is common to hand-search the cross-references in the articles identified through such searches. One could also plan to reach out to experts in the field to identify unpublished data, and to search the grey literature non-peer-reviewednon-peer-reviewed. This last option is particularly helpful non-pharmacologic (theses, conference abstracts, and non-peer-reviewed journals). These sources are particularly helpful when the intervention is relatively new, since data on these may not yet have been published as full papers and hence are unlikely to be found in literature databases. In the review by Safi et al ., the search strategy included not only several electronic databases (Cochrane, MEDLINE, EMBASE, LILACS, etc.) but also other resources (e.g. Google Scholar, WHO International Clinical Trial Registry Platform, and reference lists of identified studies).[ 5 ] It is not essential to include all the above databases in one's search. However, it is mandatory to define in advance which of these will be searched.

Step 4: Identifying and selecting relevant studies

Once the search strategy defined in the previous step has been run to identify potentially relevant studies, a two-step process is followed. First, the titles and abstracts of the identified studies are processed to exclude any duplicates and to discard obviously irrelevant studies. In the next step, full-text papers of the remaining articles are retrieved and closely reviewed to identify studies that meet the eligibility criteria. To minimize bias, these selection steps are usually performed independently by at least two reviewers, who also assign a reason for non-selection to each discarded study. Any discrepancies are then resolved either by an independent reviewer or by mutual consensus of the original reviewers. In the Cochrane review on beta-blockers referred to above, two review authors independently screened the titles for inclusion, and then, four review authors independently reviewed the screen-positive studies to identify the trials to be included in the final review.[ 5 ] Disagreements were resolved by discussion or by taking the opinion of a separate reviewer. A summary of this selection process, showing the degree of agreement between reviewers, and a flow diagram that depicts the numbers of screened, included and excluded (with reason for exclusion) studies are often included in the final review.

Step 5: Data extraction

In this step, from each selected study, relevant data are extracted. This should be done by at least two reviewers independently, and the data then compared to identify any errors in extraction. Standard data extraction forms help in objective data extraction. The data extracted usually contain the name of the author, the year of publication, details of intervention and control treatments, and the number of participants and outcome data in each group. In the review by Safi et al ., four review authors independently extracted data and resolved any differences by discussion.[ 5 ]

Handling missing data

Some of the studies included in the review may not report outcomes in accordance with the review methodology. Such missing data can be handled in two ways – by contacting authors of the original study to obtain the necessary data and by using data imputation techniques. Safi et al . used both these approaches – they tried to get data from the trial authors; however, where that failed, they analyzed the primary outcome (mortality) using the best case (i.e. presuming that all the participants in the experimental arm with missing data had survived and those in the control arm with missing mortality data had died – representing the maximum beneficial effect of the intervention) and the worst case (all the participants with missing data in the experimental arm assumed to have died and those in the control arm to have survived – representing the least beneficial effect of the intervention) scenarios.

Evaluating the quality (or risk of bias) in the included studies

The overall quality of a systematic review depends on the quality of each of the included studies. Quality of a study is inversely proportional to the potential for bias in its design. In our previous articles on interventional study design in this series, we discussed various methods to reduce bias – such as randomization, allocation concealment, participant and assessor blinding, using objective endpoints, minimizing missing data, the use of intention-to-treat analysis, and complete reporting of all outcomes.[ 6 , 7 ] These features form the basis of the Cochrane Risk of Bias Tool (RoB 2), which is a commonly used instrument to assess the risk of bias in the studies included in a systematic review.[ 8 ] Based on this tool, one can classify each study in a review as having low risk of bias, having some concerns regarding bias, or at high risk of bias. Safi et al . used this tool to classify the included studies as having low or high risk of bias and presented these data in both tabular and graphical formats.[ 5 ]

In some reviews, the authors decide to summarize only studies with a low risk of bias and to exclude those with a high risk of bias. Alternatively, some authors undertake a separate analysis of studies with low risk of bias, besides an analysis of all the studies taken together. The conclusions from such analyses of only high-quality studies may be more robust.

Step 6: Synthesis of results

The data extracted from various studies are pooled quantitatively (known as a meta-analysis) or qualitatively (if pooling of results is not considered feasible). For qualitative reviews, data are usually presented in the tabular format, showing the characteristics of each included study, to allow for easier interpretation.

Sensitivity analyses

Sensitivity analyses are used to test the robustness of the results of a systematic review by examining the impact of excluding or including studies with certain characteristics. As referred to above, this can be based on the risk of bias (methodological quality), studies with a specific study design, studies with a certain dosage or schedule, or sample size. If results of these different analyses are more-or-less the same, one can be more certain of the validity of the findings of the review. Furthermore, such analyses can help identify whether the effect of the intervention could vary across different levels of another factor. In the beta-blocker review, sensitivity analysis was performed depending on the risk of bias of included studies.[ 5 ]

IMPORTANT RESOURCES FOR CARRYING OUT SYSTEMATIC REVIEWS AND META-ANALYSES

Cochrane is an organization that works to produce good-quality, updated systematic reviews related to human healthcare and policy, which are accessible to people across the world.[ 9 ] There are more than 7000 Cochrane reviews on various topics. One of its main resources is the Cochrane Library (available at https://www.cochranelibrary.com/ ), which incorporates several databases with different types of high-quality evidence to inform healthcare decisions, including the Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Clinical Answers.

The Cochrane Handbook for Systematic Reviews of Interventions

The Cochrane handbook is an official guide, prepared by the Cochrane Collaboration, to the process of preparing and maintaining Cochrane systematic reviews.[ 10 ]

Review Manager software

Review Manager (RevMan) is a software developed by Cochrane to support the preparation and maintenance of systematic reviews, including tools for performing meta-analysis.[ 11 ] It is freely available in both online (RevMan Web) and offline (RevMan 5.3) versions.

Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement is an evidence-based minimum set of items for reporting of systematic reviews and meta-analyses of randomized trials.[ 12 ] It can be used both by authors of such studies to improve the completeness of reporting and by reviewers and readers to critically appraise a systematic review. There are several extensions to the PRISMA statement for specific types of reviews. An update is currently underway.

Meta-analysis of Observational Studies in Epidemiology statement

The Meta-analysis of Observational Studies in Epidemiology statement summarizes the recommendations for reporting of meta-analyses in epidemiology.[ 13 ]

PROSPERO is an international database for prospective registration of protocols for systematic reviews in healthcare.[ 14 ] It aims to avoid duplication of and to improve transparency in reporting of results of such reviews.

Financial support and sponsorship

Conflicts of interest.

There are no conflicts of interest.

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In stroke response, speed is key; yale study reveals where delays are worst.

A map showing average community-level delays between stroke symptom onset and hospital arrival. Beige = less than three hours; orange = three to four and a half hours; red = four and a half to six hours; and maroon = more than six hours.

When it comes to responding to a stroke, speed is a crucial factor; the longer it takes for someone experiencing a stroke to get to a hospital, the worse the outcome will be. Yet across the United States, delays to treatment can be significant.

A Yale study uncovers new insights into factors associated with treatment delays and where in the United States patients are more likely to experience slower responses.

The findings, which were published May 24 in the journal Stroke , highlight where interventions should be focused in order to improve stroke outcomes across the country. 

During acute stroke, a blood clot reaches the brain, blocking blood flow and essential oxygen to brain tissue. The longer it takes to restore blood flow, the more tissue will be damaged, leaving patients with reduced abilities in those functions for which the affected brain region is responsible.

Currently, there are two main treatments used in hospitals for patients experiencing a stroke; both aim to break the blood clot and restore blood flow. One involves a medication — a drug called tissue plasminogen activator (tPA) — and the other is a physical approach wherein doctors remove the clot with a tiny tube threaded through a patient’s blood vessels.

“ Both are time-dependent,” said Kevin Sheth , professor of neurology and neurosurgery at Yale School of Medicine and senior author of the new study. “The window to use tPA closes four and a half hours after the stroke. Physical removal is more complicated but can be done up to 12 to 16 hours after the stroke begins. But every minute counts , and even within those windows earlier is better.”

To better understand what factors contribute to treatment delays across the country, the researchers — in collaboration with researchers at Brigham and Women’s Hospital in Cambridge, Massachusetts — used data collected from the “ Get with the Guidelines-Stroke ” registry, a program launched in 2003 by the American Heart Association that distributes care guidelines and collects data from U.S. hospitals with the aim of improving patient outcomes.

Across nearly 150,000 patients who experienced a stroke between January 2015 and March 2017, 54% arrived at a hospital more than two hours after the onset of stroke symptoms, the researchers found. Compared with patients who arrived earlier, those who took longer were more likely to be older, female, Black, and to have had a mild stroke, findings that align with those of previous studies.

The researchers also looked at community-level social vulnerability. The U.S. Centers for Disease Control and Prevention calculates social vulnerability scores for every U.S. census tract based on socioeconomic factors, household characteristics and disability, racial and ethnic minority status, and housing type and transportation availability. The scores serve to track factors that adversely affect communities, with higher scores indicating greater vulnerability.

In the study, the researchers found that patients with longer delays to hospital arrival were more likely to live in communities with higher social vulnerability scores. Socioeconomic status, housing type, and transportation availability had the strongest associations with delay.

The researchers also created an interactive map that shows how long it took for patients to arrive at hospitals in different communities nationwide, which they say could be used for targeting interventions.

One important strategy to reduce delays, the researchers say, is the creation of education campaigns. 

“ The most powerful motivator for going to the emergency department is pain,” said Sheth. “But stroke isn’t usually associated with pain. Plus, neurological symptoms can be weird, leaving people unsure what’s occurring. So informing people about the signs of stroke could help motivate people to seek treatment earlier.”

There have been large-scale education campaigns, Sheth added, but they haven’t made a sizable difference. Campaigns that target communities identified in this study as having longer delays, however, could be more effective.

More ideas for interventions are also needed, said Sheth.

“ For how big a problem this is, there hasn’t really been an effort to propose or test new interventions,” he said. “So we need new ideas because the single biggest problem in treating acute stroke is getting people to the hospital fast enough.”

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