Bringing It Together
• Research studies fall into 1 of 3 categories: descriptive, correlational, or experimental. The type of study is based on the relationship that the researcher is trying to define between the independent and dependent variable.
• The purpose of a descriptive study is to identify or quantify that a certain circumstance exists. A correlational study examines the strength and direction of the relationship between 2 variables. An experiment tests the effect of the independent variable on the dependent variable.
• The level of evidence provided is based on how strong the study’s design is and how close it comes to showing a cause-and-effect relationship. Within each of the 6 levels there are stronger and weaker studies. Meta-analyses and position statements provide the best evidence for practice.
• Dose-gradient and dose-response are important concepts for clinicians. Each shows how the dependent variable reacts to changing levels of the independent variable. These are best shown with graphs. A dose-gradient is a linear relationship. The dose-response is a curvilinear relationship.
• Sports epidemiologists use RR and OR to show how much a risk factor increases the likelihood of injury. Attributable risk statistics show how much impact removing a risk factor has on the incidence of disease or injury. The NNT is another useful statistic that identifies how many patients must be given an intervention to prevent one occurrence.
• The term statistical significance means that the probability that the result was by chance is low. It is influenced by sample size so that larger numbers of study participants make it easier to find significant differences. For this reason, the effect size of a treatment is important to know. The larger the effect size, the more likely it is that an individual patient will notice an improvement.
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• Reliability is the ability of a test or evaluator to produce consistent results when performed under the same conditions. Validity describes how well a test measures what it was intended to measure. Both are critical to the quality of a research study. Common problems for reliability and validity in research studies are sample bias, the Hawthorne Effect, social desirability, and confounding variables.
As discussed in Post 1, epidemiology is the study of the distribution and determinants of disease. Epidemiological injury research involves the slow and thorough accumulation of precise data that can take years to obtain, and injury surveillance uses systematic methods for the rapid collection and dissemination of data. The most effective systems focus on an ongoing, embedded process that is easily used. Dependent on the methods, ISS can identify trends in sport injuries and evolve with new evidence to meet the changing needs of the sports medicine practitioners. Data collected on injury types, mechanisms of injury, IRs, body region, position, and predisposing risk factors are collected and analyzed to provide insight on sport safety. ISSs are important for several reasons.2 They provide the following:
• Evidence for establishing prevention guidelines
• Rationale for rule or equipment changes
• Measures to define injury risk2
Exposure to risk is a critical component of ISS,2 and consistency in data collection is critical to establishing rates of injury. Therefore, surveillance is thought to be the first step in preventing disease. Several surveillance systems request data to be collected by athletic trainers (high school, college, professional sport). Other systems use physicians and other health care professionals in hospitals and emergency departments,2-4 and some community-based injury surveys have data reported by coaches.2 Published sports injury articles are often difficult to interpret and compare because of different collection and/or analysis methods. Standard methods of data collection are needed for comparability and interpretation of data. Consensus on definitions would greatly improve the collection of comparable and reliable sports injury data. Specific issues regarding ISS data include the definition of a sports injury, how the population at risk is calculated (the denominator), and the method of data collection.1 All sport ISSs should collect information about the rates of injuries, types of injuries, and mechanisms in a form that is relevant to a range of potential users (sport associations, sport governing agencies, physicians, athletic trainers, coaches, athletes, and parents) that allow for comparisons of trends, incidence, or risk.
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