A Keen Eye

Determining the Quality of a Research Study

By Jerrilyn Cambron
[Somatic Research]

How do you know if a research study is good? It’s an important question, one that can have major implications for your practice. If you read a new study, or a client brings in an article that claims massage can help a certain condition, do you know how to determine if the results can be trusted and how to discuss them with your client? And, if you think the results might benefit other clients, do you know how to share them? 

Knowing how to evaluate and discuss research findings will enhance your professional relationships and demonstrate you are interested in continuing to increase your knowledge base within your field of expertise. The first step in this journey is to consider where the information comes from.

Establish Source Credibility

Clients often gather health-care information from many places—friends and family members, the library, other health-care providers, magazines, the Internet. This exploration may help them better understand what they are going through in terms of their symptoms or condition. However, the quality of information can vary greatly based on where it was retrieved. If a client tells you that Uncle Dave told a story about a distant cousin who successfully used a particular treatment for a similar condition, you might be suspicious about Uncle Dave’s accuracy. This is called “anecdotal information.” Sometimes these anecdotes are useful, but many times they are no more than coincidental experiences. 

Even if the source is an article from a magazine, a newspaper, or the Internet that quotes a research study, further verification is needed. This will help you better understand the research so that you will be able to have an informed conversation about it, and also give you some direction as you take a deeper look at the study. Ask yourself the following questions. 

Who Did the Research?

Were experts quoted in the article? If so, who are these experts? Do they have credentials, advanced education, a position at a major hospital or university, or a research track record? These are all good qualities in a researcher and should lead a reader to be more confident with the research results. 

Does the research group have a website you can visit? Can you determine who funded the study? If funding was through a trusted organization or association, then the research is more likely to be trustworthy. But, if the research was funded by a for-profit group that might benefit financially from presenting the information, there might be a conflict of interest potentially leading to biased research findings.  

Where Was the Research Published? 

Was the study published in a scientific journal? Most newspaper articles that describe new research will provide a citation, including the name of the journal in which the article was published. If that is not provided, we have to ask if this was a legitimate research study. Scientific journals usually reject research that was done poorly or that has too much bias. We have to be somewhat suspicious when research is first published anywhere other than in a scientific journal; authors sometimes self-publish on websites or in pamphlets to make their results seem valuable and credible. 

The quality of articles is better in journals versus other publications mainly because the article review process for journals is very rigorous. Prior to an article being accepted for publication in a journal, several scientists (called peer-reviewers) must review and approve the article. If they do not approve, because there are points of confusion or some potential bias for example, the article is sent back to the author for further clarification. These requests for revisions are meant to strengthen the manuscript, and this process can go back and forth several times. Because of this peer-review process, the quality of journal articles is greatly improved. 

Can You Access the Research Article? 

Taking the time to read the original article will give you a foundational understanding of what the researchers did and why. Finding that original article is sometimes challenging. If the newspaper article doesn’t include a reference list, look for a quote from one of the researchers within the article, then use this name in an author search on PubMed (www.pubmed.gov). 

PubMed is a search engine for research articles that provides you with research citations and their associated abstracts (abstracts are shortened versions of an article). When you perform a search, you will most likely get many results, but you can narrow your results by adding other key words. For example, if the article states that Ben Jones was the principal investigator for the study, you could start by searching “Jones B,” add a date and search “Jones B 2011,” or add a topic and search “Jones B massage therapy.” PubMed is a lot like Google in that you might have to try different combinations of words to find what you are looking for. 

Once you find the citation, check to see if it is a free, full-text article. You can also check Google Scholar (www.scholar.google.com) for the full-text article. If you are not able to access the article, a reference librarian can certainly help you. 

What Are the Study’s Pros and Cons? 

Critical appraisal of research articles is more than just hunting for bias. Instead, critical appraisal is an assessment of the pros and cons of the study, and then a determination of whether the pros outweigh the cons. Most researchers recognize that there are biases in all research studies and will freely point out their study’s limitations in the discussion section of a paper. But, it is best for us to read the article and determine for ourselves what we appreciate about the article and what concerns us.  

Here are some things to look for: Does the number of subjects included in the study seem to be enough? What outcome measures were used? Do they seem like the best way to determine if the subjects got better, or do you think other outcome measures should have been included? What were the treatments provided? Were they usual and customary, or were they modified for research purposes? (Sometimes researchers develop a treatment protocol for all subjects, even though that protocol might not be right for everyone.) Who did the treatment? Did that person have enough experience to complete the therapy provided in the study? What were the final results of the study? Did it make sense to you that this treatment would provide those results, or did it leave you scratching your head? 

Talk to Clients 

When clients bring you articles and ask for your opinion, they’re doing so because they trust your expertise. Be sure to honor that trust by thanking them, researching the study on your own, and talking to them about your subsequent findings. 

First, discuss the source. Explain the possible bias that might occur from that type of source; for example, newspapers and magazines that are trying to sell copies and have space limitations might present only the most exciting results from a study while leaving out other important components. 

Next, discuss what you found in your search for more information. If you found an abstract or even the full-text article, you might want to give the client a copy. Talk about the pros and the cons of the article as you see it, making sure to emphasize that these are your opinions. Compare the conclusions of the scientific article with those in the client’s article, and discuss whether they seemed to be the same (a good thing) or different (not so good). 

Finally, be sure to thank the client for bringing this study to your attention. Thanking the client will foster your professional relationship and strengthen that bond. Your client could have discussed this information with any health-care professional, and they chose you. That is quite an honor. 

Share Good News

Ultimately, if the research is helpful or informative, you may want to present it to some (or all) of your other clients. This process demonstrates that you are evidence-informed, that you want to help educate your clients, and that you are interested in further education for yourself. 

Ways to bring research into your clinical setting include: 

• Putting research articles or summaries in your reception room.

• Blogging about a new research article.

• Posting some brief information on your professional Facebook page.  

• Giving presentations to community groups about the research. Discussing the research with prospective clients who are trying to decide if massage is right for them.

• Presenting the research to clients after a massage so they have a take-home message to show friends and family members. 

Practice Makes Perfect

Remember, talking about research takes practice. If this is something you would like to improve on, there are many continuing education classes on varying research topics. For example, Education and Training Solutions, Inc. has a low-cost, high-quality online course on the Basics of Research Literacy. This course covers how to access research literature, evaluate it, and bring it into your practice.  

Another great way to practice talking about research findings is to form a journal club with other people, such as other massage therapists in your community. A journal club is very similar to a book club, but the participants all read the same research article rather than a book. The discussions within a journal club can be very helpful because everyone looks at research studies from a different viewpoint. Other people’s opinions may help open your eyes to pros or cons you may not have noticed. 

The bottom line is that discussing research findings with clients may lead to a better understanding of their health care and a greater appreciation for you as an evidence-informed therapist. Doing the work to find out more about a study will elevate your understanding of research, and sharing your understanding with your clients will ensure that everyone wins. 

Jerrilyn Cambron, LMT, DC, MPH, PhD, is an educator at the National University of Health Sciences and president-elect of the Massage Therapy Foundation. Contact her at jcambron@nuhs.edu.

To read this article in our digital issue, click here.