|METHODS OF HEALTH AND MEDICAL RESEARCH
|LA Simeonov: Proceed 24th Natl TB & Chest Dis
Workers Conf, Trivandrum, 1969, 315-18.
The objective of any research is to establish the
truth. According to the subject which is being studied here, the
following three levels of sciences can be distinguished: (i) The
physical sciences which have their objective as non- living in nature.
They include Astronomy, Physics, Chemistry etc. Their application
in health includes technology of drugs and tools of diagnosis and
treatment. (ii) The biological sciences deal with living things
including human beings. Medical science represent an application
of these sciences to the protection of health and the cure from
diseases. (iii) The social sciences which have human society as
their objective include Sociology, History, Economics. Their
application to health problems is known as public health.
All three levels of sciences are linked. Disciplines
which are situated on a higher level deal with much more complicated
systems than disciplines on a lower level. There is also a difference
in the levels of sophistication of the different systems coming
within the scope of the same group of sciences. Less sophisticated
systems are included in the more sophisticated and represent their
sub systems. For instance, treatment is a sub system of the control
of a communicable disease; sputum examination is a sub system of
Case-finding etc. Research in health is being done on the basis
of data collected by observation of real conditions or in experiments.
The design of the experiment depends upon the complexity of the
system under observation and on the possibility of observing one
or more factors of the system (variables) after isolation or equalization
of the other variables or in their full complexicity. In the field
of physical sciences and technology there are very good possibilities
for isolation of all variables except those which are under study.
This is done in the simple testing of urine for the content of INH,
or in similar tests. In medicine and biology it is
impossible to isolate all variables without introducing bias; therefore
a control group is needed in which all other factors (which are
not being studied) are equalized. This is being done in controlled
trials laboratory or clinical.
Epidemiologic observations are carried out with
different tools; clinical (sputum or X-ray examination, tuberculin
test); sociological (interview); physical (measurements),
etc. They represent a method which is closer to real life, but they
consider only one aspect (sub system) of a community health problem
i.e., the trend of the disease without taking care of all other
factors which play a role in the determination of this trend, such
as economic and cultural variables, behaviour, health services etc.
The highest level of research at present represents the systems
analysis (operations research). This method has as its objective
the study of all variables (or "key variables" at least)
which are involved in a public health problem. Such a problem is
being simulated by a system of functions (model) and "optimized"
(solved) by a computer. The use of mathematics is necessary for
the application of these four research methods.
|KEY WORDS: METHODS, MEDICAL RESEARCH, HEALTH
RESEARCH, SYSTEMS ANALYSIS, OPERATIONS RESEARCH.