Lizzie1990
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'm currently in my 3rd year of a radiography degree and we are required to submit a research proposal on any aspect that relates to radiography (imaging modalities, patient care within departments, recruitment methods etc). I'm having trouble finding an area that really interests me and was wondering if there's any aspects that would interest you in a research proposal. We don't have to carry out the research but we have to decide how we would carry it out (RCT's for example). Any help/ideas would be appreciated!
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evantej
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(Original post by Lizzie1990)
'm currently in my 3rd year of a radiography degree and we are required to submit a research proposal on any aspect that relates to radiography (imaging modalities, patient care within departments, recruitment methods etc). I'm having trouble finding an area that really interests me and was wondering if there's any aspects that would interest you in a research proposal. We don't have to carry out the research but we have to decide how we would carry it out (RCT's for example). Any help/ideas would be appreciated!
I am not a radiographer but another AHP student. Perhaps a proposal on the cost effectiveness of different imaging modalities for a particular disease? For example, gold standard investigation identifies cancer X 90% of the time and costs £10,000 whilst another investigation identifies cancer X 80% of the time but only costs £5000. Are the risks of reduced sensitivity (80<90%) worth the savings generated by the other patients?
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Lizzie1990
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Thanks for your reply that does seem a good area to do complete a research proposal. What sort of ideas would you recommened i could talk about in order to gaining this information like surveys? Thanks
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evantej
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(Original post by Lizzie1990)
Thanks for your reply that does seem a good area to do complete a research proposal. What sort of ideas would you recommened i could talk about in order to gaining this information like surveys? Thanks
It would either have to be a systematic review where you look at studies which have evaluated the (cost) effectiveness of different methods already or you could set up your own study. You would not conduct a survey because clinicians are prone to bias and often use methods with little known rationale (e.g. because they were taught to use it, because it has always been used, because it is the only one available). You might think this does not apply to radiotherapy but think about about the methods you use. For example, is doing an x-ray on the ward the best way to assess a patient or do you do it because you have to be practical?

If you were to set up your own study you would have to recruit a consecutive number of patients suspect of disease X. Radiographer 1 administers the assessment you want to test first then radiographer 2 administers the normal assessment that would be used. Ideally you need separate radiographers who are blind to one another to avoid bias. You then compare how accurate the new test was against the one normally used. I do not know enough about radiography methods to know whether there is this sort of scope in your practice so I will use an example from my profession which you should be able to appreciate.

100 patients
70 with dysphagia
30 without dysphagia

SLT conducts a bedside swallowing assessment and says 60 patients have dysphagia (50 had dysphagia and 10 did not). All of these patients then go for a joint videofluroscopy session between a radiographer and a separate SLT who say 65 patients have dysphagia (60 had dysphagia) and 35 did not. You compare how well the bedside swallowing assessment identifies the same patients the joint videofluroscopy session did with dysphagia and how many mistakes it made (inappropriate referrals in the real world). The stats show that the bedside assessment actually has pretty decent sensitivity (0.92). This means the SLT is identifying the same patients with dysphagia as the joint videofluroscopy session. However, the specificity is lower (0.71). This means in the real world the SLT is referring a certain number of patients without dysphagia for a videofluroscopy and effectively wasting time and money (if you want to think of it like that).

The clinical context makes all the difference on whether you value sensitivity, specificity, and how much error is acceptable. For a radiographer I imagine sensitivity is paramount as you would rather have false positives (i.e. patient undergoing uncessary tests/treatments) than miss cases of cancer and people die for example.

Some things are politically driven. Consider smear tests. A smear test is definitely cheaper than getting every woman to have a colposcopy. But given the prevalence of cervical cancer is asking every female in the UK to have a smear test reasonable and/or a good use of money? This is where you could use this sort of research to prove that actually smear tests are not really sensitive/specific (i.e. how many women who develop cervical cancer are actually picked up at the screening stage? hard to say as lots of treatment might be pre-emptive so you will never know). It might actually be better not to test everyone, let the women who get cervical cancer to present 'normally', and use the money for screening breast or prostrate cancer which are far more prevalent.

If you are interested in this sort of research then the first step is probably to think about which kind of patient group you have enjoyed working with and then looking at the different assessments that are currently used with them.
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