The purpose of this paper is to discuss important methodological issues that must be considered in planning and implementing clinical evaluation research in occupational therapy. The experiences of the authors in conducting a multi-centre intervention trial are used to illustrate issues and decisions which can both enhance the scientific integrity of clinical research while maint a ining its feasibility.
Methodological issues include choice of research design, identification of significant confounding variables, subject selection and enrollment, incidence-prevalence bias, selection of appropriate and responsive outcome measures, maintenance of treatment consistency and compliance, and “masked” evaluation of outcomes. Attention to these issues will increase the methodological quality of occupational therapy evaluation research and improve the credibility of its results.
CoxD.R. (1958). Planning of experiments. London: Wiley & Sons.
7.
CurrierD. (1984). Elements of research in physical therapy, second edition. Baltimore: Williams & Wilkins.
8.
DeMatteoC.LawM.RussellD. (1988, June). QUEST — Quality of upper extremity skills test. Presented at the Canadian Occupational Therapy Conference, Kitchener, ON.
9.
FolioR.FewellR.DuBoseR.F. (1983). Peabody Developmental Motor Scales. Toronto Teaching Resources.
10.
FriedmanL.M.FurbergC.D.DeMetsD.L. (1984). Fundamentals of clinical tri als. Boston: John Wright, PSG Inc.
11.
JenkinsJ.R.SellsC.J.BradyD.DownJ.MooreB.CarmanP.HolmR. (1982). Effects of developmental therapy on motor impaired children. Physical and Occupational Therapy in Pediatrics, 2, 19–28.
12.
LawM. (1987). Measurement in occupationa therapy: Scientific criteria for evaluation. Canadian Journal of Occupational Therapy, 54, 133–138.
13.
KirshnerB.GuyattG. (1985). A methodological framework for assessing health and disease. Journal of Chronic Disease, 38, 27–36.
14.
KleinbaumD.G.KupperL.L. (1978). Applied regression analysis and other multivariate methods. Boston: Duxbury Press.
NeyrnanJ. (1955). Statistics — servant of all sciences. Science, 122, 401.
17.
OttenbacherK.J. (1986). Evaluating clinical change: strategies for occupational and physical therapists. Baltimore: Williams and Wilkins.
18.
OttenbacherK.J. (1987). Research: Its importance to clinical practice in occupational therapy. American Journal of Occupational Therapy, 41, 213–215.
19.
OttenbacherK.ShortA.WatsonP.J. (1981). The effects of a clinically applied program of vestibular stimulation on the neuromotor performance of children withsevere developmental disability. Physical and Occupational Therapy in Pediatrics’, 1, 1–11.
20.
OttenbacherK.PetersenP. (1985). Quantitative trends in Occupational Therapy research: Implications for practice and education. American Journal of Occupational Therapy, 39, 240–246.
21.
OttenbacherK.BioccaZ.DeCremerG.BevelingerM.JedlovecK.B.JohnsonM.B. (1986). Quantitative analysis of the effectiveness of pediatric therapy. Emphasis on the neurodevelopmental treatment approach. Physical Therapy, 66, 1095–1101.
22.
OttenbacherK.J.BonderB. (1986). Scientific inquiry: design and analysis issues in occupational therapy. Rockville: American Occupational Therapy Foundation.
23.
OysterC.K.HantenW.P.LlorensL.A. (1987). Introduction to research: A guide for the health science professional. New York: Lippincott.
24.
PalisanoR.J. (1986). Concurrent and predictive validities of the Bayley Motor Scales and the Peabody Developmental Motor Scales. Physical Therapy, 66, 1714–1719.
25.
PocockS.J. (1985). Statistics in medicine: Current issues in the design and interpretation of clinical trials. British Medical Journal, 290, 39–42.
26.
SackettD.L. (1979). Bias in analytic research. Journal of Chronic Disease, 32, 51–63.
27.
SackettD.L.HaynesR.B.TugwellP. (1986). Clinical epidemiology: A basic science for clinical medicine. Toronto: Little, Brown.
28.
SussmanM.D.CusickB. (1979). Preliminary report: The role of short leg tone reducing casts as an adjunct to physical therapy of patients with cerebral palsy. John Hopkins Medical Journal, 145, 112–114.
