Research methods and methodology in telemedicine

In this issue, we introduce a new section of the journal – a series of articles about methods and methodology in telemedicine research. As researchers come to telemedicine from many different disciplines, the purpose of this collection is to provide a concise introduction to the variety of issues investigators face when designing and conducting research and evaluation in this field. They are intended to cover the spectrum from resources for new researchers, to exploring innovative methods which might further high quality research.

The quality of evidence in telemedicine research has been critiqued by many authors. Ekeland et al.’s review of reviews of methodology in telemedicine found gaps ranging from the lack of larger controlled trials to underdeveloped use of qualitative methods and implementation research. ¹ Large numbers of short-term studies with few participants, plus a failure to adequately describe the intervention, are noted by a recent review of reviews on quality and safety in telemedicine. ² Recent reviews in specific areas such as heart failure and chronic lung disease, ³ telestroke ⁴ and mental health, ⁵ continue to point out methodological concerns with the majority of primary studies.

Initially, we will be covering the following areas: choosing a theoretical framework, developing research questions, research design and statistical analysis, conducting method comparison studies, measuring the societal impact of telemedicine, survey selection and attitude measurement, mixed methods and participatory design research. In a more systematic and multidisciplinary approach to telemedicine evaluation, we also take a look at an assessment framework developed by European researchers, named the Model for Assessment of Telemedicine (MAST). The MAST comprises a range of domain areas (such as safety, clinical effectiveness and economics), and is intended to help guide the measurement of effectiveness and quality of care. ⁶

Our aim is not to replicate the extensive existing literature on research guidelines and methods, but to add to these resources with information and examples that are specific to telemedicine and to offer recommendations for research practice.

Both methods and methodology will be included. Methods are the sets of tools or processes that are utilised to conduct the research, such as sampling procedures, survey instruments or statistical tests; whereas methodology concerns the underlying principles that guide the researcher in such matters as constructing the study design or deciding which outcomes should be measured. In choosing a methodology, the researcher decides what type of knowledge is important and aligns with one or more theoretical frameworks. As this is fundamental to research planning, and is often not considered in enough depth at the commencement of a research project, an article by Wade, Gray and Carati on the use of theory in telemedicine research introduces the series of articles. ⁷

This collection will be presented initially in collaboration with the Centre of Research Excellence in Telehealth and the Centre for Online Health ⁸ at The University of Queensland; however, telemedicine researchers around the world are encouraged to propose topics that might fit within this domain. Additionally, the Education and Practice section of the journal will be rejuvenated, and we invite articles in this category that reflect the expansion of the scope of telemedicine resulting from technological, clinical and health systems change. In either case, please communicate with the editor-in-chief before submission.