Sealing wax and bits of string Professor Colin P. Bradley

Sealing wax and bits of string
- good outputs from limited inputs
Professor Colin P. Bradley
Professor of General Practice
University College Cork
Half full or half empty?
Two ways of looking at research in
Irish general practice/ primary care
– We have very few
resources so we
can do very little
– We can be
ingenious with our
meagre resources
and do quite a lot
Some examples of ingenious use of
limited resources
 Epidemiology in Country Practice – Pickles,
 The Medical Life History of Families –
Huygen, 1978
 Clinical judgement and antibiotic prescribing
– Howie, 1976
 The consultation and the therapeutic illusion
– Thomas, 1978
 The B-score – Dobbs 1996
Small studies can have a bit impact
 Goffman’s ‘Assylums’
 McBride – letter to Lancet highlighting
thalidomide disaster
 Significant event analysis study
 Uncomfortable prescribing study
Strategies for managing limited
 Keep the study small
– Limiting ambition
 Pilot and exploratory studies
 Hypothesis generation studies - qualitative
 Transfer of setting studies – concept proven
elsewhere, does it work here?
 Using non-research resources for research
 Collaboration – other practices, settings,
researchers – international collaborations
 Secondary research e.g. systematic reviews
Some take home messages
 You must cut your coat to suit your cloth
– Studies have to be scaled to answer the questions
they pose (power calculations)
 Try to develop questions of a size you can
 Be original
 Be rigorous/ thorough
 Do the best research you can with whatever
resources you have
 Qualitative research is a good option but not a
complete solution