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Posts from the ‘Research’ Category

Evaluating Web (and other) resources


In just the past few short years, the World Wide Web has become like a physical library.  Academic libraries, to a significant degree, now provide journal articles

WWW imageto their constituents as PDF files, replacing the old, large, and very popular “copy machine” room housed in their physical spaces.  A natural extension of this is the use of material “published” on the web as a resource not unlike that accessed through an academic library.

The developer of the Web (and current director of W3C, the organization that oversees Web standards) Tim Berners-Lee, established a vision of the World Wide Web as a valuable tool that would democratize knowledge, making access to valuable information accessible to all regardless of wealth, social standing, race, or any other factor. However, in many academic circles, Web resources are still regarded with skepticism and Web articles are not considered valid scholarly resources, except where a Web site is itself the subject of the investigation or is used to make a particular point.

Rather than simply dismiss Web resources, it is time to recognize the Web and its wealth of information as an opportunity to sharpen our abilities to discern a valid resource from one that is less than valid, and to refine the criteria by which we make this assessment.  Indeed, as the management team of the popular Wikipedia.org clearly states in their own guidelines on “Researching with Wikipedia”, the veracity of information published in the Wikipedia should be judged in ways similar to standards used for any other resource.

Here are “ABCSS” guidelines that I recommend in deciding on the credibility of any resource, web or otherwise:

Agency.  Is the author of the work clearly identified? Are the author’s professional affiliations and qualifications clearly identified? Is there a clearly identified way for me to contact the author if I have questions or concerns about the work? 

Bias.  Everything has a bias!  Does the author identify their perception of their own perspective on the subject?  What bias, standpoint, or perspective is implicitly embedded in the work?  How does bias potentially shape or influence what is published?

Corroboration.  How does the information in this source compare to what I find in other resources?  If it is wildly at odds with other resources, and the source can be identified as having value for my work, how can I explain the difference? 

Sponsorship.  Is the work sponsored, funded, or “commissioned” by an organization of any kind?  If so, what is the nature of that organization and do they have an explicit or implicit interest in what is published?

Scholarly value.  Do the methods used and the logic presented meet generally accepted standards of investigation, ethics and logic?  Are the sources that the author used clearly identified, and can I trace those sources accurately?

In fact, in my view the Web actually has greater power to demonstrate each of these guidelines much more explicitly than does print media.  Print media is limited by space and cost constraints that greatly constrain the kind of background information that is important to fully understand the worth of that which is published.  

In evaluating Web resources, I believe we can and should expect each and every one of the ABCSS to be clearly evident.  If they are not, unless there is some strong justification otherwise, the source needs to be eliminated from serious consideration.  What are your thoughts, and what shifts might you recommend for the ABCSS guidelines?  

Nurse scholars shape the future – funding opportunities pending


The groundbreaking report release last fall by the Institute of Medicine and the Robert Wood Johnson Foundation on the Future of Nursing.  This report provides a blueprint for action to shape a stronger, more effective nursing presence in health care.   It also opens doors of opportunity for nurse scholars. Nurse researchers played a key role in shaping the substance of the report, and in the months ahead, the Robert Wood Johnson Foundation will publish a national research agenda based on the report’s recommendations.  You can sign up for alerts on funding opportunities related to this agenda at www.rwjf.org.

I recently invited Lori Melichar and Susan B. Hassmiller to share their thoughts about the role of nurse scholars in fulfilling to vision of the future that the report sets forth.
Here is their message for the ANS blog:

Nurse researchers played a crucial role in producing the evidence that resulted in the recommendations from the landmark Institute of Medicine report, The Future of Nursing: Leading Change, Advancing HealthNow they must play Read more

New paper in Journal of Healthcare Risk Management


Just had my latest paper published in the Journal of Healthcare Risk Management:

Cox, T. (2011), Exposing the true risks of capitation financed healthcare. Journal of Healthcare Risk Management, 30: 34–41. doi: 10.1002/jhrm.20066

The key points:

Small insurers are inefficient insurers: They have lower probabilities of achieving modest profit goals, higher probabilities of incurring operating losses, and higher probabilities of Insurance "not allowed"insolvency than larger insurers when both randomly select policyholders from the same populations.

Small insurers also have to cut benefits to match larger insurer’s probabilities of achieving modest profit goals, avoiding operating losses, and avoiding insolvency.

Despite this, and the obvious impact it has on service quality and quantity, almost every proposal for trimming health care costs assumes Read more

Regulating Medical Loss Ratios


I was just thinking about a new paper in the American Journal of Managed Care:

—————————————————————————————————————————————————
Regulating the Medical Loss Ratio: Implications for the Individual Market
Jean M. Abraham, PhD; and Pinar Karaca-Mandic, PhD
(Am J Manag Care. 2011;17(3):211-218)

“Results:In 2009, using a PPACA-adjusted MLR definition, we estimated that 29% of insurer-state observations in the individual market would have MLRs below the 80% minimum, corresponding to 32% of total enrollment. Nine states would have at least one-half of their health insurers below the threshold. If insurers below the MLR threshold exit the market, major coverage disruption could occur for those in poor health; we estimated the range to be between 104,624 and 158,736 member-years.”Conclusion: The introduction of MLR regulation as part of the PPACA has the potential to significantly affect the functioning of the individual market for health insurance.”————————————————————————————————————————

The Robert Wood Johnson Foundation thought enough of it to post it on their website and I did a post over there

http://www.rwjf.org/coverage/product.jsp?id=72089&cid=XEM_910232#disqus_thread

but sometimes they don’t like them, so I’ll edit it and redo it here because I think Read more

Social Media for Researchers


Here’s a well-kept secret — there are actually many nurses using all forms of social media for a host of different purposes!  And, I am aware that the “internet” in general has become a very useful tool for nurse researchers.  But have we tuned in to what social media can really offer?  I am actually not sure!  This resource – “Social Media for Researchers” came to my attention today on Twitter!  Check it out …. even if you do not consider yourself a “researcher” (yet), this is a resource you will not want to pass up.  Check it out – http://bit.ly/ekgWfS