Evaluating Research Questions, Hypotheses, and Quantitative Research Designs

The study by Flynn et al. (2013) is a quantitative retrospective cohort study conducted to determine what types of patients were visiting the primary care, express care and emergency department of a group practice facility over the course of a year. Patient typology was based on whether the individual required an interpreter or not and whether the patient had mental health issues. Flynn et al. (2013) stated that the purpose of their study was “to examine health care utilization patterns of adult outpatients requiring interpreters, with a focus on the PC [primary care] setting” (p. 387). They alsos identified a secondary aim, which they described as “to compare frequencies of mental health diagnoses and somatic symptoms between patients requiring interpreters and those not requiring interpreter services” (Flynn et al., 2013, p. 387). No specific research question was identified in the study, but a hypothesis was stated along with the purpose statement made by the researchers. Flynn et al. (2013) hypothesized that “patients requiring interpreters would have a greater number of visits/encounters over the study period, as compared to patients not requiring interpreters” (p. 387). Neither a null nor an alternative hypothesis was provided. The hypothesis does, however, specify the sample for the study. The purpose and hypothesis aligned with the design of the study and the method used to obtain data for analysis.
The method used to obtain data to examine a 1 year time period at Mayo Clinic in Rochester, Minnesota. Visits were counted for adult patients (18 years +) who had one or more outpatient visit to the Clinic’s facilities over the 1 year time period. Visits were counted via the electronic ID affixed to every visitor to the Clinic and obtained from electronic medical records maintained by the Clinic. Multivariable linear regression was used to analyze the data once it was obtained.
The alignment of theory, problem, purpose and research aim, design and hypotheses was described well by the researchers well in the introduction to the study. They supplied a clear rationale for their methods and approach and used suitable evidence to justify why they were conducting the study in this manner. They noted that “language can be a meaningful barrier to health care access for individuals with limited English proficiency, including immigrants and refugees” (Flynn et al., 2013, p. 386). They also noted that they were filling a gap in knowledge about the patterns of hospital visits made by individuals requiring interpreters vs. non-interpreter needing patients, as well as by patients with a mental health diagnosis.
The researchers did not highlight a specific theory underlying their hypothesis or point to a particular framework that they used when developing their design. Because the design was a simple retrospective cohort study—i.e., a study in which the researchers simply looked at the numbers and categories of patients visiting the Clinic over the course of the year—it was not exactly experimental or the type of study that looks at specific variables to see how they impact one another. However, the study did indicate that predictive variables may be identified from the Clinic’s point of view: individuals needing interpreters could be a predictive variable in terms of how many primary care visits the Clinic could expect. This information could be useful in determining what steps the Clinic should take to prepare for these visits. For that reason, the cohort design was aligned with the problem (a lack of information on patterns of visits) and the purpose and hypothesis stated.
References
Flynn, P. M., Ridgeway, J. L., Wieland, M. L., Williams, M. D., Haas, L. R., Kremers,
W. K., & Breitkopf, C. R. (2013). Primary care utilization and mental health diagnoses among adult patients requiring interpreters: A retrospective cohort study. Journal of General Internal Medicine, 28(3), 386–391. doi: 10.1007/s11606-012-2159-5