Metodologa

de la
Investigacin
I.
Planeacin del proyecto: De
la idea al
Dr. Osman protocolo.
David Acosta Ortega
Pediatra del HGZ No. 6 Ciudad Valles
SLP
Marzo 2017
Unidad 1:
Introduccin a la
Metodologa de la
Investigacin
Objetivo especfico:

Contrastar los diferentes tipos y diseos de

investigacin analizando sus caractersticas
para adaptar la temtica elegida a un
proyecto de investigacin.
Contenido:

Introduccin al mtodo
cientfico
Tipos de Investigacin
Diseos de investigacin
Eleccin del tema de
investigacin
Qu es el mtodo
cientfico?

Conjunto de abordajes, tcnicas y

procesos utilizados por la ciencia para
formular y resolver problemas y
adquirir de manera objetiva y
sistemtica nuevos conocimientos.
 Qu es el mtodo
cientfico?
La investigacin cientfica no sigue un
camino lineal:

Maniobra
Observaci Pregun Hiptes Conclusi
de
n ta is n
investigaci
n
Qu es el mtodo
cientfico?
Sino un ciclo de retroalimentacin
(Refutacin y replanteamiento):

Pregun Hiptes
ta is
Observaci Maniobra
n de
investigaci
Refutaci Conclusi n
n n
Etapas de la
Investigacin:
Protocolo de
Planificaci Investigacin
n

Trabajo de
Ejecucin Campo y
Anlisis de
datos

Tesis, Cartel,
Publicaci Congreso,
n Internet, Revista
El principio de todo....

Qu
Investigar?
 Bases moleculares, Investigacin

Investigacin
bioqumicas o celulares de Bsica o

Biomdica
la enfermedad Preclnica
Prevencin, diagnstico o Investigacin
tratamiento de la
Clnica
enfermedad
Salud pblica y servicios de Investigacin
salud epidemiolgica

Implementacin de Investigacin
programas o procesos de Operativa
trabajo
Educacin Mdica y Investigacin
educacin a pacientes Educativa
 Investigacin
Bsica o
Preclnica

Pediatr Infect Dis J. 2016 Nov;35(11):e326-e338.

Viral Bronchiolitis is Associated With Altered Cytokine Gene Expression and

Lymphocyte Activation Status.
Leahy TR1, McManus R, Doherty DG, Grealy R, Carr MJ, Slattery D, Ryan T.

Abstract
BACKGROUND: Disease severity in viral bronchiolitis is often difficult to predict at onset, and may be related to the
host immune response. Recognizing the particular immunologic features of infants who develop severe disease
might offer an opportunity for developing diagnostic tools to facilitate early intervention and improve outcomes.
METHODS: We compared cytokine gene expression (by real-time reverse-transcriptase polymerase chain reaction),
cytokine concentrations (by enzyme-linked immunosorbent assay) and the activation status of lymphocytes (by flow
cytometry) in the peripheral blood of children hospitalized with moderate and severe viral bronchiolitis and a group of
age-matched controls.
RESULTS: Analysis was undertaken on 57 children with viral bronchiolitis and 33 controls. Interleukin-7 mRNA
expression at enrollment in peripheral blood mononuclear cells differed significantly between those with moderate
and severe bronchiolitis, and correlated with both the subsequent length of hospital stay and need for supplemental
oxygen therapy. Serum interleukin-10 concentration also distinguished moderate from severe disease. Participants
with viral bronchiolitis demonstrated a more activated -T cell phenotype (V1+), but a more naive TCR -T cell
compartment compared with controls.
CONCLUSIONS: Viral bronchiolitis is characterized by a distinct pattern of cytokine expression and lymphocyte
activation. These changes suggest an inadequate innate response in severe disease, and may offer potential as
markers of disease severity.
PMID: 27434830 DOI: 10.1097/INF.0000000000001299
 Investigacin
Clnica

Pediatrics. 2015 Jun;135(6):e1399-408. Epub 2015 May 18.

Validity of bronchiolitis outcome measures.

Fernandes RM1, Plint AC2, Terwee CB3, Sampaio C4, Klassen TP5, Offringa M6, van der Lee JH7.

Abstract
BACKGROUND: The Respiratory Distress Assessment Instrument (RDAI) and Respiratory Assessment Change Score
(RACS) are frequently used in bronchiolitis clinical trials, but evidence is limited on their measurement properties. We
investigated their validity, reliability, and responsiveness.
METHODS: We included data from up to 1765 infants with bronchiolitis enrolled in 2 studies conducted in pediatric
emergency departments. We assessed RDAI construct validity by testing hypotheses of associations with physiologic
measures (respiratory rate, oxygen saturation) and with constructs related to hospitalization, using correlation
coefficients, and multivariable analysis. RDAI/RACS responsiveness was evaluated by using anchors of change based
on these constructs; measures of responsiveness included the area under the curve. RDAI test-retest agreement and
interrater reliability were evaluated by using limits of agreement and intraclass correlation coefficients.
RESULTS: Baseline RDAI scores were weakly correlated with respiratory rate (r = 0.38, P < .001), and scores
increased in lower oxygen saturation categories (P < .001). Higher RDAI scores were associated with hospitalization
(odds ratio: 1.36; 95% confidence interval: 1.26-1.47); scores differed between participants who were discharged,
admitted, or stayed in the emergency department (P < .001). Our hypotheses were met, but the magnitude of
associations was below our predefined thresholds. RDAI test-retest limits of agreement were -3.80 to 3.64 (20% of the
range), whereas interrater reliability was good (intraclass correlation coefficient = 0.93). Formulated hypotheses for
responsiveness were confirmed, with moderate responsiveness (area under the curve: RDAI, 0.64-0.70; RACS, 0.72).
CONCLUSIONS: RDAI has poor to moderate construct validity, with good discriminative properties but considerable
test-retest measurement error. The RDAI and RACS are responsive measures of respiratory distress in bronchiolitis
but do not encompass all determinants of disease severity.
PMID:25986025 DOI: 10.1542/peds.2014-3557
 Investigacin
Clnica

Med J Islam Repub Iran. 2015 May 6;29:212. eCollection 2015.

Therapeutic effects of Ventolin versus hypertonic saline 3% for acute

bronchiolitis in children.
Zamani MA1, Movahhedi M2, Nourbakhsh SM3, Ganji F4, Rafieian-Kopaei M5, Mobasheri M6, Khoshdel A7, Etemadifar S8, Shirani M9, Keivani
Hafshejani Z10.

Abstract
BACKGROUND: Complications of Ventolin as the most common drug used for bronchiolitis are widely known.
The present study was conducted to determine the efficacy of hypertonic saline 3%, compared with Ventolin, for
treatment of acute bronchiolitis in children.
METHODS: This double-blinded clinical trial study was conducted in Hajar Hospital, Shahrekord, Iran, from 2011
to 2012. A total of 70 patients under the age of two years with bronchiolitis were divided into two groups of 35
each. Ventolin nebulizer and hypertonic saline 3% nebulizer three times per day were administered in the first
(Ventolin) and second (Hypersaline) group, respectively. The length of recovery was compared between the two
groups. The data were analyzed by SPSS software (version 22) using chi-square, t-test, paired t-test, and Mann-
Whitney.
RESULTS: The meanSD length of recovery was 4.140.9 and 3.060.6 in the Ventolin and hypersaline groups,
respectively. The mean duration of recovery was significantly lower in the hypersaline group (p<0.001).
CONCLUSION: Hypertonic saline 3% nebulizer has more pleasant therapeutic effects on acute bronchiolitis than
Ventolin. Therefore, use of hypertonic saline 3% nebulizer is recommended for the treatment of acute
bronchiolitis in children under two years old.
PMID: 26478870 PMCID: PMC4606955
 Investigacin
epidemiolgic
a

Enferm Clin. 2013 Jul-Aug;23(4):160-3. doi: 10.1016/j.enfcli.2013.06.002. Epub 2013 Aug 6.

The most prevalent environmental risk factors in respiratory syncytial virus

bronchiolitis in infants from 0 to 24 months in a seasonal study performed
in two hospitals.
Len-Carrillo B1, Baldris-Catafau J, Jimnez-Martnez S.

Abstract
OBJECTIVE: Our aim is to describe the environmental aspects of children between 0 and 24 months, who
arrived in the Emergency Department of the Hospital General de Catalua and Hospital Parc Tauli (both within
Barcelona province), and were diagnosed with respiratory syncytial virus bronchiolitis from November 2010 to
February 2011.
METHOD: A cross-sectional observational study was conducted on children of both sexes, with ages from 0 to 24
months, and diagnosed with bronchiolitits respiratory syncytial virus +. Data was obtained by completing a non-
validated questionnaire, with information provided by parents and the medical history.
RESULTS: The most common features in the study were: a mean age of 3.8 months, most were males, with
siblings of school age, mothers who did not smoke during pregnancy, were in a non-smoking environment in their
home, and finally, less than 5 people living together in their home.
CONCLUSIONS: The most common risk factors n order of prevalence were, having siblings of school age, male
sex, and living in smoking environment. It was observed that the majority of children had risk associated factors
associated, with only 8.2% of samples not presenting any risk factors.
PMID: 23928150 DOI: 10.1016/j.enfcli.2013.06.002
 Investigacin
Operativa

An Pediatr (Barc). 2013 Sep;79(3):167-76. doi: 10.1016/j.anpedi.2013.01.015. Epub 2013 Mar 6.

Management of acute bronchiolitis in spanish emergency wards: variability

and appropriateness analysis (aBREVIADo project).
Ochoa Sangrador C1, Gonzlez de Dios J; Grupo Investigador del Proyecto aBREVIADo (BRonquiolitis-Estudio de Variabilidad, Idoneidad y
ADecuacin).

Abstract
INTRODUCTION: The management of acute bronchiolitis (AB) is controversial. The aim of this multicenter
nationwide study in Spain is to determine the variability in the management of AB in Primary Care centers.
METHODS: A cross-sectional observational study (from October 2007 to March 2008) was conducted on all cases
of AB (McConnochie criteria) seen in a sample of 60 Health Care Centers from 11 regions of Spain, who did not
require hospital admission. A comparison between autonomous communities was made.
RESULTS: A total of 940 cases were collected. It was found that there was a low use of diagnostic tests, although
with significant differences between communities. There was an excessive use of inhaled (64.1%) or oral (17.8%)
beta 2-adrenergics, and to a lesser degree of corticosteroids (25%) and other treatments of unclear efficacy
(antibiotics, bronchodilators, oral, inhaled corticosteroids, ipratropium bromide, etc...). The treatment methods in the
different communities varied significantly. In the acute phase there was an inappropriate use of treatments in 74.8%
of cases, and in 47.4% in the maintenance phase.
CONCLUSIONS: There are discrepancies between routine practice and evidence-based management of outpatient
AB, due to a wide use of inappropriate treatments. The variability in the prescription of bronchodilators or steroids
between communities shows the lack of justification and there is scope for improvement.
PMID: 23481463 DOI:10.1016/j.anpedi.2013.01.015
 Investigacin
Educativa

Arch Dis Child. 2015 Jul;100(7):654-8. Epub 2015 Apr 17.

Using multifaceted education to improve management in acute viral

bronchiolitis.
Murch H1, Oakley J2, Pierrepoint M3, Powell C4.

Abstract
OBJECTIVE: To establish current bronchiolitis management across hospitals in Wales, improve compliance with
national guidelines and standardise evidence-based clinical practice.
DESIGN: A complete audit cycle with implementation of a multifaceted education bundle prior to the follow-up audit.
SETTING: Twelve acute paediatric departments between 1 November and 31 December in 2012 and 2013.
PATIENTS: All infants under 12 months with a clinical diagnosis of bronchiolitis.
INTERVENTIONS: The first audit assessed management of bronchiolitis with reference to both the Scottish
Intercollegiate Guideline Network (SIGN) guidelines and local hospital guidelines. Following analysis and dissemination
of these results, an education bundle was implemented nationwide, with completion of the audit cycle to assess change.
MAIN OUTCOME MEASURES: Compliance with SIGN recommendations for investigation, treatment and discharge.
Compliance with the education bundle requirements also assessed in 2013.
RESULTS: Data were collected for 1599 infants. The education bundle was delivered in all hospitals. The level of
severity, defined by oxygen saturations in air at presentation, length of stay and paediatric intensive care unit transfers,
was equivalent for both years. Mean compliance percentage (95% CI) across Wales significantly improved between
2012 and 2013, with compliance with investigations increasing from 50% (46% to 53%) to 71% (68% to 74%), with
management increasing from 65% (61% to 68%) to 74% (71% to 77%), and overall compliance improving from 38%
(37% to 39%) to 59% (56% to 62%) in 2013.
CONCLUSIONS: This audit demonstrated a significant improvement in compliance following implementation of our
educational bundle. This has enabled improvement in standardised and evidence-based patient care across Wales.
PMID: 25888695 DOI: 10.1136/archdischild-2014-307353
La
inspiracin..
.

Ciencia sin seso,

locura doble
Baltasar Gracin
 Qu quiero
obtener con
Cul es el Cmo lo voy
mi
problema? a hacer?
investigacin
?

Cul es mi
hiptesis? Cules
Cul es el podran ser
sustento mis
terico? conclusiones
?
 Qu quiero
obtener con
Cul es el Cmo lo voy
mi
problema? a hacer?
investigacin
?
Mi Objetivo:
Mi Pregunta: Determinar la eficacia de
Es ms efectiva la la solucin salina
solucin salina hipertnica nebulizada Mi diseo:
hipertnica para el tratamiento de la Ensayo clnico
bronquiolitis en
nebulizada para el comparacin al
tratamiento de la salbutamol nebulizado
bronquiolitis en Mi hiptesis:
comparacin al La solucin salina
salbutamol hipertnica nebulizada es
ms eficaz para el
nebulizado? Cul es mi
tratamiento de la
hiptesis? Cules
bronquiolitis que el
Cul es el salbutamol nebulizado
podran ser
sustento mis
terico? conclusiones
?
 Mi Objetivo:
Mi Pregunta: Determinar la eficacia de
Es ms efectiva la la solucin salina
solucin salina hipertnica nebulizada Mi diseo:
hipertnica para el tratamiento de la Ensayo clnico
bronquiolitis en
nebulizada para el comparacin al
tratamiento de la salbutamol nebulizado
bronquiolitis en Mi hiptesis:
comparacin al La solucin salina
salbutamol hipertnica nebulizada es
ms eficaz para el
nebulizado? tratamiento de la
bronquiolitis que el
salbutamol nebulizado
Cuestionars
e...

Es aplicable?
Aporta
conocimiento?
Vale la pena?
... Y ahora....

Cmo
Investigar?
Enfoques y Diseos de
investigacin
 Enfoques de
investigacin
Investigacin
Cuantitativa

Investigacin
Cualitativa
 Objetiv
a
Patrn predecible y
estructurado
Investiga
cin Admite subjetividad
Razonamiento
deductivo
Cuantitat
Interpretacin Investiga
iva Patrn abierto, flexible,
adaptable al trabajo de
externa al
investigador
cin campo
(neutral, imparcial, Cualitativ Razonamiento
no valores o inductivo
creencias
a Interpretacin interna
personales) del investigador
(reconoce valores y
creencias propias)
 Investigacin
Cuantitativa
Proble
ma
concre
to
Revisin
literatura
(Marco
Terico) Contraste de
Hiptesis Creencias con
(Creencia del Observaciones:
investigador)
Creencia =
Observacin Realidad
fenmeno Hiptesis aceptada
(Recoleccin datos y
anlisis estadstico) Creencia
Realidad externa al Realidad
investigador
Hiptesis rechazada
 Investigacin
Cualitativa
Proble
ma
concre
to

Observacin fenmeno
(Recoleccin datos no
numricos)
Realidad internalizada Recopilacin de
al investigador Interpretaciones:

Las hiptesis se
Hiptesis afinan para
(Interpretacin del postular teoras
investigador) o para
compararse a
otras teoras
 Investigacin
Cuantitativa
J Clin Nurs. 2016 Dec 21. doi: 10.1111/jocn.13698. [Epub ahead of print]

Breast-related stereotype threat contributes to a symptom cluster in women

with breast cancer.
Li J1, Gao W 2, Yu LX3, Zhu SY2, Cao FL1.

Abstract
AIMS AND OBJECTIVES: To investigate the prevalence of breast-related stereotype threat and its effects on a
symptom cluster consisting of anxiety, depression and fatigue and on each symptom.
BACKGROUND: The stereotype that breasts are a sign of women's femininity results in patients with breast cancer
fearing diminished femininity and rejection, which may induce psychological problems that co-occur as a symptom
cluster.
DESIGN: Cross-sectional study.
METHODS: A total of 131 patients with breast cancer postmastectomy completed the study. A question measuring
breast-related stereotype threat, the Hospital Anxiety and Depression Scale and the Functional Assessment of
Chronic Illness Therapy-Fatigue Scale were used to assess their breast-related stereotype threat and symptoms of
anxiety, depression and fatigue.
RESULTS: Of the 131 patients who answered the breast-related stereotype threat question, 86 (656%) reported
breast-related stereotype threat. They did not differ significantly in social and clinical characteristics compared with
those without the stereotype, but did report significantly higher levels of the symptom cluster and each symptom
(anxiety, depression and fatigue). The odds ratios of the stereotype were significant for the symptom cluster,
depression and fatigue (odds ratios = 252-398, p < 005).
CONCLUSION: The breast-related stereotype threat was common in patients with breast cancer. There was about a
twofold increase in their risk of experiencing the symptom cluster and symptoms of depression and fatigue.
PMID: 28001333 DOI: 10.1111/jocn.13698
 Investigacin
Cualitativa

Int J Surg Oncol. 2011;2011:132461. doi: 10.1155/2011/132461. Epub 2011 Jun 4.

Psychological problems derived from mastectomy: a qualitative study.

Arroyo JM1, Lpez ML.
Abstract
Advances in treatment of breast cancer have not avoided using mastectomy in all cases, and when this happens, we
are dealing with a woman who is suffering from psychological problems. In order to study this issue we have carried
out a research with the collaboration of The Andalusian Association of Women with Mastectomies (AMAMA) in
Seville, which provided us with a sample of 46 mastectomized women. The objective of this study is to analyze in
depth the psychological reaction of women to mastectomy through its different stages from diagnosis to surgical
treatment. We chose a cualitative method so as to explore the subjective components of psicologycal respons. As a
result, we found in studied women: (a) The "fracture" of the "corporal imaginary" related to the disappearance of a
valuable organ, linked to the feeling of loss of personal attractiveness, low self-esteem and avoidance of social
relationships. (b) The problem with "femininity" has been linked to the issue of "desirability", something innate in the
"feminine position". (c) Many of them keep in mind the idea of mutilation, as a "hole" which is impossible to integrate.
(d) Finally, we demonstrate how certain features of personality made them especially vulnerable to the explained
phenomena.
PMID: 22312492 PMCID: PMC3265278 DOI: 10.1155/2011/132461
 Investigacin
Cuantitativa

Planteamie Desarrollo
La Idea nto del del Marco
problema Terico

Reporte de Visualizar
resultados el alcance

Hiptesis y
Anlisis de definicin
los datos de
variables
Definicin
Recolecci
y seleccin Desarrollo
n de los
de la del diseo
datos
muestra
 Investigacin
Cualitativa

Planteamie Inmersin
La Idea nto del inicial en
problema el campo

Reporte de Desarrollo
resultados del diseo
Revisin literatura
(Marco de Definicin
Interpretac Referencia) de la
in de muestra y
resultados acceso a
ella

Recolecci
Anlisis de
n de los
los datos
datos
 Diseos etnogrficos
Diseos narrativos /
Diseos biogrficos
Diseos
Descriptiv fenomenolgicos
os
Diseos De investigacin-accin
de
Investigac Diseos documentales
in
Cualitativi
ta Diseos de teora
Diseos fundamentada
Interpretat
ivos Diseos de induccin
analtica
 Diseos etnogrficos

Estudio complejo de
un grupo humano.
Diagnsticos y
Cultura, ideas,
tratamientos
creencias,
frecuentes de los
actividades, mdicos tradicionales
relaciones, lenguaje, Prcticas de salud de
etc. las parteras rurales
Recogida de datos:
Observacin
participante,
entrevistas
profundas
 Diseos narrativos /
biogrficos

Construccin de una Como vive su

historia individual o sexualidad una
grupal. sobreviviente de
Hechos, experiencias, mastectoma radical
opiniones. por CA de mama
Vida y obra de la
Recogida de datos:
madre de un
Entrevistas adolescente con
profundas, videos, secuelas profundas
fotos, etc. de asfixia
 Diseos
fenomenolgicos

Estudio de
fenmenos . sociales Acoso escolar desde
desde la perspectiva la perspectiva del
de los actores acosador
Recogida de datos: Maltrato obsttrico
Observacin desde la perspectiva
participante, de las pacientes
entrevistas
profundas
 De investigacin-accin

Estudio en el que el La eficiencia mdica

investigador, con su frente al diagnstico
accin y oportuno de
complicaciones en
participacin,
diabticos e
colabora a la par de implementacin de
un grupo a resolver un modelo de
un problema. atencin integral.
Recogida de datos: Principales factores
Observacin opositores de la
participante, lactancia materna
entrevistas exclusiva y su
profundas, talleres, erradicacin a travs
de la educacin
trabajo de campo
participativa
 Diseos documentales

Meta-sntesis de las
Es la consulta de sugerencias de
documentos: libros, mejora expresadas
revistas, peridicos, por los pacientes de
memorias, anuarios, la UMF No. 3
registros, cdices, Anlisis de opiniones
constituciones, etc. en foros de discusin
El objeto de anlisis en el diplomado para
mdicos generales
son los documentos
Refleja lo que
realmente ha
aprendido?
 Diseos de teora
fundamentada

Pretende generar Cmo adquirieron

teoras (donde no las motivacin y apego
hay) que expliquen al ejercicio los
un fenmeno en su pacientes que han
contexto natural perdido ms del 20%
Se estudia un de su peso corporal?
Anlisis de casos de
fenmeno a travs de
xito.
informantes
 Diseos de induccin
analtica

procedimiento para Factores asociados al

verificar teoras
. y desapego al ejercicio
proposiciones y que condicionan
basadas en datos recidiva y
cualitativos. recuperacin del
Bsqueda activa de peso perdido en
pacientes obesos.
casos o escenarios
que refuten o
verifiquen una teora.
 Poblacin

Maniob Desenl
ra o ace o
Efector Efecto

Diseos
de
Investigac
in
Cuantitati
va
 Transversales o de
Prevalencia
Diseos Cohortes o de
Observacio seguimiento
Diseos nales
Casos y Controles
de
Investigac
in
Cuantitati
Diseos Ensayos clnicos
va
Experiment
ales Cuasi experimental
Transversales o de
Prevalencia
 Transversales o de
Prevalencia

Describen las Prevalencia de

variables en un grupo trastornos
de sujetos en un depresivos en
momento mujeres que sufren
determinado maltrato
No incluye grupo Factores asociados al
abandono del
control Poblacin tratamiento en
No establece
pacientes diabticos
causales ni riesgos Sin
Con
Enfermed Enfermed
ad ad

Sin
Enfermed
Sin ad
Enfermed
ad
Cohortes o de
seguimiento
 Cohortes o de
seguimiento
Se comparan dos
grupos: Uno con un
determinado factor o Diferencias en el
exposicin y el otro sin nmero de cesreas
stos. entre los trabajos de
A lo largo del tiempo se parto inducidos vs los
compara la frecuencia de espontneos
enfermedad (o
desenlace) entre la
poblacin expuesta y la
no expuesta.
Enfermo
Establece relacin
Con
Cons
causa-efecto
Exposicin
Exposicin
No
Tiempo Enfermos
Enfermo
Sin
Sin
s
Exposicin
Exposicin
No
Enfermos
Casos y Controles
 Se comparan dos Casos y Controles
grupos: Uno con una
determinada
Hbitos alimentarios,
enfermedad o
actividad fsica y
desenlace (casos) y el
binomio
otro sin la enfermedad
ansiedad/depresin
o desenlace (controles).
como factores de
Se compara en ambos
riesgo asociados con el
grupos el antecedente
desarrollo de obesidad
de un determinado
en poblacin adulta
factor o exposicin, o
su ausencia.
EstableceExpuest
relacin
causa-efecto Enfermos
os
Enfermos (Casos)

No Tiempo
Expuestos
Expuest No
Noos enfermos
enfermos (Controles)
No
Expuestos
Ensayo Clnico
 Se comparan dos
grupos. Un grupo recibe Ensayo Clnico
del investigador el
efector o exposicin
que se estudia (grupo Eficacia de una
experimental) y el otro intervencin educativa
grupo no lo recibe grupal sobre cambios
(grupo control). en los estilos de vida
Se compara en ambos la en hipertensos en
presencia o no del atencin primaria: un
desenlace. ensayo clnico
Ambos grupos deben aleatorio.
ser similares excepto
por la maniobra.
La asignacin de Afectad
Con ser
individuos debe os
Con
aleatoria. Maniobra Maniobra
No
Tiempo Afectados
Afectad
Sin os
Sin
Maniobra
Maniobra
No
Cuasi experimental
 Cuasi experimental

Similar al diseo
anterior slo que en
Ensayo no aleatorizado
este diseo no hay
asignacin aleatoria de del tratamiento con
individuos a los grupos acupuntura de la
a comparar o bien, no cefalea resistente a
existe un grupo control terapias convencionales
Conocimientos en
como tal o ste es
histrico. Reanimacin en
Si no hay grupo control, personal de enfermera
la comparacin es en antes y despus de una
relacin al antes y intervencin educativa.
despus de la
exposicin
Volverse a
cuestionar...

El diseo es factible?
Es tico?
Hay suficientes sujetos de estudio?
Hay suficientes desenlaces y son medibles en
forma adecuada?
Continuar..
.