Foundations of Clinical Research: Applications to Practice.

Portney LG, Watkins MP. East Norwalk, CT 06855, Appleton & Lange, 1993, hardback, 722 pp, illus, $44.95.

According to the preface, the authors have been developing this compendium for over 15 years with the intention of guiding the clinician in clinical research. The result is a comprehensive reference for clinicians and students in research design and statistical analysis. This important text is written primarily for physical therapists and occupational therapists, but the health-related research applications are germane to all other health professionals.

The authors present a balanced and fair treatment of numerous research designs, addressing strengths and weaknesses of all of them in light of their applicability to clinical research.

Five major parts form the framework of the text, reflective of the research process itself, although in this text, the process of proposal development comes last. Each of the 31 chapters has a summary, a list of key terms, and relevant references.

The introduction, part 1, is informative, with pertinent examples provided to orient the novice to theory and ethics found in research. There are many examples relevant to health care, both from recent literature and from a historical past, that make for good reading.

Part 2 contains three chapters on measurement, reliability, and validity, which include sufficient coverage of statistics to make this part understandable. The chapter on measurement would have been a good place to include a section on normalization of data. There is a very comprehensive treatment of reliability and validity, and the authors present and explain numerous methods for establishing the many aspects of these two constructs.

Part 3 has 10 chapters devoted to hypothesis testing, sampling and control of variables, as well as descriptions of 16 different experimental designs, and designs for sequential trials, single case studies, descriptive research, surveys, epidemiological studies, evaluative studies, and secondary analyses (not including meta-analysis). The authors provide details of random sampling, including a list of random numbers so the reader can work through the concept, not just read about it. Such thorough coverage of a topic is typical of the authors' approach. With experimental designs, the authors include appropriate analyses for each design, giving examples and explanations in detail. Where the levels of statistics required are beyond the scope of the text (such as nested designs and time-series analyses), references are provided. The authors' treatment of qualitative research includes phenomenological and grounded research designs to generate hypotheses, and many references are provided. The roles of the observer, interviewer, and participant-observer are addressed. Overall, however, this text is weighted toward quantitative research.

Part 4 includes 11 chapter on statistics, from the most basic to the more complex multivariate tests and discriminant analyses. The descriptions are clearly written, and the formulae are easy to read and follow. Excellent graphs illustrate the data being analyzed.

Part 5 addresses how to write good proposals and report results in a variety of formats, as well as how to evaluate research reports. There are five appendixes for statistical tables and procedures, power analysis, data transformation, and a sample of an informed consent. There is also a glossary of terms, symbols, and abbreviations. The text is cross-indexed, making it easy to look up information.

The authors have provided a rich volume of information for both the beginning researcher and the more advanced reseachers who is branching out into new research designs or analyses. The text is very clearly written and is easy to use. It is not necessary to wade through the entire text to find answers to questions on design, statistics, or sample-size determinations. This is a user-friendly text containing information that is useful, applicable, and easy to find.