Research Study Types

There are many different types of research studies, and each has distinct strengths and weaknesses. In general, randomized trials and cohort studies provide the best information when looking at the link between a certain factor (like diet) and a health outcome (like heart disease).

Laboratory and Animal Studies

These are studies done in laboratories on cells, tissue, or animals.

  • Strengths: Laboratories provide strictly controlled conditions and are often the genesis of scientific ideas that go on to have a broad impact on human health. They can help understand the mechanisms of disease.
  • Weaknesses: Laboratory and animal studies are only a starting point. Animals or cells are not a substitute for humans.

Cross-Sectional Surveys

These studies examine the incidence of a certain outcome (disease or other health characteristic) in a specific group of people at one point in time. Surveys are often sent to participants to gather data about the outcome of interest.

  • Strengths: Inexpensive and easy to perform.
  • Weaknesses: Can only establish an association in that one specific time period.

Case-Control Studies

These studies look at the characteristics of one group of people who already have a certain health outcome (the cases) and compare them with a similar group of people who do not have the outcome (the controls). An example may be looking at a group of people with heart disease and another group without heart disease who are similar in age, sex, and economic status, and comparing their intakes of fruits and vegetables to see if this exposure could be associated with heart disease risk.

  • Strengths: Case-control studies can be done quickly and relatively cheaply.
  • Weaknesses: Not ideal for studying diet because they gather information from the past, which can be difficult for most people to recall accurately. Furthermore, people with illnesses often recall past behaviors differently from those without illness. This opens such studies to potential inaccuracy and bias in the information they gather.

Cohort Studies

These are observational studies that follow large groups of people over a long period of time, years or even decades, to find associations of an exposure(s) with disease outcomes. Researchers regularly gather information from the people in the study on several variables (like meat intake, physical activity level, and weight). Once a specified amount of time has elapsed, the characteristics of people in the group are compared to test specific hypotheses (such as a link between high versus low intake of carotenoid-rich foods and glaucoma, or high versus low meat intake and prostate cancer).

  • Strengths: Participants are not required to change their diets or lifestyle as may be with randomized controlled studies. Study sizes may be larger than other study types. They generally provide more reliable information than case-control studies because they don’t rely on information from the past. Cohort studies gather information from participants at the beginning and throughout the study, long before they may develop the disease being studied. As a group, many of these types of studies have provided valuable information about the link between lifestyle factors and disease.
  • Weaknesses: A longer duration of following participants make these studies time-consuming and expensive. Results cannot suggest cause-and-effect, only associations. Evaluation of dietary intake is self-reported.

Two of the largest and longest-running cohort studies of diet are the Harvard-based Nurses’ Health Study and the Health Professionals Follow-up Study.

Randomized Trials

Like cohort studies, these studies follow a group of people over time. However, with randomized trials, the researchers intervene with a specific behavior change or treatment (such as following a specific diet or taking a supplement) to see how it affects a health outcome. They are called “randomized trials” because people in the study are randomly assigned to either receive or not receive the intervention. This randomization helps researchers determine the true effect the intervention has on the health outcome. Those who do not receive the intervention or labelled the “control group,” which means these participants do not change their behavior, or if the study is examining the effects of a vitamin supplement, the control group participants receive a placebo supplement that contains no active ingredients.

  • Strengths: Considered the “gold standard” and best for determining the effectiveness of an intervention (e.g., dietary pattern, supplement) on an endpoint such as cancer or heart disease. Conducted in a highly controlled setting with limited variables that could affect the outcome. They determine cause-and-effect relationships.
  • Weaknesses: High cost, potentially low long-term compliance with prescribed diets, and possible ethical issues. Due to expense, the study size may be small.

Meta-Analyses and Systematic Reviews

A meta-analysis collects data from several previous studies on one topic to analyze and combine the results using statistical methods to provide a summary conclusion. Meta-analyses are usually conducted using randomized controlled trials and cohort studies that have higher quality of evidence than other designs. A systematic review also examines past literature related to a specific topic and design, analyzing the quality of studies and results but may not pool the data. Sometimes a systematic review is followed by conducting a meta-analysis if the quality of the studies is good and the data can be combined.

    • Strengths: Inexpensive and provides a general comprehensive summary of existing research on a topic. This can create an explanation or assumption to be used for further investigation.
    • Weaknesses: Prone to selection bias, as the authors can choose or exclude certain studies, which can change the resulting outcome. Combining data that includes lower-quality studies can also skew the results.



A primer on systematic review and meta-analysis in diabetes research

Systematic review and meta-analysis (SRMAs) have risen in popularity across the scientific realm including diabetes research. Although well-conducted SRMAs are an indispensable tool in informing evidence-based medicine, the proliferation of SRMAs has led to many reviews of questionable quality and misleading conclusions. The objective of this article is to provide up-to-date knowledge and a comprehensive understanding of strengths and limitations of SRMAs.
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