The College of Optometrists

Research and audit

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Key points

  • You must make the care and safety of the patient your first and continuing concern.
  • You should ensure that you have gained ethical approval for any research you undertake on people or animals.
  • You must work within relevant legislation.

Definition of research

Research is a systematic activity that:
  1. attempts to answer a clearly defined question
  2. employs systematic and rigorous methods, and
  3. leads to generalisable and new knowledge.258 

Ethical research

You must make the care and safety of the patient your first and continuing concern.259
If you undertake research on people or animals, you should seek ethical approval, where appropriate, using the relevant research ethics approval process.
In the UK, the routes to ethical approval are:
  1. university ethics committees, or
  2. The National Research Ethics Service, which is part of the Health Research Authority.260 
If your research involves even one NHS patient or record you should apply for ethical approval using the HRA Approval system.
University research will be subject to the ethics processes in place at the individual institution.
You must work within the relevant legislation; see Useful information and links section below.
Where you conduct research on people you must get consent from the research participants before involving them in any research project. For people who are unable to consent you will need to make an additional application.
You must maintain confidentiality.261
You must act with honesty and integrity when designing, supervising or carrying out research.

See sections on Consent and Confidentiality.

College research principles

You should protect the evidence base for optometry and vision science as follows:
  1. you should publish data of any trial in humans within one year of completion of the trial. This applies even if the trial appears to have been unsuccessful; publishing all data helps to ensure the evidence base is robust
  2. you should not enter into contracts that restrict your ability to publish results or provide appropriate access to data; such agreements can prevent researchers from independently publishing unbiased reports of their research
  3. you must not deliberately falsify data or information
  4. you must not deliberately misrepresent data. Doing so may lead to untrue or misleading findings which may skew the evidence base
  5. you must not plagiarise others’ work
  6. you should declare any interest or connection relevant to the outcome of a research project in all dissemination. This will enable a fair evaluation of any potential conflicts of interest
  7. you should name all authors involved in a publication before submission of a paper, to ensure transparency, and
  8. you should avoid duplicate publication of the same material in multiple journals to ensure transparency for literature reviews and a robust evidence base.

Definition of audit

Audit is a test of whether things are being done as they should. It compares current practice with predefined standards. Audit may raise questions that might be answered by further research.258  Examples of things that may be audited in optometric practice are the completeness of clinical records and the outcome of optometric referrals, for example whether feedback is received from the clinician to whom the patient has been referred.

Audit principles

If you are only using your existing patient record base for the purpose of audit you do not need to get patient consent since they have already given their consent to you creating and retaining their records. You must get patient consent if you are publishing any patient identifiable data.
Normally audits can be undertaken without the requirement of ethical approval, however, there may be rare instances where the nature of the audit or the local guidelines mean it is necessary to get approval. The chart on Differentiating clinical audit, service evaluation, research and usual practice or surveillance work in public health gives some useful definitions of audit and research.262
You should identify, and agree with other practice staff as appropriate, the audit:
  1. purpose
  2. scope
  3. topic, and
  4. criteria or standards.
You should use an audit to measure the level of performance in your practice.
You should use the results of your audit to inform changes and improvements in your practice.
You should review any changes made on a regular basis.

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