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Advantages	
  and	
  Disadvantages	
  of	
  the	
  ‘Distance’	
  that	
  
       Quantitative	
  Research	
  Establishes	
  Between	
  the	
  Researcher	
  
                            and	
  the	
  Researched?	
  
                                                                      By	
  
                    Dr.	
  Awais	
  e	
  Siraj	
  Managing	
  Director	
  Genzee	
  Solutions	
  Islamabad	
  Pakistan	
  
	
  

In	
   2003,	
   first	
   Beta	
   Interferon	
   was	
   launched	
   in	
   Pakistan	
   used	
   for	
   the	
   treatment	
   of	
   Multiple	
  
Sclerosis.	
  Till	
  that	
  time,	
  Multiple	
  Sclerosis	
  was	
  not	
  taken	
  very	
  seriously	
  by	
  physicians	
  as	
  well	
  as	
  
patients.	
  The	
  common	
  belief	
  was	
  that	
  it	
  does	
  not	
  exist	
  in	
  this	
  part	
  of	
  the	
  world	
  and	
  even	
  if	
  it	
  
does,	
   it	
   is	
   not	
   possible	
   to	
   offer	
   a	
   solution.	
   There	
   was	
   no	
   market	
   data	
   as	
   the	
   ‘market’	
   did	
   not	
  
exist.	
  There	
  were	
  no	
  formal	
  studies	
  of	
  incidence	
  and	
  prevalence,	
  only	
  stories	
  and	
  anecdotes.	
  	
  

One	
  story	
  goes	
  like	
  this:	
  

“Yasmin	
   was	
   a	
   great	
   student	
   of	
   arts	
   and	
   textile	
   designing.	
   Since	
   her	
   childhood	
   she	
   was	
   also	
  
active	
   in	
   sports	
   and	
   always	
   won	
   medals	
   in	
   100	
   meters	
   and	
   400	
   meters	
   events.	
   She	
   represented	
  
her	
  college	
  in	
  many	
  competitions	
  and	
  brought	
  name	
  and	
  fame	
  for	
  herself,	
  institution	
  and	
  her	
  
parents.	
  On	
  21	
  August	
  1997,	
  she	
  started	
  feeling	
  numbness	
  and	
  loss	
  of	
  power	
  in	
  her	
  left	
  hand.	
  
She	
  just	
  ignored	
  it.	
  Then	
  in	
  the	
  evening,	
  when	
  she	
  started	
  her	
  daily	
  routine	
  of	
  studies,	
  she	
  could	
  
see	
  only	
  half	
  of	
  the	
  page.	
  The	
  other	
  half	
  was	
  blurred.	
  Next	
  day,	
  her	
  father	
  took	
  her	
  to	
  a	
  GP	
  who	
  
prescribed	
   certain	
   multivitamins	
   and	
   described	
   it	
   as	
   ‘exam	
   pressure,	
   you	
   know’.	
   They	
   came	
  
back	
   and	
   she	
   recouped.	
   After	
   a	
   week,	
   right	
   on	
   the	
   dinner	
   table	
   she	
   fainted	
   and	
   had	
   to	
   be	
  
immediately	
   rushed	
   to	
   the	
   hospital.	
   This	
   time,	
   she	
   was	
   lucky	
   to	
   be	
   seen	
   by	
   a	
   ‘specialist’	
   who	
  
performed	
  a	
  series	
  of	
  tests	
  and	
  also	
  got	
  an	
  MRI	
  scan.	
  He	
  immediately	
  put	
  her	
  on	
  steroids	
  for	
  
four	
   days.	
   On	
   the	
   third	
   day,	
   he	
   announced	
   much	
   to	
   the	
   anxiety	
   and	
   ignorance	
   of	
   her	
  
bamboozled	
   parents	
   that	
   she	
   has	
   some	
   signs	
   of	
   ‘demyelination’	
   in	
   her	
   brain	
   and	
   that	
   she	
   is	
  
suffering	
   from	
   a	
   disease	
   called	
   Multiple	
   Sclerosis	
   which	
   is	
   rare	
   in	
   Pakistan	
   but	
   still	
   exists.	
   She	
  
will	
  have	
  to	
  use	
  some	
  kind	
  of	
  injections	
  called	
  Beta	
  Interferons	
  for	
  the	
  rest	
  of	
  her	
  life.	
  “These	
  
injections	
   are	
   currently	
   not	
   available	
   in	
   Pakistan	
   and	
   you	
   will	
   have	
   to	
   get	
   them	
   from	
  
somewhere.	
   They	
   are	
   very	
   expensive”,	
   informed	
   their	
   well	
   reputed	
   and	
   well	
   informed	
  
neurologist.	
  
	
  
“Yasmin’s	
  parents	
  belonged	
  to	
  a	
  middle	
  class	
  family	
  of	
  an	
  underdeveloped	
  country.	
  Her	
  father	
  
was	
   an	
   administration	
   manager	
   in	
   a	
   small	
   semi	
   government	
   organization	
   and	
   mother	
   was	
   a	
  
house	
  wife.	
  They	
  had	
  five	
  children	
  including	
  Yasmin,	
  all	
  in	
  their	
  school	
  going	
  age.	
  They	
  had	
  no	
  
other	
   source	
   of	
   income	
   and	
   healthcare	
   reimbursement	
   was	
   never	
   heard	
   of	
   in	
   Pakistan.	
   Beta	
  
Interferons	
  were	
  very	
  expensive	
  even	
  by	
  international	
  standards	
  and	
  still	
  did	
  not	
  offer	
  complete	
  
cure.	
   Her	
   father	
   decided	
   to	
   sell	
   off	
   their	
   only	
   property,	
   a	
   small	
   house	
   worth	
   a	
   few	
   thousand	
  
dollars	
  to	
  buy	
  the	
  drug	
  that	
  could	
  save	
  the	
  life	
  of	
  his	
  dear	
  daughter	
  only	
  to	
  find	
  out	
  later	
  that	
  
the	
  disease	
  is	
  not	
  going	
  away	
  and	
  that	
  the	
  entire	
  family	
  is	
  now	
  bankrupt.	
  Yasmin	
  is	
  completely	
  
paralyzed	
  and	
  on	
  bed	
  for	
  the	
  last	
  one	
  year.”	
  
	
  
The	
  head	
  of	
  marketing	
  of	
  this	
  company	
  had	
  some	
  point	
  to	
  start	
  with,	
  at	
  least.	
  But	
  one	
  story	
  is	
  
not	
  going	
  to	
  hammer	
  the	
  point	
  home,	
  he	
  thought.	
  “I	
  need	
  some	
  concrete	
  evidence	
  and	
  solid	
  
data	
  to	
  prove	
  that	
  the	
  disease	
  exists/does	
  not	
  exist	
  in	
  Pakistan.	
  Moreover,	
  I	
  have	
  to	
  base	
  my	
  
company	
  decisions	
  on	
  some	
  data	
  which	
  has	
  to	
  be	
  more	
  than	
  just	
  one	
  or	
  two	
  stories”.	
  He	
  had	
  to	
  
convince	
  the	
  health	
  authorities	
  as	
  well	
  as	
  physicians	
  that	
  this	
  disease	
  exists	
  in	
  Pakistan.	
  He	
  also	
  
thought	
   of	
   raising	
   funds	
   for	
   patients	
   who	
   could	
   not	
   afford	
   his	
   drug	
   through	
   philanthropist	
  
activity	
  but	
  everyone	
  seemed	
  to	
  ask	
  for	
  ‘numbers’	
  and	
  not	
  just	
  stories.	
  

After	
   spending	
   a	
   very	
   hard	
   time	
   he	
   was	
   able	
   to	
   motivate	
   a	
   few	
   neurologists	
   to	
   collect	
   some	
  
meaningful	
   data	
   and	
   put	
   it	
   together	
   in	
   the	
   shape	
   of	
   a	
   publication.	
   An	
   instrument	
  
(questionnaire)	
   was	
   designed	
   after	
   much	
   deliberations	
   and	
   data	
   was	
   collected	
   from	
   different	
  
neurology	
   clinics,	
   radiology	
   centers	
   and	
   hospitals.	
   They	
   could	
   only	
   identify	
   142	
   cases	
   but	
   this	
  
time	
   we	
   they	
   also	
   had	
   some	
   numbers	
   to	
   play	
   with	
   like	
   mean	
   age,	
   male	
   to	
   female	
   ratio,	
   disease	
  
progression,	
  disease	
  stage	
  etc.etc.	
  The	
  following	
  paragraph	
  is	
  an	
  abstract	
  of	
  the	
  publication.	
  

“We	
   describe	
   retrospective	
   data	
   from	
   the	
   largest	
   series	
   of	
   patients	
   (n_/142)	
   with	
   multiple	
  
sclerosis	
  (MS)	
  from	
  Pakistan.	
  Mean	
  age	
  at	
  onset	
  was	
  27	
  years,	
  with	
  a	
  female	
  to	
  male	
  ratio	
  of	
  
1.45:1.	
  The	
  disease	
  onset	
  was	
  polysymptomatic	
  in	
  75%	
  patients.	
  Motor	
  weakness	
  was	
  the	
  most	
  
common	
  onset	
  symptom	
  (70%),	
  followed	
  by	
  sensory	
  symptoms	
  (45%).	
  Optico-­‐spinal	
  type	
  of	
  MS	
  
was	
   seen	
   in	
   only	
   3%	
   of	
   patients	
   The	
   course	
   was	
   relapsing-­‐remitting	
   (RR)	
   in	
   81%,	
   primary	
  
progressive	
  (PP)	
  in	
  21%,	
  and	
  secondary	
  progressive	
  (SP)	
  in	
  4%	
  of	
  patients.	
  Almost	
  three-­‐fourths	
  
of	
   the	
   patients	
   were	
   moderately	
   (45%)	
   or	
   severely	
   (31%)	
   disabled	
   at	
   the	
   time	
   of	
   evaluation.	
  
Two-­‐thirds	
  of	
  patients	
  with	
  severe	
  disability	
  had	
  a	
  mean	
  disease	
  duration	
  of	
  only	
  5.2	
  years.	
  In	
  
conclusion,	
   MS	
   is	
   not	
   uncommon	
   in	
   Pakistan,	
   and	
   many	
   patients	
   were	
   found	
   to	
   have	
   severe	
  
disability	
   despite	
   short	
   disease	
   duration.”	
   M	
   Wasay,	
   S	
   Ali,	
   IA	
   Khatri,	
   A	
   Hassan,	
   M	
   Asif,	
   N	
  
Zakiullah,	
   A	
   Ahmed,	
   A	
   Malik,	
   B	
   Khealani,	
   A	
   Haq	
   and	
   S	
   Fredrikson	
   Multiple	
   Sclerosis	
   2007;	
   00:	
  
000_000.	
  http://msj.sagepub.com	
  
	
  
Yasmin	
  was	
  one	
  of	
  the	
  142	
  cases	
  mentioned	
  in	
  the	
  abstract	
  given	
  above.	
  
	
  
It	
   was	
   only	
   after	
   the	
   publication	
   of	
   this	
   data	
   that	
   all	
   stakeholders	
   started	
   seriously	
   thinking	
  
about	
   Multiple	
   Sclerosis	
   in	
   Pakistan.	
   Debates	
   started	
   generating	
   later,	
   building	
   on	
   this	
   and	
  
stories	
   became	
   more	
   and	
   more	
   available	
   when	
   individual	
   explorers	
   started	
   looking	
   beyond	
  
numbers	
   into	
   the	
   lives	
   of	
   patients	
   and	
   their	
   families.	
   This	
   study	
   became	
   a	
   building	
   block	
   for	
  
further	
  studies	
  and	
  currently	
  an	
  extensive	
  ‘genetic’	
  study	
  on	
  Multiple	
  Sclerosis	
  is	
  under	
  process.	
  
At	
   the	
   same	
   time,	
   philanthropists	
   and	
   NGO’s	
   are	
   beginning	
   to	
   believe	
   in	
   its	
   existence	
   and	
  
treatment	
   strategies	
   are	
   under	
   immense	
   discussion	
   so	
   are	
   the	
   treatment	
   guidelines	
   specific	
   for	
  
Pakistan	
  where	
  healthcare	
  reimbursement	
  is	
  	
  almost	
  non	
  –	
  existent.	
  	
  
	
  
The	
  data	
  presented	
  by	
  Wasay	
  et	
  al	
  is	
  “natural	
  science”	
  and	
  advocates	
  of	
  quantitative	
  research	
  
would	
  emphasize	
  that	
  all	
  research	
  carried	
  out	
  in	
  social	
  sciences	
  should	
  be	
  similar.	
  Furthermore,	
  
a	
   quantitative	
   data	
   on	
   social	
   aspects	
   of	
   this	
   study	
   would	
   be	
   possible	
   like	
   the	
   ‘affordability’	
  
‘disability’	
   ‘financial	
   impact	
   on	
   the	
   family’	
   and	
   ‘financial	
   burden	
   on	
   the	
   family’	
   and	
   ultimately	
  
some	
   development	
   economist	
   would	
   also	
   be	
   able	
   to	
   calculate	
   the	
   Disability	
   Adjusted	
   Life	
   Years	
  
and	
   Economic	
   Burden	
   of	
   this	
   disease	
   on	
   society	
   some	
   day.	
   But	
   all	
   of	
   this	
   started	
   with	
   one	
   story	
  
of	
   Yasmin.	
   Without	
   the	
   story,	
   no	
   researcher	
   will	
   ever	
   be	
   able	
   to	
   understand	
   what	
   was	
   really	
  
going	
  on	
  in	
  the	
  mind	
  of	
  Yasmin	
  and	
  her	
  family.	
  
It	
   is	
   sometimes	
   a	
   story	
   of	
   chicken	
   and	
   egg.	
   When	
   this	
   study	
   was	
   being	
   conducted	
   there	
   was	
   no	
  
data	
   to	
   understand	
   Multiple	
   Sclerosis	
   in	
   Pakistan.	
   Only	
   such	
   stories	
   as	
   that	
   of	
   Yasmin	
   came	
  
along	
  and	
  no	
  one	
  really	
  cared	
  about	
  it.	
  It	
  was	
  only	
  after	
  collection,	
  collation	
  and	
  publication	
  of	
  
this	
  data	
  that	
  led	
  many	
  to	
  recognize	
  that	
  Multiple	
  Sclerosis	
  needs	
  to	
  be	
  taken	
  seriously	
  as	
  it	
  is	
  in	
  
rest	
  of	
  the	
  world.	
  Then	
  they	
  started	
  digging	
  out	
  stories	
  again	
  and	
  reaching	
  individual	
  patients	
  
and	
  their	
  families	
  of	
  these	
  142	
  (and	
  more	
  as	
  they	
  were	
  diagnosed)	
  and	
  trying	
  to	
  find	
  similarities	
  
and	
  differences,	
  later	
  extrapolating	
  and	
  generalizing	
  for	
  ‘masses’	
  and	
  society.	
  
	
  
The	
   ‘distance’	
   between	
   story	
   of	
   Yasmin	
   and	
   M	
   Wasay	
   et	
   al	
   was	
   created	
   by	
   the	
   difference	
  
between	
   the	
   methodologies	
   of	
   research.	
   Through	
   quantitative	
   research,	
   Wasay	
   and	
   his	
  
colleagues	
  could	
  reach	
  wider	
  range	
  of	
  population,	
  get	
  some	
  hard	
  data	
  and	
  make	
  it	
  meaningful	
  
for	
  those	
  who	
  were	
  associated	
  to	
  this	
  disease	
  somehow.	
  However,	
  the	
  story	
  of	
  Yasmin	
  per	
  se	
  
takes	
   us	
   into	
   a	
   different	
   world	
   altogether,	
   a	
   world	
   of	
   social	
   systems	
   and	
   beliefs,	
   of	
   families	
   and	
  
their	
   thinking,	
   of	
   individuals	
   and	
   their	
   response	
   to	
   different	
   calamities	
   of	
   life,	
   of	
   developing	
  
world	
  and	
  their	
  healthcare	
  systems.	
  
	
  
When	
  the	
  data	
  was	
  shared	
  with	
  patients	
  and	
  their	
  families,	
  there	
  was	
  a	
  big	
  ‘so	
  what’	
  question	
  
mark	
   in	
   their	
   eyes.	
   “What	
   is	
   in	
   it	
   for	
   me?”	
   “I	
   have	
   a	
   story	
   to	
   tell	
   and	
   I	
   am	
   looking	
   for	
   a	
   solution	
  
to	
   my	
   problems”	
   was	
   a	
   standard	
   response.	
   They	
   wanted	
   the	
   researchers	
   to	
   see	
   the	
   situation	
  
through	
  their	
  eyes.	
  Some	
  were	
  even	
  keen	
  to	
  take	
  researchers	
  to	
  their	
  homes	
  and	
  shared	
  their	
  
life	
  with	
  them.	
  	
  
	
  
In	
  the	
  beginning	
  of	
  research	
  carried	
  out	
  by	
  Wasay	
  et	
  al,	
  there	
  was	
  a	
  clear	
  ‘research	
  strategy’.	
  
The	
   theory	
   was	
   “Multiple	
   Sclerosis	
   is	
   a	
   known	
   and	
   established	
   disease	
   of	
   the	
   world”.	
  
Hypothesis	
  to	
  be	
  tested	
  was	
  “If	
  it	
  exists	
  in	
  the	
  rest	
  of	
  the	
  world,	
  it	
  must	
  exist	
  in	
  Pakistan”.	
  The	
  
research	
   design	
   thus	
   revolved	
   around	
   finding	
   the	
   true	
   “incidence”	
   and	
   “prevalence”	
   of	
   this	
  
disease	
   but	
   this	
   was	
   not	
   possible	
   in	
   the	
   available	
   resources	
   and	
   time.	
   So,	
   a	
   shortcut	
   was	
  
designed	
   by	
   selecting	
   specific	
   research	
   sites	
   where	
   the	
   chances	
   of	
   finding	
   such	
   patients	
   was	
  
thought	
   maximum.	
   A	
   simple	
   instrument	
   was	
   designed	
   that	
   could	
   record	
   all	
   the	
   ‘measurable’	
  
information.	
  Data	
  collected	
  was	
  processed,	
  analyzed,	
  written	
  down	
  and	
  published.	
  	
  
	
  
During	
  this	
  entire	
  process,	
  if	
  the	
  researchers	
  were	
  asked	
  to	
  describe	
  the	
  ‘feelings’	
  of	
  subjects	
  
under	
   study,	
   they	
   would	
   simply	
   say	
   “this	
   was	
   not	
   the	
   design	
   of	
   research”.	
   Thus	
   the	
   researchers	
  
could	
  not	
  distinguish	
  people	
  and	
  social	
  institutions	
  from	
  ‘the	
  world	
  of	
  nature’.	
  The	
  researchers	
  
believed	
   that	
   ‘the	
   principles	
   of	
   scientific	
   method	
   can	
   and	
   should	
   be	
   applied	
   to	
   all	
   phenomenon	
  
that	
   are	
   the	
   focus	
   of	
   investigation.	
   The	
   researchers	
   in	
   this	
   case	
   turned	
   a	
   ‘blind	
   eye’	
   to	
   the	
  
difference	
  between	
  the	
  social	
  and	
  natural	
  world.	
  In	
  the	
  words	
  of	
  Schutz,	
  “it	
  means	
  ignoring	
  and	
  
riding	
   roughshod	
   over	
   the	
   fact	
   that	
   people	
   interpret	
   the	
   world	
   around	
   them,	
   whereas	
   this	
  
capacity	
  for	
  self	
  –	
  reflection	
  cannot	
  be	
  found	
  among	
  the	
  objects	
  of	
  natural	
  sciences”.	
  
	
  
Another	
   aspect	
   that	
   created	
   the	
   ‘distance’	
   between	
   the	
   researchers	
   and	
   subjects	
   in	
   this	
   case	
  
was	
  a	
  sense	
  of	
  precision	
  and	
  accuracy	
  in	
  the	
  research	
  design.	
  While	
  the	
  researchers	
  had	
  a	
  lot	
  of	
  
‘yes’,	
  ‘no’	
  in	
  their	
  questionnaire,	
  the	
  subjects	
  being	
  humans,	
  had	
  a	
  tendency	
  to	
  talk	
  more	
  or	
  try	
  
to	
   describe	
   what	
   a	
   ‘yes’	
   or	
   ‘no’	
   would	
   mean	
   to	
   them	
   but	
   since	
   they	
   were	
   limited	
   by	
   the	
  
questions	
  with	
  fixed	
  choice	
  answers,	
  important	
  information	
  could	
  have	
  been	
  missed	
  out.	
  
	
  
The	
  story	
  of	
  Yasmin	
  came	
  without	
  reliance	
  on	
  instruments	
  and	
  procedures	
  and	
  therefore	
  the	
  
connection	
  between	
  research	
  and	
  everyday	
  life	
  remained	
  intact.	
  Usually	
  the	
  undue	
  reliance	
  of	
  
quantitative	
   research	
   on	
   administering	
   research	
   instruments	
   to	
   subjects	
   or	
   on	
   controlling	
  
situations	
   to	
   determine	
   their	
   effects	
   may	
   lead	
   to	
   incorrect	
   information.	
   For	
   example	
   if	
   a	
  
question	
   was	
   put	
   to	
   Yasmin	
   “Would	
   you	
   like	
   to	
   share	
   your	
   health	
   status	
   with	
   public	
   at	
   large	
  
through	
  media?”	
  she	
  may	
  immediately	
  say	
  “yes”	
  but	
  in	
  reality,	
  talking	
  about	
  Multiple	
  Sclerosis	
  
would	
  mean	
  that	
  she	
  would	
  probably	
   have	
  a	
  difficult	
  social	
  and	
  marital	
  life	
  or	
  may	
  never	
  get	
  
married	
  altogether	
  for	
  the	
  rest	
  of	
  her	
  life	
  as	
  people	
  around	
  her	
  would	
  consider	
  her	
  a	
  life	
  long	
  
liability.	
  The	
  point	
  here	
  is	
  that	
  subjects	
  sometimes	
  do	
  not	
  fully	
  understand	
  the	
  questions	
  and	
  
their	
   implications	
   in	
   a	
   structured	
   setting	
   whereas	
   in	
   an	
   open	
   setting,	
   the	
   same	
   issues	
   can	
   be	
  
explored	
  and	
  put	
  into	
  perspective.	
  	
  
	
  
The	
  abstract	
  of	
  the	
  article	
  published	
  by	
  Wasay	
  et	
  al	
  looks	
  very	
  ‘scientific’,	
  very	
  ‘natural’	
  yet	
  very	
  
‘static’.	
  It	
  seems	
  as	
  if	
  they	
  are	
  talking	
  about	
  molecules,	
  atoms,	
  chemicals,	
  metals	
  and	
  electrons	
  
and	
   not	
   about	
   human	
   individuals.	
   The	
   denotation	
   of	
   events	
   to	
   humans	
   is	
   ignored.	
   The	
  
connection	
  of	
  findings	
  to	
  everyday	
  contexts	
  is	
  not	
  known.	
  It	
  has	
  in	
  fact	
  created	
  a	
  ‘static	
  social	
  
world’	
  that	
  is	
  mutually	
  exclusive	
  of	
  people	
  who	
  are	
  its	
  constituents.	
  	
  
	
  
Advocates	
   of	
   qualitative	
   research	
   or	
   antagonists	
   of	
   quantitative	
   research	
   put	
   forward	
   the	
  
concept	
   of	
   empathy	
   or	
   ‘take	
   the	
   role	
   of	
   the	
   other’.	
   In	
   other	
   words	
   one	
   has	
   to	
   ‘stand	
   in	
   the	
  
shoes’	
  of	
  the	
  researched	
  to	
  understand	
  their	
  concepts	
  better.	
  This	
  is	
  only	
  possible	
  when	
  there	
  
is	
  no	
  distance	
  between	
  the	
  researcher	
  and	
  researched.	
  Again,	
  the	
  story	
  of	
  Yasmin	
  and	
  similar	
  
other	
  stories	
  would	
  never	
  have	
  emerged	
  if	
  the	
  researchers	
  from	
  the	
  very	
  beginning	
  would	
  have	
  
stayed	
   at	
   a	
   ‘distance’	
   from	
   the	
   subject	
   in	
   order	
   to	
   follow	
   a	
   certain	
   methodology	
   of	
   research	
  
instead	
  of	
  undertaking	
  research	
  per	
  se.	
  
	
  
Another	
   key	
   advantage	
   of	
   quantitative	
   research	
   is	
   its	
   objectivity.	
   However	
   objectivity	
   is	
   too	
  
plain	
  and	
  utterly	
  inhuman.	
  In	
  the	
  above	
  example,	
  Wasay	
  et	
  al	
  fail	
  to	
  recognize	
  the	
  cognitive	
  and	
  
intellectual	
  processes	
  going	
  on	
  in	
  the	
  minds	
  of	
  their	
  subjects	
  while	
  collecting	
  this	
  data.	
  On	
  the	
  
other	
   hand	
   subjective	
   data	
   will	
   lead	
   to	
   emotional	
   stories	
   and	
   description	
   of	
   the	
   new	
   and	
  
challenging	
   social	
   processes	
   engulfing	
   the	
   lives	
   of	
   Multiple	
   Sclerosis	
   patients,	
   their	
   families,	
  
physicians	
  and	
  society.	
  
	
  
One	
   of	
   the	
   reasons	
   why	
   quantitative	
   research	
   creates	
   a	
   distance	
   between	
   researcher	
   and	
  
researched	
   is	
   the	
   underpinning	
   belief	
   that	
   quantitative	
   research	
   can	
   be	
   replicated	
   whereas	
   this	
  
is	
  not	
  the	
  case	
  with	
  qualitative	
  research.	
  The	
  core	
  reason	
  for	
  this	
  is	
  the	
  ‘disconnection’	
  between	
  
researcher	
   and	
   subjects	
   on	
   a	
   human	
   and	
   emotional	
   level.	
   Researchers,	
   being	
   human	
  
themselves,	
  are	
  likely	
  to	
  be	
  carried	
  away	
  while	
  undertaking	
  research	
  on	
  emotional	
  issues	
  like	
  
the	
  one	
  described	
  in	
  case	
  of	
  Yasmin.	
  It	
  can	
  therefore	
  be	
  argues	
  that	
  some	
  distance	
  is	
  essentially	
  
required	
  to	
  collect	
  meaningful	
  information.	
  However,	
  similar	
  stories	
  revealed	
  a	
  lot	
  of	
  common	
  
areas	
   of	
   discussion	
   and	
   future	
   course	
   of	
   action	
   thereby	
   bolstering	
   the	
   idea	
   that	
   qualitative	
  
research	
  had	
  a	
  key	
  role	
  to	
  play	
  as	
  well	
  
	
  
In	
   conclusion,	
   there	
   is	
   no	
   right	
   or	
   wrong	
   argument	
   in	
   favor	
   of	
   or	
   against	
   the	
   ‘distance’	
   that	
  
quantitative	
  research	
  established	
  between	
  the	
  researcher	
  and	
  the	
  researched.	
  It	
  all	
  depends	
  on	
  
the	
   nature	
   of	
   research.	
   It	
   is	
   sometimes	
   necessary	
   to	
   keep	
   a	
   distance	
   while	
   it	
   is	
   sometimes	
  
necessary	
  to	
  remove	
  it.	
  The	
  process	
  may	
  go	
  in	
  full	
  circle	
  will	
  repetitions	
  of	
  'distance'	
  and	
  'no	
  -­‐	
  
distance'	
  (Qualitative	
  may	
  follow	
  quantitative	
  or	
  Vice	
  Versa)	
  as	
  shown	
  by	
  example.	
  Given	
  below	
  
is	
   a	
   summary	
   of	
   advantages	
   and	
   disadvantages	
   and	
   the	
   researcher	
   has	
   to	
   choose	
   a	
  
methodology	
  that	
  suits	
  the	
  requirements	
  of	
  research	
  in	
  a	
  given	
  time	
  and	
  space.	
  	
  	
  
	
  
Summary:	
  

                                   Advantages	
                                                             Disadvantages	
  

               1. Collection	
  of	
  hard	
  core	
  objective	
  data	
              1. Leave	
  out	
  human	
  element	
  

               2. Data	
   collected	
   is	
   close	
   to	
   ‘natural	
            2. Fail	
  to	
  understand	
  and	
  record	
  feelings	
  

                    sciences	
  experimentation’.	
                                    3. Emotionally	
   involved	
   researcher	
   likely	
  

               3. Does	
  not	
  allow	
  ‘drifting’	
  in	
  emotion	
                       to	
  misread	
  important	
  information	
  

               4. Data	
  collected	
  is	
  verifiable	
                              4. Replication	
  is	
  a	
  question	
  mark	
  because	
  

               5. Replication	
  possible	
                                                   of	
      dependence	
                 on	
      researcher	
  

               6. Data	
   can	
   be	
   processed	
   and	
   analyzed	
                    observation	
  and	
  finding	
  

                    using	
  sophisticated	
  statistical	
  tools	
  and	
            5. Generalization	
                  is	
       difficult	
      with	
  

                    computer	
  soft-­‐wares	
  like	
  SPSS	
                                emotionally	
  loaded	
  responses.	
  

               7. Saves	
   researched	
   from	
   information	
                      6. Descriptive	
  information	
  is	
  scanty	
  that	
  is	
  

                    overload	
                                                                deemed	
   necessary	
   while	
   explaining	
  

               8. Extrapolation	
  of	
  data	
  is	
  acceptable	
                           findings	
  from	
  quantitative	
  data.	
  

               9. Larger	
  scale	
  generalization	
  of	
  concepts	
  	
  

	
  	
  	
  
 
	
  
Section	
  B	
  	
  
	
  
4a)	
   Are	
   the	
   following	
   variable	
   names	
   acceptable	
   by	
   SPSS?	
   Provide	
   explanations	
   in	
   your	
  
answers.	
  
	
  
i)	
  var	
  1	
  
ii)	
  earningsaftertax	
  
iii)	
  pt/job	
  
iv)	
  var_0001	
  
	
  
“Var	
  1”,	
  “pt/job”	
  and	
  “Var_0001”	
  are	
  not	
  acceptable	
  by	
  SPSS	
  as	
  it	
  does	
  not	
  entertain	
  spaces,	
  
signs	
   or	
   symbols	
   between,	
   before	
   or	
   after	
   each	
   variable.	
   When	
   these	
   three	
   were	
   entered	
   at	
  
variables	
   in	
   the	
   “Variable	
   view”,	
   a	
   window	
   “variable	
   contains	
   an	
   illegal	
   character”	
   appeared	
  
promptly.	
  	
  
	
  
Variable	
  “earningsaftertax”	
  was	
  acceptable	
  as	
  a	
  variable.	
  
	
  
4b)	
   If	
   you	
   are	
   given	
   the	
   task	
   to	
   code	
   up	
   a	
   set	
   of	
   survey	
   data	
   which	
   consists	
   of	
   mainly	
  
attitudinal	
  and	
  open-­‐ended	
  responses,	
  what	
  cautions	
  would	
  you	
  bear	
  in	
  mind	
  when	
  you	
  carry	
  
out	
  the	
  task?	
  
	
  
Coding	
   for	
   open	
   –	
   ended	
   questions	
   is	
   complicated.	
   Answers	
   to	
   open	
   –	
   ended	
   or	
   attitudinal	
  
response	
   should	
   be	
   summarized	
   into	
   a	
   number	
   of	
   different	
   categories	
   or	
   groups	
   before	
  
entering	
   data	
   in	
   SPSS.	
   Groups	
   are	
   easier	
   to	
   make	
   once	
   the	
   researcher	
   has	
   gone	
   through	
   or	
  
enlisted	
   all	
   the	
   responses	
   to	
   a	
   specific	
   question	
   from	
   the	
   respondents.	
   These	
   categories	
   or	
  
groups	
  then	
  need	
  to	
  be	
  assigned	
  numbers	
  for	
  entry	
  into	
  SPSS	
  and	
  record	
  must	
  be	
  maintained	
  
so	
  that	
  it	
  can	
  be	
  referred	
  to	
  during	
  explanation.	
  	
  
	
  
Take	
  this	
  question	
  as	
  an	
  example:	
  
	
  
Q.	
  What	
  do	
  you	
  think	
  is	
  the	
  root	
  cause	
  of	
  terrorism	
  in	
  Afghanistan?	
  
	
  
The	
  responses	
  can	
  be	
  many	
  but	
  mostly	
  would	
  fall	
  into:	
  
	
  
         a) Local	
  Culture/Fragmented	
  Society	
  
         b) Religious	
  Extremism	
  
         c) Poverty	
  
         d) Lack	
  of	
  Education	
  
         e) Lack	
  of	
  employment	
  
         f) Geostrategic	
  influence	
  
	
  
Almost	
  80	
  to	
  90%	
  of	
  responses	
  would	
  fall	
  into	
  either	
  of	
  the	
  above	
  but	
  there	
  would	
  be	
  certain	
  
answers	
  that	
  fall	
  into	
  neither.	
  For	
  those,	
  another	
  category	
  (Others)	
  can	
  be	
  made	
  and	
  coded	
  as	
  
following:	
  
	
  
       a) Local	
  Culture/Fragmented	
  Society	
  =	
  1	
  
       b) Religious	
  Extremism	
  =	
  2	
  
       c) Poverty	
  =	
  3	
  
       d) Lack	
  of	
  Education	
  =	
  4	
  
       e) Lack	
  of	
  employment	
  =	
  5	
  
       f) Geostrategic	
  influence	
  =	
  6	
  
       g) Others	
  =	
  99	
  
	
  
This	
  data	
  can	
  then	
  be	
  entered	
  in	
  SPSS	
  and	
  analyzed	
  further.	
  
	
  
4c)	
  When	
  do	
  we	
  use	
  Cronbach’s	
  Alpha?	
  What	
  can	
  Cronbach’s	
  Alpha	
  tell	
  us?	
  
	
  
We	
   use	
  Cronbach’s	
   Alpha	
  to	
   ascertain	
   the	
  degree	
   to	
  which	
   the	
   items	
   that	
  make	
  up	
  a	
  scale	
   are	
  coherent	
  
with	
  one	
  another.	
  

Cronbach's	
  alpha	
  is	
  a	
  test	
  of	
  internal	
  reliability	
  or	
  consistency	
  and	
  is	
  used	
  to	
  measure	
  how	
  well	
  a	
  set	
  of	
  
items	
   (or	
   variables)	
   measures	
   a	
   single	
   unidimensional	
   latent	
   construct.	
  	
   It	
   calculates	
   the	
   average	
   of	
   all	
  
possible	
   split	
   –	
   half	
   reliability	
   coefficients.	
  Cronbach’s	
   Alpha	
   ranges	
   between	
   0.00	
   to	
   1.00.	
   A	
   reliability	
  
coefficient	
  of	
  .70	
  or	
  higher	
  is	
  considered	
  	
  "acceptable"	
  in	
  most	
  social	
  science	
  research	
  situations(DeVellis	
  
2003)	
   however	
   Bryman	
   (Alan	
   Bryman	
   2008:	
   151)	
   advocates	
   a	
   figure	
   of	
   0.80	
   to	
   be	
   ‘typically	
   employed	
   as	
  
a	
  rule	
  of	
  thumb	
  to	
  denote	
  an	
  acceptable	
  level	
  of	
  internal	
  reliability’.	
  A	
  minimum	
  level	
  of	
  0.60	
  has	
  been	
  
described	
   as	
   ‘good’	
   by	
   Berthoud	
   (2000b:	
   169).	
   When	
   data	
   have	
   a	
   multidimensional	
   structure,	
  
Cronbach's	
   alpha	
   will	
   usually	
   be	
   low.	
   Briggs	
   and	
   Cheek	
   (1986)	
   have	
   recommended	
   inter	
   –	
   item	
  
correlation	
  of	
  0.2	
  to	
  0.4	
  as	
  an	
  optimal	
  range.	
  	
  

Cronbach's	
   alpha	
   can	
   be	
   written	
   as	
   a	
   function	
   of	
   the	
   number	
   of	
   test	
   items	
   AND	
   the	
   average	
  
inter-­‐correlation	
  among	
  the	
  items.	
  	
  The	
  formula	
  for	
  the	
  standardized	
  Cronbach's	
  alpha	
  is:	
  	
  



                                            	
  

where	
  N	
  	
  is	
  equal	
  to	
  the	
  number	
  of	
  items,	
  c-­‐bar	
  is	
  the	
  average	
  inter-­‐item	
  covariance	
  among	
  the	
  
items	
  and	
  v-­‐bar	
  equals	
  the	
  average	
  variance.	
  	
  	
  

The	
  formula	
  indicates	
  that	
  if	
  we	
  increase	
  the	
  number	
  of	
  items,	
  Cronbach's	
  alpha	
  will	
  increase.	
  	
  	
  
Alpha	
  will	
  be	
  low	
  if	
  the	
  average	
  inter-­‐item	
  correlation	
  is	
  low.	
  Cronbach’s	
  alpha	
  increases	
  if	
  the	
  
average	
  inter-­‐item	
  correlation	
  increases.	
  	
  
If	
  the	
  inter-­‐item	
  correlations	
  are	
  high,	
  then	
  there	
  is	
  evidence	
  that	
  the	
  items	
  are	
  measuring	
  the	
  
same	
  underlying	
  construct.	
  	
   This	
  is	
  really	
  what	
  is	
  meant	
  by	
  "high"	
  or	
  "good"	
  reliability	
  when	
  a	
  
reference	
  is	
  made	
  to	
  a	
  unidimensional	
  latent	
  construct.	
  	
  

Cronbach's	
  alpha	
  will	
  generally	
  be	
  low	
  for	
  all	
  items	
  in	
  case	
  of	
  a	
  multi-­‐dimensional	
  data.	
  For	
  such	
  
cases,	
   it	
   is	
   suggested	
   that	
   a	
   factor	
   analysis	
   be	
   carried	
   out	
   to	
   see	
   which	
   items	
   load	
   highest	
   on	
  
which	
  dimensions	
  and	
  then	
  take	
  the	
  alpha	
  of	
  each	
  subset	
  of	
  items	
  separately.	
  	
  

Bibliography:	
  

      1. Acton	
  C.,	
  Miller	
  R.,	
  SPSS	
  for	
  Social	
  Scientists,	
  Pelgrave,	
  Second	
  Edition,	
  2009	
  
      2. Bezerra	
  R.	
  F.,	
  Jalloh,	
  S.	
  and	
  Stevenson,	
  J.	
  (1998)	
  “Formulating	
  Hypothesis	
  Graphically	
  in	
  
          Social	
  Research’,	
  Quality	
  and	
  Quantity	
  32(4):327	
  –	
  353	
  
      3. Bryman	
  A.,	
  Social	
  Research	
  Methods,	
  Oxford	
  University	
  Press,	
  3rd	
  Edition,	
  2008.	
  
      4. Bryman,	
   A.	
   and	
   Cramer,	
   D.	
   (1990)	
   ‘Concepts	
   and	
   Their	
   Measurement’,	
   in	
   Quantitative	
  
          Data	
  Analysis	
  for	
  Social	
  Scientists,	
  pp.61-­‐74.	
  London:	
  Routledge	
  
      5. CLMS,	
  (Version	
  No.	
  2)	
  Doctorate	
  in	
  Social	
  Sciences,	
  Module	
  1,	
  Unit	
  3	
  
      6. De	
  Vaus,	
  D.A.	
  (1996)	
  “Developing	
  Indicators	
  for	
  Concepts”,	
  in	
  Surveys	
  in	
  Social	
  Research,	
  
          (4th	
  Edition),	
  pp.47	
  –	
  59.	
  London:	
  UCL	
  Press.	
  
      7. Dijkstra,	
   W.,	
   Smit,	
   J.H.	
   and	
   Comijs,	
   H.	
   C.	
   (2001)	
   ‘Using	
   Social	
   Desirability	
   Scales	
   the	
  
          Research	
  among	
  the	
  Elderly’,	
  Quality	
  and	
  Quantity	
  35(1):107-­‐115	
  
      8. Drennan,	
  J.	
  (2003)	
  Cognitive	
  Interviewing:	
  Verbal	
  Data	
  in	
  the	
  Design	
  and	
  Pre	
  –	
  Testing	
  of	
  
          Questionnaires’,	
   Journal	
   of	
   Advanced	
   Nursing	
   Methodological	
   Issues	
   in	
   Nursing	
  
          Research	
  42(1):	
  57	
  –	
  63	
  
      9. Kraus,	
   L.	
   and	
   Augustin,	
   R.	
   (2001)	
   ‘Research	
   Report	
   –	
   Measuring	
   Alcohol	
   Consumption	
  
          and	
   Alcohol	
   Related	
   Problems:	
   Comparison	
   of	
   Responses	
   from	
   Self	
   –	
   Administered	
  
          Questionnaires	
  and	
  Telephone	
  Interviews’,	
  Addiction	
  96(3):459	
  –	
  471	
  
      10. Palant	
  J.,	
  (2007)	
  SPSS	
  Survival	
  Manual,	
  Third	
  Edition,	
  McGraw	
  Hill,	
  Open	
  University	
  Press	
  
      11. Schutz,	
  A.	
  (1962),	
  Collected	
  Papers	
  I,	
  The	
  Problem	
  of	
  Social	
  Reality	
  (The	
  Hague:	
  Martinus	
  
          Nijhof)	
  
      12. Wasay,	
  M.	
  et	
  al,	
  Multiple	
  Sclerosis	
  in	
  Pakistan,	
  Multiple	
  Sclerosis,	
  Vol.	
  13,	
  No.	
  5,	
  668-­‐669	
  
          (2007)	
  
      13. Wright	
   Mills,	
   C.	
   (2000)	
   ‘Abstracted	
   Empiricism’,	
   in	
   The	
   Social	
   Imagination,	
   (40th	
  
          Anniversary	
  Edition),	
  pp.	
  50	
  –	
  75.	
  New	
  York;	
  Oxford:	
  Oxford	
  University	
  Press	
  

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Advantages and disadvantages of the ‘distance’ that quantitative research establishes between the researcher and the researched

  • 1. Advantages  and  Disadvantages  of  the  ‘Distance’  that   Quantitative  Research  Establishes  Between  the  Researcher   and  the  Researched?   By   Dr.  Awais  e  Siraj  Managing  Director  Genzee  Solutions  Islamabad  Pakistan     In   2003,   first   Beta   Interferon   was   launched   in   Pakistan   used   for   the   treatment   of   Multiple   Sclerosis.  Till  that  time,  Multiple  Sclerosis  was  not  taken  very  seriously  by  physicians  as  well  as   patients.  The  common  belief  was  that  it  does  not  exist  in  this  part  of  the  world  and  even  if  it   does,   it   is   not   possible   to   offer   a   solution.   There   was   no   market   data   as   the   ‘market’   did   not   exist.  There  were  no  formal  studies  of  incidence  and  prevalence,  only  stories  and  anecdotes.     One  story  goes  like  this:   “Yasmin   was   a   great   student   of   arts   and   textile   designing.   Since   her   childhood   she   was   also   active   in   sports   and   always   won   medals   in   100   meters   and   400   meters   events.   She   represented   her  college  in  many  competitions  and  brought  name  and  fame  for  herself,  institution  and  her   parents.  On  21  August  1997,  she  started  feeling  numbness  and  loss  of  power  in  her  left  hand.   She  just  ignored  it.  Then  in  the  evening,  when  she  started  her  daily  routine  of  studies,  she  could   see  only  half  of  the  page.  The  other  half  was  blurred.  Next  day,  her  father  took  her  to  a  GP  who   prescribed   certain   multivitamins   and   described   it   as   ‘exam   pressure,   you   know’.   They   came   back   and   she   recouped.   After   a   week,   right   on   the   dinner   table   she   fainted   and   had   to   be   immediately   rushed   to   the   hospital.   This   time,   she   was   lucky   to   be   seen   by   a   ‘specialist’   who   performed  a  series  of  tests  and  also  got  an  MRI  scan.  He  immediately  put  her  on  steroids  for   four   days.   On   the   third   day,   he   announced   much   to   the   anxiety   and   ignorance   of   her   bamboozled   parents   that   she   has   some   signs   of   ‘demyelination’   in   her   brain   and   that   she   is   suffering   from   a   disease   called   Multiple   Sclerosis   which   is   rare   in   Pakistan   but   still   exists.   She   will  have  to  use  some  kind  of  injections  called  Beta  Interferons  for  the  rest  of  her  life.  “These   injections   are   currently   not   available   in   Pakistan   and   you   will   have   to   get   them   from   somewhere.   They   are   very   expensive”,   informed   their   well   reputed   and   well   informed   neurologist.     “Yasmin’s  parents  belonged  to  a  middle  class  family  of  an  underdeveloped  country.  Her  father   was   an   administration   manager   in   a   small   semi   government   organization   and   mother   was   a   house  wife.  They  had  five  children  including  Yasmin,  all  in  their  school  going  age.  They  had  no   other   source   of   income   and   healthcare   reimbursement   was   never   heard   of   in   Pakistan.   Beta   Interferons  were  very  expensive  even  by  international  standards  and  still  did  not  offer  complete   cure.   Her   father   decided   to   sell   off   their   only   property,   a   small   house   worth   a   few   thousand   dollars  to  buy  the  drug  that  could  save  the  life  of  his  dear  daughter  only  to  find  out  later  that   the  disease  is  not  going  away  and  that  the  entire  family  is  now  bankrupt.  Yasmin  is  completely   paralyzed  and  on  bed  for  the  last  one  year.”    
  • 2. The  head  of  marketing  of  this  company  had  some  point  to  start  with,  at  least.  But  one  story  is   not  going  to  hammer  the  point  home,  he  thought.  “I  need  some  concrete  evidence  and  solid   data  to  prove  that  the  disease  exists/does  not  exist  in  Pakistan.  Moreover,  I  have  to  base  my   company  decisions  on  some  data  which  has  to  be  more  than  just  one  or  two  stories”.  He  had  to   convince  the  health  authorities  as  well  as  physicians  that  this  disease  exists  in  Pakistan.  He  also   thought   of   raising   funds   for   patients   who   could   not   afford   his   drug   through   philanthropist   activity  but  everyone  seemed  to  ask  for  ‘numbers’  and  not  just  stories.   After   spending   a   very   hard   time   he   was   able   to   motivate   a   few   neurologists   to   collect   some   meaningful   data   and   put   it   together   in   the   shape   of   a   publication.   An   instrument   (questionnaire)   was   designed   after   much   deliberations   and   data   was   collected   from   different   neurology   clinics,   radiology   centers   and   hospitals.   They   could   only   identify   142   cases   but   this   time   we   they   also   had   some   numbers   to   play   with   like   mean   age,   male   to   female   ratio,   disease   progression,  disease  stage  etc.etc.  The  following  paragraph  is  an  abstract  of  the  publication.   “We   describe   retrospective   data   from   the   largest   series   of   patients   (n_/142)   with   multiple   sclerosis  (MS)  from  Pakistan.  Mean  age  at  onset  was  27  years,  with  a  female  to  male  ratio  of   1.45:1.  The  disease  onset  was  polysymptomatic  in  75%  patients.  Motor  weakness  was  the  most   common  onset  symptom  (70%),  followed  by  sensory  symptoms  (45%).  Optico-­‐spinal  type  of  MS   was   seen   in   only   3%   of   patients   The   course   was   relapsing-­‐remitting   (RR)   in   81%,   primary   progressive  (PP)  in  21%,  and  secondary  progressive  (SP)  in  4%  of  patients.  Almost  three-­‐fourths   of   the   patients   were   moderately   (45%)   or   severely   (31%)   disabled   at   the   time   of   evaluation.   Two-­‐thirds  of  patients  with  severe  disability  had  a  mean  disease  duration  of  only  5.2  years.  In   conclusion,   MS   is   not   uncommon   in   Pakistan,   and   many   patients   were   found   to   have   severe   disability   despite   short   disease   duration.”   M   Wasay,   S   Ali,   IA   Khatri,   A   Hassan,   M   Asif,   N   Zakiullah,   A   Ahmed,   A   Malik,   B   Khealani,   A   Haq   and   S   Fredrikson   Multiple   Sclerosis   2007;   00:   000_000.  http://msj.sagepub.com     Yasmin  was  one  of  the  142  cases  mentioned  in  the  abstract  given  above.     It   was   only   after   the   publication   of   this   data   that   all   stakeholders   started   seriously   thinking   about   Multiple   Sclerosis   in   Pakistan.   Debates   started   generating   later,   building   on   this   and   stories   became   more   and   more   available   when   individual   explorers   started   looking   beyond   numbers   into   the   lives   of   patients   and   their   families.   This   study   became   a   building   block   for   further  studies  and  currently  an  extensive  ‘genetic’  study  on  Multiple  Sclerosis  is  under  process.   At   the   same   time,   philanthropists   and   NGO’s   are   beginning   to   believe   in   its   existence   and   treatment   strategies   are   under   immense   discussion   so   are   the   treatment   guidelines   specific   for   Pakistan  where  healthcare  reimbursement  is    almost  non  –  existent.       The  data  presented  by  Wasay  et  al  is  “natural  science”  and  advocates  of  quantitative  research   would  emphasize  that  all  research  carried  out  in  social  sciences  should  be  similar.  Furthermore,   a   quantitative   data   on   social   aspects   of   this   study   would   be   possible   like   the   ‘affordability’   ‘disability’   ‘financial   impact   on   the   family’   and   ‘financial   burden   on   the   family’   and   ultimately   some   development   economist   would   also   be   able   to   calculate   the   Disability   Adjusted   Life   Years  
  • 3. and   Economic   Burden   of   this   disease   on   society   some   day.   But   all   of   this   started   with   one   story   of   Yasmin.   Without   the   story,   no   researcher   will   ever   be   able   to   understand   what   was   really   going  on  in  the  mind  of  Yasmin  and  her  family.   It   is   sometimes   a   story   of   chicken   and   egg.   When   this   study   was   being   conducted   there   was   no   data   to   understand   Multiple   Sclerosis   in   Pakistan.   Only   such   stories   as   that   of   Yasmin   came   along  and  no  one  really  cared  about  it.  It  was  only  after  collection,  collation  and  publication  of   this  data  that  led  many  to  recognize  that  Multiple  Sclerosis  needs  to  be  taken  seriously  as  it  is  in   rest  of  the  world.  Then  they  started  digging  out  stories  again  and  reaching  individual  patients   and  their  families  of  these  142  (and  more  as  they  were  diagnosed)  and  trying  to  find  similarities   and  differences,  later  extrapolating  and  generalizing  for  ‘masses’  and  society.     The   ‘distance’   between   story   of   Yasmin   and   M   Wasay   et   al   was   created   by   the   difference   between   the   methodologies   of   research.   Through   quantitative   research,   Wasay   and   his   colleagues  could  reach  wider  range  of  population,  get  some  hard  data  and  make  it  meaningful   for  those  who  were  associated  to  this  disease  somehow.  However,  the  story  of  Yasmin  per  se   takes   us   into   a   different   world   altogether,   a   world   of   social   systems   and   beliefs,   of   families   and   their   thinking,   of   individuals   and   their   response   to   different   calamities   of   life,   of   developing   world  and  their  healthcare  systems.     When  the  data  was  shared  with  patients  and  their  families,  there  was  a  big  ‘so  what’  question   mark   in   their   eyes.   “What   is   in   it   for   me?”   “I   have   a   story   to   tell   and   I   am   looking   for   a   solution   to   my   problems”   was   a   standard   response.   They   wanted   the   researchers   to   see   the   situation   through  their  eyes.  Some  were  even  keen  to  take  researchers  to  their  homes  and  shared  their   life  with  them.       In  the  beginning  of  research  carried  out  by  Wasay  et  al,  there  was  a  clear  ‘research  strategy’.   The   theory   was   “Multiple   Sclerosis   is   a   known   and   established   disease   of   the   world”.   Hypothesis  to  be  tested  was  “If  it  exists  in  the  rest  of  the  world,  it  must  exist  in  Pakistan”.  The   research   design   thus   revolved   around   finding   the   true   “incidence”   and   “prevalence”   of   this   disease   but   this   was   not   possible   in   the   available   resources   and   time.   So,   a   shortcut   was   designed   by   selecting   specific   research   sites   where   the   chances   of   finding   such   patients   was   thought   maximum.   A   simple   instrument   was   designed   that   could   record   all   the   ‘measurable’   information.  Data  collected  was  processed,  analyzed,  written  down  and  published.       During  this  entire  process,  if  the  researchers  were  asked  to  describe  the  ‘feelings’  of  subjects   under   study,   they   would   simply   say   “this   was   not   the   design   of   research”.   Thus   the   researchers   could  not  distinguish  people  and  social  institutions  from  ‘the  world  of  nature’.  The  researchers   believed   that   ‘the   principles   of   scientific   method   can   and   should   be   applied   to   all   phenomenon   that   are   the   focus   of   investigation.   The   researchers   in   this   case   turned   a   ‘blind   eye’   to   the   difference  between  the  social  and  natural  world.  In  the  words  of  Schutz,  “it  means  ignoring  and   riding   roughshod   over   the   fact   that   people   interpret   the   world   around   them,   whereas   this   capacity  for  self  –  reflection  cannot  be  found  among  the  objects  of  natural  sciences”.    
  • 4. Another   aspect   that   created   the   ‘distance’   between   the   researchers   and   subjects   in   this   case   was  a  sense  of  precision  and  accuracy  in  the  research  design.  While  the  researchers  had  a  lot  of   ‘yes’,  ‘no’  in  their  questionnaire,  the  subjects  being  humans,  had  a  tendency  to  talk  more  or  try   to   describe   what   a   ‘yes’   or   ‘no’   would   mean   to   them   but   since   they   were   limited   by   the   questions  with  fixed  choice  answers,  important  information  could  have  been  missed  out.     The  story  of  Yasmin  came  without  reliance  on  instruments  and  procedures  and  therefore  the   connection  between  research  and  everyday  life  remained  intact.  Usually  the  undue  reliance  of   quantitative   research   on   administering   research   instruments   to   subjects   or   on   controlling   situations   to   determine   their   effects   may   lead   to   incorrect   information.   For   example   if   a   question   was   put   to   Yasmin   “Would   you   like   to   share   your   health   status   with   public   at   large   through  media?”  she  may  immediately  say  “yes”  but  in  reality,  talking  about  Multiple  Sclerosis   would  mean  that  she  would  probably   have  a  difficult  social  and  marital  life  or  may  never  get   married  altogether  for  the  rest  of  her  life  as  people  around  her  would  consider  her  a  life  long   liability.  The  point  here  is  that  subjects  sometimes  do  not  fully  understand  the  questions  and   their   implications   in   a   structured   setting   whereas   in   an   open   setting,   the   same   issues   can   be   explored  and  put  into  perspective.       The  abstract  of  the  article  published  by  Wasay  et  al  looks  very  ‘scientific’,  very  ‘natural’  yet  very   ‘static’.  It  seems  as  if  they  are  talking  about  molecules,  atoms,  chemicals,  metals  and  electrons   and   not   about   human   individuals.   The   denotation   of   events   to   humans   is   ignored.   The   connection  of  findings  to  everyday  contexts  is  not  known.  It  has  in  fact  created  a  ‘static  social   world’  that  is  mutually  exclusive  of  people  who  are  its  constituents.       Advocates   of   qualitative   research   or   antagonists   of   quantitative   research   put   forward   the   concept   of   empathy   or   ‘take   the   role   of   the   other’.   In   other   words   one   has   to   ‘stand   in   the   shoes’  of  the  researched  to  understand  their  concepts  better.  This  is  only  possible  when  there   is  no  distance  between  the  researcher  and  researched.  Again,  the  story  of  Yasmin  and  similar   other  stories  would  never  have  emerged  if  the  researchers  from  the  very  beginning  would  have   stayed   at   a   ‘distance’   from   the   subject   in   order   to   follow   a   certain   methodology   of   research   instead  of  undertaking  research  per  se.     Another   key   advantage   of   quantitative   research   is   its   objectivity.   However   objectivity   is   too   plain  and  utterly  inhuman.  In  the  above  example,  Wasay  et  al  fail  to  recognize  the  cognitive  and   intellectual  processes  going  on  in  the  minds  of  their  subjects  while  collecting  this  data.  On  the   other   hand   subjective   data   will   lead   to   emotional   stories   and   description   of   the   new   and   challenging   social   processes   engulfing   the   lives   of   Multiple   Sclerosis   patients,   their   families,   physicians  and  society.     One   of   the   reasons   why   quantitative   research   creates   a   distance   between   researcher   and   researched   is   the   underpinning   belief   that   quantitative   research   can   be   replicated   whereas   this   is  not  the  case  with  qualitative  research.  The  core  reason  for  this  is  the  ‘disconnection’  between   researcher   and   subjects   on   a   human   and   emotional   level.   Researchers,   being   human   themselves,  are  likely  to  be  carried  away  while  undertaking  research  on  emotional  issues  like  
  • 5. the  one  described  in  case  of  Yasmin.  It  can  therefore  be  argues  that  some  distance  is  essentially   required  to  collect  meaningful  information.  However,  similar  stories  revealed  a  lot  of  common   areas   of   discussion   and   future   course   of   action   thereby   bolstering   the   idea   that   qualitative   research  had  a  key  role  to  play  as  well     In   conclusion,   there   is   no   right   or   wrong   argument   in   favor   of   or   against   the   ‘distance’   that   quantitative  research  established  between  the  researcher  and  the  researched.  It  all  depends  on   the   nature   of   research.   It   is   sometimes   necessary   to   keep   a   distance   while   it   is   sometimes   necessary  to  remove  it.  The  process  may  go  in  full  circle  will  repetitions  of  'distance'  and  'no  -­‐   distance'  (Qualitative  may  follow  quantitative  or  Vice  Versa)  as  shown  by  example.  Given  below   is   a   summary   of   advantages   and   disadvantages   and   the   researcher   has   to   choose   a   methodology  that  suits  the  requirements  of  research  in  a  given  time  and  space.         Summary:   Advantages   Disadvantages   1. Collection  of  hard  core  objective  data   1. Leave  out  human  element   2. Data   collected   is   close   to   ‘natural   2. Fail  to  understand  and  record  feelings   sciences  experimentation’.   3. Emotionally   involved   researcher   likely   3. Does  not  allow  ‘drifting’  in  emotion   to  misread  important  information   4. Data  collected  is  verifiable   4. Replication  is  a  question  mark  because   5. Replication  possible   of   dependence   on   researcher   6. Data   can   be   processed   and   analyzed   observation  and  finding   using  sophisticated  statistical  tools  and   5. Generalization   is   difficult   with   computer  soft-­‐wares  like  SPSS   emotionally  loaded  responses.   7. Saves   researched   from   information   6. Descriptive  information  is  scanty  that  is   overload   deemed   necessary   while   explaining   8. Extrapolation  of  data  is  acceptable   findings  from  quantitative  data.   9. Larger  scale  generalization  of  concepts          
  • 6.     Section  B       4a)   Are   the   following   variable   names   acceptable   by   SPSS?   Provide   explanations   in   your   answers.     i)  var  1   ii)  earningsaftertax   iii)  pt/job   iv)  var_0001     “Var  1”,  “pt/job”  and  “Var_0001”  are  not  acceptable  by  SPSS  as  it  does  not  entertain  spaces,   signs   or   symbols   between,   before   or   after   each   variable.   When   these   three   were   entered   at   variables   in   the   “Variable   view”,   a   window   “variable   contains   an   illegal   character”   appeared   promptly.       Variable  “earningsaftertax”  was  acceptable  as  a  variable.     4b)   If   you   are   given   the   task   to   code   up   a   set   of   survey   data   which   consists   of   mainly   attitudinal  and  open-­‐ended  responses,  what  cautions  would  you  bear  in  mind  when  you  carry   out  the  task?     Coding   for   open   –   ended   questions   is   complicated.   Answers   to   open   –   ended   or   attitudinal   response   should   be   summarized   into   a   number   of   different   categories   or   groups   before   entering   data   in   SPSS.   Groups   are   easier   to   make   once   the   researcher   has   gone   through   or   enlisted   all   the   responses   to   a   specific   question   from   the   respondents.   These   categories   or   groups  then  need  to  be  assigned  numbers  for  entry  into  SPSS  and  record  must  be  maintained   so  that  it  can  be  referred  to  during  explanation.       Take  this  question  as  an  example:     Q.  What  do  you  think  is  the  root  cause  of  terrorism  in  Afghanistan?     The  responses  can  be  many  but  mostly  would  fall  into:     a) Local  Culture/Fragmented  Society   b) Religious  Extremism   c) Poverty   d) Lack  of  Education   e) Lack  of  employment   f) Geostrategic  influence    
  • 7. Almost  80  to  90%  of  responses  would  fall  into  either  of  the  above  but  there  would  be  certain   answers  that  fall  into  neither.  For  those,  another  category  (Others)  can  be  made  and  coded  as   following:     a) Local  Culture/Fragmented  Society  =  1   b) Religious  Extremism  =  2   c) Poverty  =  3   d) Lack  of  Education  =  4   e) Lack  of  employment  =  5   f) Geostrategic  influence  =  6   g) Others  =  99     This  data  can  then  be  entered  in  SPSS  and  analyzed  further.     4c)  When  do  we  use  Cronbach’s  Alpha?  What  can  Cronbach’s  Alpha  tell  us?     We   use  Cronbach’s   Alpha  to   ascertain   the  degree   to  which   the   items   that  make  up  a  scale   are  coherent   with  one  another.   Cronbach's  alpha  is  a  test  of  internal  reliability  or  consistency  and  is  used  to  measure  how  well  a  set  of   items   (or   variables)   measures   a   single   unidimensional   latent   construct.     It   calculates   the   average   of   all   possible   split   –   half   reliability   coefficients.  Cronbach’s   Alpha   ranges   between   0.00   to   1.00.   A   reliability   coefficient  of  .70  or  higher  is  considered    "acceptable"  in  most  social  science  research  situations(DeVellis   2003)   however   Bryman   (Alan   Bryman   2008:   151)   advocates   a   figure   of   0.80   to   be   ‘typically   employed   as   a  rule  of  thumb  to  denote  an  acceptable  level  of  internal  reliability’.  A  minimum  level  of  0.60  has  been   described   as   ‘good’   by   Berthoud   (2000b:   169).   When   data   have   a   multidimensional   structure,   Cronbach's   alpha   will   usually   be   low.   Briggs   and   Cheek   (1986)   have   recommended   inter   –   item   correlation  of  0.2  to  0.4  as  an  optimal  range.     Cronbach's   alpha   can   be   written   as   a   function   of   the   number   of   test   items   AND   the   average   inter-­‐correlation  among  the  items.    The  formula  for  the  standardized  Cronbach's  alpha  is:       where  N    is  equal  to  the  number  of  items,  c-­‐bar  is  the  average  inter-­‐item  covariance  among  the   items  and  v-­‐bar  equals  the  average  variance.       The  formula  indicates  that  if  we  increase  the  number  of  items,  Cronbach's  alpha  will  increase.       Alpha  will  be  low  if  the  average  inter-­‐item  correlation  is  low.  Cronbach’s  alpha  increases  if  the   average  inter-­‐item  correlation  increases.    
  • 8. If  the  inter-­‐item  correlations  are  high,  then  there  is  evidence  that  the  items  are  measuring  the   same  underlying  construct.     This  is  really  what  is  meant  by  "high"  or  "good"  reliability  when  a   reference  is  made  to  a  unidimensional  latent  construct.     Cronbach's  alpha  will  generally  be  low  for  all  items  in  case  of  a  multi-­‐dimensional  data.  For  such   cases,   it   is   suggested   that   a   factor   analysis   be   carried   out   to   see   which   items   load   highest   on   which  dimensions  and  then  take  the  alpha  of  each  subset  of  items  separately.     Bibliography:   1. Acton  C.,  Miller  R.,  SPSS  for  Social  Scientists,  Pelgrave,  Second  Edition,  2009   2. Bezerra  R.  F.,  Jalloh,  S.  and  Stevenson,  J.  (1998)  “Formulating  Hypothesis  Graphically  in   Social  Research’,  Quality  and  Quantity  32(4):327  –  353   3. Bryman  A.,  Social  Research  Methods,  Oxford  University  Press,  3rd  Edition,  2008.   4. Bryman,   A.   and   Cramer,   D.   (1990)   ‘Concepts   and   Their   Measurement’,   in   Quantitative   Data  Analysis  for  Social  Scientists,  pp.61-­‐74.  London:  Routledge   5. CLMS,  (Version  No.  2)  Doctorate  in  Social  Sciences,  Module  1,  Unit  3   6. De  Vaus,  D.A.  (1996)  “Developing  Indicators  for  Concepts”,  in  Surveys  in  Social  Research,   (4th  Edition),  pp.47  –  59.  London:  UCL  Press.   7. Dijkstra,   W.,   Smit,   J.H.   and   Comijs,   H.   C.   (2001)   ‘Using   Social   Desirability   Scales   the   Research  among  the  Elderly’,  Quality  and  Quantity  35(1):107-­‐115   8. Drennan,  J.  (2003)  Cognitive  Interviewing:  Verbal  Data  in  the  Design  and  Pre  –  Testing  of   Questionnaires’,   Journal   of   Advanced   Nursing   Methodological   Issues   in   Nursing   Research  42(1):  57  –  63   9. Kraus,   L.   and   Augustin,   R.   (2001)   ‘Research   Report   –   Measuring   Alcohol   Consumption   and   Alcohol   Related   Problems:   Comparison   of   Responses   from   Self   –   Administered   Questionnaires  and  Telephone  Interviews’,  Addiction  96(3):459  –  471   10. Palant  J.,  (2007)  SPSS  Survival  Manual,  Third  Edition,  McGraw  Hill,  Open  University  Press   11. Schutz,  A.  (1962),  Collected  Papers  I,  The  Problem  of  Social  Reality  (The  Hague:  Martinus   Nijhof)   12. Wasay,  M.  et  al,  Multiple  Sclerosis  in  Pakistan,  Multiple  Sclerosis,  Vol.  13,  No.  5,  668-­‐669   (2007)   13. Wright   Mills,   C.   (2000)   ‘Abstracted   Empiricism’,   in   The   Social   Imagination,   (40th   Anniversary  Edition),  pp.  50  –  75.  New  York;  Oxford:  Oxford  University  Press