|HOW TO DO IT
|Year : 2022 | Volume
| Issue : 2 | Page : 184-186
Research data collection in field locations situated at high altitude
Jayanti Pant1, Rashmi Malhotra2, S Srikant1, Latika Mohan1
1 Department of Physiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
2 Department of Anatomy, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
|Date of Submission||29-Jun-2022|
|Date of Decision||16-Jul-2022|
|Date of Acceptance||18-Jul-2022|
|Date of Web Publication||29-Aug-2022|
Prof. Latika Mohan
Department of Physiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Pant J, Malhotra R, Srikant S, Mohan L. Research data collection in field locations situated at high altitude. J Med Evid 2022;3:184-6
| Introduction|| |
The collection of samples from a field location for research in health care provides an opportunity to understand the actual condition of patients/subjects in their environment. Such sampling is executed in person in subjects' dwelling areas in contrast to remote hospital/health care set ups. This helps to preview the subjects' perspectives, orientation to the treatment protocol, living conditions, their practices and helps to identify pertinent problems and lacunae associated with them. The process of collecting such data not only helps in developing a great rapport with the subjects, it also provides valuable information related to them to the medical researchers which may serve as the basis for the development of several health care practices to be followed in future. The collection of samples from a field location can present several problems, very different from research carried out in a controlled laboratory environment. Patience and diplomacy in dealing with the local population, keeping local customs and sentiments in mind and trying to maintain as close to laboratory levels of standardisation and calibration are some of the challenges faced.
The collection of field data and samples at high altitude areas is further challenging due to extreme environment conditions. Due to the difficulty in the collection of such information, it makes it valuable to the scientific community. The altitude, effects of hypoxia, difficult terrain, cold temperature, and long and arduous travel are some of the critical situations which the researchers face while collecting data in such geographical areas., Further, challenges may be in form of restricted and fixed time of collection of samples, limited resources and workforce and failure of operation of some equipment due to poor electricity supply or malfunctioning due to the transportation on the rough terrain and cold weather.
It must be accepted that such kind of field data collection is a joint effort put together by several members of the research team and simultaneous co-operation by the local population. The present manuscript is a description of the important practices to be followed while preparing for collecting such field data at high altitude areas. [Figure 1] repesents the scheme of steps to be taken during high altitude research data collection.
|Figure 1: Schema for steps to be taken during high altitude research data collection |
Click here to view
| Identification of the Geographical Area and Population|| |
The study population has to be identified before taking up the study. Their areas of dwelling and the respective altitude must be identified in the beginning. If the study population is indigenous, it must be ensured whether any clearance or approval from administrative authority or community body is required for conducting the data collection from the population. It is advisable to communicate with the village/community head before proceeding with the study. The head of the community helps to bridge the gap between the population and the researcher. The gap may be in form of language barrier or feeling of suspicion in the community for the research team.
The team must interact with the community/study population before their actual collection of data and discuss about their research and its benefits to the community. This helps in developing rapport and confidence and data collection becomes easy later on. A prior understanding of cultural practices and communication taboos is useful for a fruitful interaction. Travel to high altitude location must factor in time for physiological adjustments to ambient hypoxia, cold and team must be prepared to rest for a day or two before ascending to their actual destination.
| Financial Support|| |
Field studies involve costs of travel, stay and food. Funding has to be arranged before embarking such an assignment. Financial support must be availed in form of research grants from various funding bodies.
| Manpower|| |
An adequately trained team of researchers is mandatory for the field data sampling. Manpower in form of technical/nursing staff who can draw blood samples, run specific equipment required for the study proficiently and having good communication skills with knowledge of local language must be selected. Staff for maintaining documents relevant for the study is also required. Each of the team members must be allotted with a particular assignment. The data points or the parameters to be collected need to be constructed and number of researchers required for collecting the parameter must be decided in advance to complete the task in a short period of time. It is very important to understand here that if any of the team members is inadequately trained to do the assigned duty, it affects the data collection, causes unrest and loss of confidence among the participants and leads to loss of time and money utilised to conduct the data collection. Further, it must be realised that the opportunity to collect the data from the population may be missed even if a single member of the team is not capable of performing the designated task. Hence, the selection of team members plays a pertinent role and must be taken care of before initiating the collection.
| Equipment|| |
The equipment used for the field research data sampling may be of two type: primary equipment and secondary or associated equipment. Primary equipment include those which are mandatory for the data collection, for example, vacutainers and syringes for the collection of blood samples. The associated equipment are not mandatory and data collection is not dependent on them, for example, a centrifuge machine. A check list for the primary and associated equipment must be prepared before beginning the travel. The list must be checked and matched after data collection is completed in the field. This avoids any misplacement of equipment during the trip.
The equipment which have to be transported to the site must be previously calibrated. Sometimes, the calibration might be disturbed due to transportation on the rough terrain; hence, it is advisable to re-calibrate them after reaching the place a day before. This avoids unwanted time loss during the actual data collection and the authenticity of the data is maintained.
Power failures are quite common in remote areas; hence, power back up in form of additional batteries, solar charging cells, etc., must be carried along.
It is further suggested that additional sets of equipment may be carried as feasible, in case if one fails, the other set can be used for the data collection.
| Documents|| |
Copy of study proposal with ethical approval and administrative approval if any, may be carried. Consent forms, survey forms/questionnaire, data entry sheets, record maintaining register/diary and additional blank papers must be carried along.
| Identification of Place of Conduct of Data Collection|| |
The collection of samples and data might be dependent on equipment or devices which are electricity driven such as ECG or multi-paramonitors. Hence, a place like primary health care centre or school or village headquarters with adequate provision of electricity and electrical grounding may be opted for such tests. Hence, prior approval for the use of these buildings has to be taken. Such buildings must be scrutinised in advance for availability of electrical facility and setting up of various stations for the sample collections.
Further, an additional building/area with adequate power supply must also be identified simultaneously in case, the power supply of main building fails, the other building/area may be used.
| Storage and Transportation of Body Fluid Samples|| |
Field collection of body fluid samples, maintenance of cold chain, and their transportation is an important aspect in these trips. The distance between the site of collection and the testing laboratory must be calculated and time of transportation of the samples to the laboratory must be considered. Hence, storage equipment of the samples must be selected in way that they maintain the temperature required for transportation of the required samples. Adequate quantity of ice gels/ice packs must be carried for the same. Further, an additional area having facility for cooling/freezing the packs must be identified enroute. Since these geographical areas are prone to landslides and frequent road blocks, the delay in transportation of the samples may be expected. Hence, it advisable to identify few local restaurants/shops having freezers and drop some ice packs in these freezers, so that there is an option available for changing the packs on the way to the laboratory.
| Information|| |
A prior information to the community/village head must be given so that people of the community are prepared for participation in the study. Further, the participants may be informed to be appropriately prepared for blood samples which need to be collected in fasting state.
Sequence of Data/Sample Collection
It is advisable that a blue print of the workflow must be prepared well in advance before the day of sample collection. For example, registration of participants must be the first step of data collection followed by initial/screening examination and signing of relevant documents such as consent form. This may be followed by specific data/sample collection procedures. It is important to understand that at every step, good communication skills are essential. All the team members must thoroughly understand the blue print of the workflow, so that time loss can be prevented on site and state of confusion do not exist among the members. It must be emphasised that time management is extremely important during these field collections, since participants cannot be kept waiting for long periods.
| Self Care|| |
The research team members must take care of their own health during such expeditions. If any of the team members are unwell, it lowers the morale of the entire team. Temperature is an important factor which must be taken care of by the research team. Adequate clothing must be carried by the team members. Dry snacks, protein bars, biscuits, nuts, etc., must be carried. Fluid intake must be appropriate and measures to prevent dehydration must be taken by the members. Usage of UV-protection sunglasses, sunscreens, appropriate moisturizers, etc., is important. Medications such as acetazolamide, steroids, inhalers, aspirin, antiallergic drugs and drugs for motion sickness must be available in the first aid box. Team members on prior medication for any disease must continue with their medication.
| Conclusions|| |
The success of data or sample collection in field from high altitude areas is dependent on determined and skilled team and needs additional preparation based on the geographical set up. It is not similar to the collection of data on a plain area. It is pertinent to understand that the research data obtained through these trips is hard earned and is extremely valuable. It tests the physical and mental resilience of the team members collecting the data. Hence, systematic execution of each and every step counts and decides the fate of the expedition.
Financial support and sponsorship
The present manuscript is a part of extramural project funded by Uttarakhand State Council for Science and Technology (UCOST) (Grant No-UCS&T/R&D-19/19-20/17630).
Conflicts of interest
There are no conflicts of interest.
| References|| |
ABC of oxygen: Oxygen at high altitude. BMJ 1998;317:1063-6.
West JB, Schoene RB, Luks A, Milledge JS. The atmosphere. In: High Altitude Medicine and Physiology. 5th
ed. New York: CRC Press; 2012. p. 16-27.
West JB, Schoene RB, Luks A, Milledge JS. Altitude acclimatization and deterioration. In: High Altitude Medicine and Physiology. 5th
ed. New York: CRC Press; 2012. p. 40-52.
West JB, Schoene RB, Luks A, Milledge JS. Physiology and medical aspects of heat and cold. In: High Altitude Medicine and Physiology. 5th
ed. New York: CRC Press; 2012. p. 311-72.
Mohan L, Singh SP, Pant J. Pilgrim health: Short sojourns to high altitude with pre-existing medical problems. J Med Evid 2022;3:42-8. [Full text]