Large scale studies are important to ascertain whether a phenomenon manifests similarly in different individuals, in different settings; whether demographics such as age, gender and cultural variables impact the phenomenon, etc.

In intervention studies it is important to discover whether the same intervention "works" consistently or not, and factors that impact this, in relation to the different demographic groups, diagnoses, social variables and cultural considerations.

Certainly though, in a large data set, it is often a less nuanced analysis that is possible. This is often not due to a lack of interest in sophisticated answer-seeking, but rather a limitation around 'available' data. A population-level study on suicidality, for example, will typically examine issues such as mortality rates, ambulance service call outs, emergency department presentations and severity of risk indicators on presentation.

We then set up multi-site comparisons - again where possible within budgets and workloads - or at least conduct cohort analyses to learn more.

Very importantly, in intervention studies, we want a sense of whether and how the way we attempt to assist people makes a difference, so we need to measure change over time. Again, large (public) data sets are typically available as de-identified pooled data at a single time point. We do indeed thus need 'nuanced spaces' to look at 'complexity'. I'm not sure about the utility or buy-in out there for the term 'minutia' though...

Hmmmm yes Melissa, thank-you for your thoughts and insight into large scale studies and what this type of research and data is valued for. Your final point is very much of interest however in pointing out that we do need nuanced spaces to be investigated in order to to look at the complexity of contextual circumstances and how behaviour manifests differently in different individuals. This type of approach to data gathering and analysis helps to clearly understand the individual and social factors that regulate behaviour (including age and culture), as well how factors that influence attitudes, perceptions and values come to be embedded and enculturated.

In a study that investigated the interaction between health care professionals and patients at the St Andrews Medical school, researcher found of value the pursuit of the “minutia of everyday interactions” to explore the complex nurse-child interactive behaviours and conversations (Zhou, Cameron, Forbes, & Humphris, 2012). This data micro level focus of contextual data was beneficial in helping to reveal patterns in the way that doctors deal with patient concerns taking into account the context of the doctors training, experience and patient factors such as age, gender and deprivation. This type of research is also a great example of blending ecological field work in a study that also employs more macro analysis.

One of the limitations of large studies is that there is always a significant number of data that cannot be explained or where there is an inability to account for the variance and other factors that exist. An investigation of the minutia can help in this respect, for example Barton and Grant (2006), investigators in public health research, were interested in exploring the complexity and interconnectivity that exists within contexts and individuals, particularly factors that operate at different levels from household contexts to community to wider system levels. A further examination of those details located within particularly the micro environment or specificity of place helps to provide greater insight into what differentially impacts on how factors and determinants influence individuals and groups. Thompson (2013) suggests that individual characteristics and preferences need to be accounted for and these are active within various environments (cultural, political, socio-economic) and operate at different scales from individual households to neighbourhoods, communities, urban/rural regions and wider geographic levels.

I suppose therefore that we need market and articulate the validation of the importance of this data for those investing in the research. It may be the case that with all large scale studies a component of the research investment goes into better understanding the minutia.

Cheers, Alice :)

Ah, yes, the analysis of 'minutia' of this kind is full of useful insights into and opportunities to explore good practice; to open up a deep dialogue of this kind is perhaps the most facilitative when it comes to being able to educate professionals who might otherwise be resistant due to perceived skill already in these areas.

A colleague of mine - Bridget Hamilton - writes beautifully on such close observational work and the learning possible from examining staff-patient interactions; see:

Hamilton, B., & Manias, E. (2006). ‘She's manipulative and he's right off’: A critical analysis of psychiatric nurses’ oral and written language in the acute inpatient setting. International journal of mental health nursing, 15(2), 84-92.

Hamilton, B. E., & Manias, E. (2007). Rethinking nurses’ observations: Psychiatric nursing skills and invisibility in an acute inpatient setting. Social Science & Medicine, 65(2), 331-343.

Wonderful information and links to research in this field Melissa. I appreciate your generous sharing and will explore these publications, thank-you.