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Discussion Over Hypertension due to Obesity.....

We will be reviewing a “keeper study” this week—evaluate an article by working through the following 7 questions

Again, keeper studies can be identified using handy Rapid Critical Appraisal checklists consisting of a set of simple but important questions. Below are sample questions developed for use with quantitative studies that are applicable to most appraisal situations (it’s important to note that qualitative evidence, if it’s relevant to the clinical question, should not be dismissed):

Why was the study done? Make sure the study is directly relevant to the clinical question.

What is the sample size? Size can and should vary according to the nature of the study. Since determining a valid minimum sample size in a single study can be difficult, taking into account multiple studies is beneficial.

The answer to this question alone should not remove a study from the appraisal process.

Are instruments of the variables in the study clearly defined and reliable? Make sure the variables were consistently applied throughout the study and that they measured what the researchers said they were going to measure.

How was the data analyzed?

Make sure that any statistics are relevant to the clinical question.

Were there any unusual events during the study? If the sample size changed, for example, determine whether that has ramifications if you wish to replicate the study.

How do the results fit in with previous research in this area? Make sure the study builds on other studies of a similar nature.

What are the implications of the research for clinical practice? Ask whether the study addresses a relevant and important clinical issue.

As you work on your capstone project proposal, you will want to share your progress with your peers and instructor and seek or provide guidance or share insights. By the due date assigned, go to the Discussion Area and post responses to the discussion question. All responses should be posted to the appropriate topic in this Discussion Area. It is important to support what you say with relevant citations in the APA format from both the course materials and outside resources. Include the South University online library in your research activities utilizing not only the nursing resource database, but also those pertaining to education, business, and human resources.

I have to add my PICOT question to the end of it. So here it is too.

PICOT Question

The PICOT question is, ‘does healthy lifestyle among individuals with high blood pressure lead to better management of the condition as compared to hypertension patients who seek medical treatment in a recovery period of eight months?’In this context, a healthy lifestyle means regular exercise and healthy food.


WEEK 5 NOTES I tried to upload them and it told me it was an invalid upload, Hmmm weird

Critical Appraisal

Questions to ask when evaluating a study:

1. Is this relevant to my patient or the problem?

  • Once you begin reading an article, you may find that the study population isn't representative of the patient or problem you are treating or addressing. Research abstracts alone do not always make this apparent.
  • You may also find that while a study population or problem matches that of your patient, the study did not focus on an aspect of the problem you are interested in. E.g. You may find that a study looks at oral administration of an antibiotic before a surgical procedure, but doesn't address the timing of the administration of the antibiotic.
  • The question of relevance is primary when assessing an article--if the article or report is not relevant, then the validity of the article won't matter (Slawson & Shaughnessy, 1997).
  • Validity is the extent to which the methods and conclusions of a study accurately reflect or represent the truth. Validity in a research article or report has two parts: 1) Internal validity--i.e. do the results of the study mean what they are presented as meaning? e.g. were bias and/or confounding factors present?; and 2) External validity--i.e. are the study results generalizable? e.g. can the results be applied outside of the study setting and population(s)?
  • Study reliability refers to the “repeatability” of the study—that is, if the study were repeated under the same circumstances, would the results be the same?

2. Is the evidence in this study valid?

3. Is the study reliable?

Instrument reliability refers to the consistency of the instruments—will they yield the same results under the same conditions?

Rapid Critical Appraisal (RCA)

This first step is actually composed of two parts. The first enables clinicians to identify, from the enormous quantities of published research, those studies that are most relevant to the specific clinical question at hand and are valid. These studies are called “keeper studies.”

The second part involves the appraisal of the keeper studies.

Keeper studies can be identified using handy Rapid

Critical Appraisal checklists consisting of a set of simple but important questions. Below are sample questions developed for use with quantitative studies that are applicable to most appraisal situations (it’s important to note that qualitative evidence, if it’s relevant to the clinical question, should not be dismissed):

1. Why was the study done?Make sure the study is directly relevant to the clinical question.

2. What is the sample size?Size can and should vary according to the nature of the study. Since determining a valid minimum sample size in a single study can be difficult, taking into account multiple studies is beneficial.

The answer to this question alone should not remove a study from the appraisal process.

3. Are instruments of the variables in the study clearly defined and reliable?Make sure the variables were consistently applied throughout the study and that they measured what the researchers said they were going to measure.

4. How was the data analyzed?

Make sure that any statistics are relevant to the clinical question.

5. Were there any unusual events during the study?If the sample size changed, for example, determine whether that has ramifications if you wish to replicate the study.

6. How do the results fit in with previous research in this area?Make sure the study builds on other studies of a similar nature.

7. What are the implications of the research for clinical practice?Ask whether the study addresses a relevant and important clinical issue.

Valid and Reliable

Once keeper studies have been identified, it’s time to analyze them using a similar set of RCA questions, but ones that enable clinicians to further hone a study’s applicability to a clinical situation. Below are sample questions—along with sample related sub-questions—taken from the appraisal of study presenting the results of a randomized clinical trial for a drug*:

1. Are the study’s findings valid?Specific sub-questions asking about the participants of the study, the demographic make-up of the control group, and other variables provide further guidance.

2. What are the results of the study and are they important?Readers should also pay attention to the size and significance of the healthcare intervention or treatment proposed, the specific statistics relevant to the clinical situation, and more.

3. Will the results actually help clinicians care for patients?Clinicians should determine whether the results are applicable to his or her set of patients, identify the risks and benefits of the specific treatment recommended, and analyze whether the treatment conforms to patient preferences is feasible within the institution.

*It is also important to recognize that the funding organization behind the study is a factor in determining the reliability of a study.

Clinicians may question studies funded by private entities such as pharmaceutical companies, which may have profit-driven reasons for ensuring positive outcomes.

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