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Critical Appraisal of Clinical Researches

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Critical Appraisal:

This is a term used for subjective writing because it helps to express the writer’s opinion about the given paper, analysis refer to breakdown the parts of study and critical means of reading the paper critically and then writing exact information about the paper, this is an appropriate way to express and evaluate the study done in paper. When a researcher submits his paper to a journal, they send that paper to their experts to check the authenticity of the paper and the nature of the study. This report provides a critical analysis of two papers, both are medical related studies which provides insights regarding those health issues along with their possible solutions. Major keys of critical analysis kept in mind while writing about both papers, proper introduction, key points of the paper and focal points are discussed in the paper. Paper one is about tai chi and its effects of people who are suffering fromfibromyalgia, every aspect regarding that paper is discussed along with its methodology and results, whereas 2nd paper is about dementia and role of family carers in their life, both papers are analysed critically and in order to provide authentic information regarding both papers.
A critical appraisal of effect of tai chi versus aerobic exercise for fibromyalgia: competitive effectiveness randomized controlled trail

Did the paper address clearly focus issue?

Yes, this paper discussed a relevant and important issue, this study is based on a clinical trial which allows people to get an insight of this health issue along with its non-medical cure, this paper also provides different visions about intervention in the field to make it helpful for related people. This paper is quite good for a general readership as well as it consists of some strong scientific study which shows that how its impact on a human who is going through Fibromyalgia. Although there was no significant study related to this field was provided to choosing this issue and providing a valid study in the field will contribute a lot in the field, however, the issues were clearly focused and every related aspect was focused throughout the study(Chenchen, et al., 2018)

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Is the hypothesis stated clearly?

There is no proper hypothesis statement in the paper, or it could be better to say that the hypothesis statement is not prominent, there are some sections in the paper where researcher used an approach to address the situation where he used the term “hypothesized” to state their concept, these statements are used in different portions of paper with the same context that tai chi has a positive impact on patients health which is better than aerobic exercise treatment. Although it can be difficult for some readers to get an insight of that statement on the first go, but later it can explain the relation of statements in the stated segments (Chenchen, et al., 2018).

Is that study original?

Yes, this study is based on a true health issue and the different effects of its two different non-medicated treatments. Every concept stated in this paper is authentic, this research paper will be helpful for other researchers as well. this paper discussed the impact of tai chi on people who are going through fibromyalgia, researchers provided another approach, aerobic, which may affect their health. Collection of data was based on true methodology; results were concluded after going through the whole process. This study shows that authentic approaches are used to come up with suitable results which may contribute tothe clinical field. Staff used in this research was also authentic which helps to provide the best possible facility to make this research beneficial for the population.

Design of study?

The design used in this study is prospective, researchers have used the randomized approach to ensure its benefits to every person who goes through this medical condition. Overall this research was done in 52 weeks, other than that, this trail was the single-blinded approach of comparative effectiveness. Researchers selected the observation method to assess the situation of patients, there were two groups of people suffering from fibromyalgia, one group was treated by aerobics while other was treated with tai chi. Both groups were treated equally expect the given intervention, both get the same amount of treatment, expect a group who was given treatment twice in a week to show its results. The results showed that people who were treated with tai chi shoes more improvement than those who were treated with aerobic exercise. Although this method was used for a year it was assured in the whole process that sample will be treated accurately to ensure exact results(Chenchen, et al., 2018).

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Was this design appropriate?

Yes, this design was appropriate according to the research type. Nature of study requires this type of design to ensure the authenticity and accuracy of the research study. Selection of sample and its size was appropriate for this study, timeline used for this research is adequate to ensure the long-lasting results of treatment on people. This research is not a single day practice, researchers spent a lot of time on the process to get the right results without any minor issue. The research design was appropriate for another reason that time of 52 weeks requires this type of method to assess the data and observe the changes, which later helps in analysing and conclusion procedure. This design helps researchers by providing ease of accuracy.

Were participants blinded in this research?

It was clearly mentioned in the paper that research was totally blinded regarding treatment allocation, every involved member e.g. nurses, health workers, and patients were blinded. Staff was blinded because they were the key members who have to conduct the baseline and they have to follow up on the assessment as well.This allows forgetting results without any biased report. In this research paper, it was somehow necessary to maintain that scenario, as it was a clinical trial, perception of any participant may affect this study, that may end up in a biased result. Using blinded technique researcher ensured that they are providing the actual insight of the whole study without any interruption of someone else’s perspective.

Was the treatment assigned and patients were randomized?

Yes, the sample was selected randomly, the researcher may be used this paper to make this sure that, this research paper is free from any involvement of personal perception throughout the procedure of research. Sample in the study was random which ensure that the study is not biased and not focusing on any single group, results of this study can be implemented on anyone from the population. Three trails of that study were randomized, while the other three was non-randomized, but both show the same results of the study. Selecting that medium nay allows them to get results with ease and accuracy. The treatment selected for this sample was also implemented randomly, on both groups.

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Aside from the experimental intervention, were the groups treated equally?

Yes, every group in this research was treated equally, it can be seen in the paper that the researcher provided the same resources to all groups but the experimental intervention. The idea of treating every group equally was accurate, this allows them to treat every person equally. By ensuring the similarities in both groups researchers reduced the ratio of any difference which may cause a problem in the result of the research paper. There were groups which were treated randomly and some which were treated nonrandomly, nature of treatment also varies along with the timing of treatment. A group of patients was treated with tai chi once in a week while other was treated twice in a week, this approach was used to check out the result of excessive treatment. Randomizing similar groups allows confounding factors in the trail, this paper also based on the same approach, researchers work on this method which helps them in gaining the exact results without any disturbing factor which attributed in treatment of patients.

Were all clinical outputs considered?

Results from this research are addressed appropriately in this paper, every clinical output is considered while setting the research and conclusion of the study. True clinical approaches were used in the paper to assure the right explanation of intervention done in the paper. This research paper throughout maintained its style and every concept is addressed properly, which is helpful for the reader to understand the outputs effectively.

Is data supporting the conclusion?

Data given in the research paper shows the accuracy in the conclusion, the total conclusion is based on the actual data, which shows that the process is followed thoroughly. Conclusion described the fact that tai chi has a positive impact on the physical condition of the patient, its impact is clearer and more beneficial for them, the same thing is addressed in the data. Relation of data and conclusion can be seen clearly in the paper, researchers efficiently portray the right image of his research by keeping proper association with data and the results.

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Can results be applied to the local population?

Yes, the results of this research can be applied to the local population, as this factor was already kept in mind before conducting the research, that this paper will contribute to clinical practices. Selecting random samples allows generating those results which can be applied to every person which is going through the same medical conditions approached in this paper.

Critical appraisal of “Making decisions for people with dementia who lack capacity: qualitative study of family careers in UK”

A clear statement of the aim

The area of the paper is health care and it specifically targets the people who are suffering from dementia and facing challenges regarding lack of capacity in decision making. The chosen topic is quite important in health care. As the people age, the number of dementia victim also increased because often older people experience this illness. The patients who face dementia are unable to make a decision on their own and require the help of family members and close friends. Some countries allow legislation proxy in decision making, enabling the family to make the decision on behalf of people who are suffering from dementia. The problem of statement aims to identify some decision that is common but difficult to make by family members on behalf of the patient. Further, the aim to identify facilitator along with the barriers to decision making in order to give proper care to avoid such barriers(Livingston, et al., 2010). 

Assignments of patient treatment

The ethical perspective was quite the concern of the researcher. For the individual interviews, the constant of the respondent was getting through the phone call. After the positive response by the respondent, the researcher sends the questioner to them. Later on, on phone call researcher asked their constant, if they want to give a response to these questions or not. The participation of the people was completely voluntary. The topic is very sensitive to the people who participated in the research were provided detail information and the importance of their participation. The researcher further mentioned that the data collected for this study was completely used for the informative purpose and there is no such detail regarding the collected data which is not mentioned is the research paper. Furthermore, the research ethics and along with research and development committees has given approval to this research study.

Is a qualitative methodology appropriate?

Yes. The nature of the research topic is descriptive and the selected topic require in-depth information. By using the qualitative method, the research was able to get the individual perspective of the people who are involved in the concern phenomena the discussion with the respondents using qualitative research has provided researcher different perspectives. The research design chose for this study is very suitable.

Was the research design appropriate?

The researcher has used a qualitative research design and related tools to carry out the research. But there is no proper justification mentioned in the research paper that elaborates on what basis the researcher chose qualitative research design and why the other designs are not appropriate for the research. The research design is very important to conduct research because the whole research process depends on it. The researcher should mention the appropriate justification for using this design instead of only stating which design is used.  There are certain criteria to chooses research design and the researcher cannot select it on their own. The lacking of research design justification can decrease the quality of the research paper. Further, the researcher did mention the tools that will be used in the research, there was more than one qualitative method used in this study for data collection.

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The recruitment strategy

In the research paper, the sample of the participant was 43 involving family cares of the population with dementia, it was the sample for focus group discussion.  The other 46 participants were those who had experience of making such decisions, they were chosen for interviews. In the study, the career refers toward adult family member or friend who gives unpaid assistance to the dementia patients. For the interviews section, the career describes a respondent who had already made decisions on behalf of a dementia patient. All the selected participants were somehow connected with concern phenomena.The research has selected the participant from diver’s socioeconomic characteristic to cover the range of different experiences. For the selection of participant in the research study, the purposive sampling was used to ensure the validity of the findings and it provided maximum variation in the data.

Was the data collected addressed the research issue?

The research study was conducted in two phases, firstly an initial focus group discussion. The reason for using this method was to make a list of the common areas which are reported to have more difficulties in decisions making on the behalf of patients. While, in the second sitting which was interviews, the domains were discussed that were gathered in the 1st phase during the in-depth interviews individually. In the second phase, the researcher stopped the process of recruiting at the point where the possibility of gathering new information becomes useless because the responses were starts to repeat the same phenomena. The data collection methods used in the research are quite suitable and provided detailed and accurate primary data.

The relationship between the researcher and participants?

The researcher contacts the respondent before conducting research and asked their constant. It is vital in research to gain the trust of respondents in order to get accurate data. The researchers often use small talks before the interview and focus group discussion to break the ice and to make the respondent more comfortable with the environment. However, in the research study, the researcher did not mention such a method to develop the participants, researcher relation. The contact prior to discussion and interviews regarding questioner and the constant of the percipients may consider the indicator of developing positive relationships. There should be a better approach to approach the respondents because at this level both researcher and participants are strange to each other and this factor can lead to hesitant answers, which can affect the reliability of the data.

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Data Analysis   

The data collected from the participants were recorded digitally. The digital record of data is considered to be more reliable because field notes or other manual records only give the information that the researcher has written and there is a possibility of missing important details. Through the digital record, the researcher can listen to the discussion and interviews multiple time to ensure the key points. In the research paper, the digital record removes the identity of the respondents and the researcher categorize them as respondent 1, 2 and so on. Further, the researcher used Atlas.I 5.2 software, which is specifically used for the qualitative research for coding and managing the spread data. After converting the recorded data into understandable written form, the researcher sends it to the participants in case if they want to alter or change anything. In both phases the analysis was part of the iterative process, the researcher used the preliminary coding frame for initial interviews followed by a thematic analysis approach. Using different data analyzing approach made decreases the chances of mistakes in the results.

Statement of findings

The research paper is very descriptive and provides detailed information about the topic. However, one most important feature was seemed to be ignored by the researcher which is clear statement t of findings. The findings of the research were mentioned in the descriptive form and there was no such section that sums up all the aspects of findings. The research study totally based on the data collection, analysis and other processes that can lead it toward the findings. So, it is necessary to make a clear finding of statements. However, the readers who critically study the research paper can have the proper idea about the research paper, 2 qualitative methods were used in collecting data which make it rather vast and the findings of each section are mentioned within them.  There should be a section in the paper that gives a proper statement regarding the findings.

Value of the research

The topic is quite researched worthy and address a very important issue regarding health. The patient of dementia faces challenges because of lack of ability. The family members, close friends, and professional had to step in to make a decision on their behalf.  The study has shed light on a few barriers a problem that people face while making decisions for dementia patients such as legal: financial matters and so on.  The study has made a great contribution to the literature regarding this issue. However, the significant of the study was missing in the paper. The researchers who conducted the study can explain better its value but it was not mentioned in this research paper.

Conclusion

Both research paper was the same in the nature of research design. Qualitative research allows the researcher to use different methods in order to collect the data. In both of the papers, there were different qualitative methods used such as observation, focus group discussion and in-depth interviews. The observation method of qualitative research allowed the researcher to gather accurate data instantly instead of predicting it later with the collected data. Further, the in-depth interviews and focus group discussion provided the research reliable and accurate data about the concern phenomena. However, there were some important research elements were missing such as positive relation between researcher and participants, there was no such method that was used to break the ice, the precise finding statements was also missing along with the significance of the study. This absence of these elements can decrease the quality of the research paper.

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