critique an article

Running Head: CRITICAL APPRAISAL        1
CRITICAL APPRAISAL        12
CRITICAL APPRAISAL
Table of Contents
Introduction    3
Question 1    3
Question 2    3
Question 3    4
Question 4    5
Question 5    5
Question 6    6
Question 7    6
Question 8    7
Question 9    8
Question 10    8
Question 11    9
Conclusion    9
References    11
    
Introduction
Critical appraisal of a research article is a necessary aspect in order to determine the quality of research paper. It helps to identify the strengths and weaknesses of a paper and further helps to determine the areas where future research may be required. A Critical Appraisal Skill Program (CASP) checklist will be used in order to identify the strengths and weaknesses of the cu
ent paper.
Question 1
The chosen article is a randomized control trial (RCT) which addresses benefits of the use of mobile application by discharged patients with stoma. Wang, Zhao, Huo, Wu, Yang, Li & Wang (2018) through their study addresses a clearly focused issue in terms of the population studied during RCT and the outcomes considered. Authors selected a range of patients with some common and characteristic criteria, which helped to identify the control as well as intervention group. Moreover, the inclusion-exclusion principle used for the selection of patients helped to address the focused issue. Aim presented by the authors clearly addresses that this study addresses the self-efficacy in stoma patients post-operation.
Question 2
Patient’s selection for this study was a very complex process as authors used number of steps and levels in order to na
ow down number of patients to be actually included in the study. Nanjing, China was selected as the prefe
ed location from where 10 tertiary hospitals were selected. Patients from these selected hospitals were monitored and an exclusion-inclusion principle was being implied which helped to segregate patients on the basis inclusions of permanent stoma after surgery, age, language, smartphone owner. Beside the inclusion criteria, following exclusion criteria were used; other type of cancer, some other disorder, substance abuse, possibility of death within 48 hours of surgery.
This helped to identify 212 patients, which later were randomized by assigning a number to every patient. Two groups of 106 patients each were created as control and intervention group respectively. The Research Randomizer helped to generate a set of 53 numbers ranging between 1-106 and the number selected by patient determined whether they belonged to control or intervention group. Therefore, the criteria reflects that the assignments of patients was definitely randomized and unbiased however, the prior used exclusion-inclusion principle can be considered as a factor of biasness.
Question 3
Yes, the authors of this study made sure that the patients who entered the trial were properly accounted for the conclusion. This can be supported by the fact that patients who spoke Chinese and has accessibility of smart phone was the major inclusion criteria along with presence of stoma in both the groups. Moreover, whether patients were or were not properly aware of using the mobile application, they were being accounted for the conclusion. Likewise, in the control group patients were given similar routine care but it was face-to-face that is inn personal. Therefore, it is evident that the trial did not stop earlier and patients were analyzed in groups according to which they were randomized.
Further, the flow chart presented by authors clearly depicts the follow up process. Within intervention group, there were 6-drop outs therefore; total analyzed patients were only 100. While in control group, there were only 3-drop outs who did not want to continue the trial therefore, 103 patents were analyzed overall in control group.
Question 4
Thabane et al. (2013) suggested that it is necessary for the patients, clinicians or other study personnel to be blinded by the course of trial and this is majorly because the suspects may change their attitude or behavior towards the trial. This change adds to the biasness towards trial and also points towards the effectiveness of trial (Peters, Adam, Alonge, Agyepong & Tran, 2013). Authors of this paper mentioned that the trial performed by them may not be blinded that is the participants or patients were aware of different interventions they were receiving. Further, they also suggested that structure of a randomized control trial (RCT) might not be suitable for effective testing of an application. Therefore, proper and extensive research is require in order to add provisions within the structure.
Further, if the patients were not blinded to the trial interventions there may be a possibility of ‘placebo effect’ that suggests that patients reflects stronger treatment results when they are aware of...