Table 1 Cross-sectional study: (Insert the title of the paper you are appraising) Critical...

Question

Table 1 Cross-sectional study: (Insert the title of the paper you are appraising)
    Critical appraisal questions
    Underline your answe
    1.Were the criteria for inclusion in the sample clearly defined?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    2.Were the study subjects and the setting described in detail?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    3.Was the exposure measured in a valid and reliable way?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    4.Were objective, standard criteria used for measurement of the condition?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    5.Were confounding factors identified?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    6.Were strategies to deal with confounding factors stated?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    7.Were the outcomes measured in a valid and reliable way?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    8.Was appropriate statistical analysis used?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
Add additional pages if needed
Reference: (insert the reference here according to APA 6th edition)
    Table 2 Case-control study: (Insert the title of the paper you are appraising)
    Critical appraisal questions
    Underline your answe
    1.Did the study address a clearly focused issue?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    2. Did the authors use an appropriate method to answer their question?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    3. Were the cases recruited in an acceptable way?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    4. Were the controls selected in an acceptable way?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    5. Was the exposure accurately measured to minimise bias?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution


Critical appraisal questions

Underline your answe
    6. Aside from the experimental intervention, were the groups treated equally?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    7. Have the authors taken account of the potential confounding factors in the design and/or in their analysis?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    8. How large was the treatment effect?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    9. How precise was the estimate of the treatment effect?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    10. Do you believe the results?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    11. Can the results be applied to the local population?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    12. Do the results of this study fit with other available evidence?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Add additional pages if needed
Reference: (insert the reference here according to APA 6th edition)
    Table 3 Cohort study: (Insert the title of the paper you are appraising)
    Critical appraisal questions
    Underline your answe
    1.Did the study address a clearly focused issue?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    2.Was the cohort recruited in an acceptable way?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    3.Was the exposure accurately measured to minimise bias?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    4.Was the outcome accurately measured to minimise bias?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    5(a)Have the authors identified all important confounding factors?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    5(b)Have they taken account of the confounding factors in the design and/or analysis?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    6(a)Was the follow up of subjects complete enough?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    6(b)Was the follow up of subjects long enough?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    7.What are the results of this study?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    8.How precise are the results?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    9.Do you believe the results?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    10.Can the results be applied to the local population?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    11.Do the results of this study fit with other available evidence?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    12.What are the implications of this study for practice?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
Add additional pages if needed
Reference: (insert the reference here according to APA 6th edition)
Add additional pages if needed
    Table 3 Randomised controlled trial: (Insert the title of the paper you are appraising)
    Critical appraisal questions
    Underline your answe
    1. Did the trial address a clearly focused issue?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    2. Was the assignment of patients to treatments randomised?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    3. Were all of the patients who entered the trial properly accounted for at its conclusion?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    4.Were patients, health workers and study personnel ‘blind’ to treatment?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    5.Were the groups similar at the start of the trial?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    6.Aside from the experimental intervention, were the groups treated equally?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    7.How large was the treatment effect?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    8.How precise was the estimate of the treatment effect?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    9.Can the results be applied to the local population, or in your context?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    10.Were all clinically important outcomes considered?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution
    Critical appraisal questions
    Underline your answe
    11.Are the benefits worth the harms and costs?
    Yes/No/Unclea
    Evidence: justification, compare and contrasting o
and providing solution

PUBH6005_Assessment 3 template    Page 1

PUBH6005_Assessment
3 template

Page
1
Table 1

Cross
-
sectional study
:

(Insert the title of the paper you are appraising)

Critical appraisal questions

Underline your answe

1.
Were the criteria for inclusion in the
sample
clearly defined?

Yes/No/Unclea

Evidence:
justification, compare and contrasting o
and providing solution

Critical appraisal questions

Underline your answe

2.
Were the study subjects and the setting
described in detail?

Yes/No/Unclea

Evidence:
justification, compare and contrasting o
and providing solution

Critical appraisal questions

Underline your answe

3.
Was the exposure measured in a valid and
eliable way?

Yes/No/Unclea

Evidence:
justification, compare and contrasting o
and providing

solution

Critical appraisal questions

Underline your answe

4.
Were objective, standard criteria used for
measurement of the condition?

Yes/No/Unclea

Evidence:
justification, compare and contrasting o
and providing solution

Critical appraisal
questions

Underline your answe

PUBH6005_Assessment 3 template Page 1

Table 1 Cross-sectional study: (Insert the title of the paper you are appraising)
Critical appraisal questions Underline your answer
1.Were the criteria for inclusion in the
sample clearly defined?
Yes/No/Unclear
Evidence: justification, compare and contrasting o
and providing solution
Critical appraisal questions Underline your answer
2.Were the study subjects and the setting
described in detail?
Yes/No/Unclear
Evidence: justification, compare and contrasting o
and providing solution
Critical appraisal questions Underline your answer
3.Was the exposure measured in a valid and
eliable way?
Yes/No/Unclear
Evidence: justification, compare and contrasting o
and providing solution
Critical appraisal questions Underline your answer
4.Were objective, standard criteria used for
measurement of the condition?
Yes/No/Unclear
Evidence: justification, compare and contrasting o
and providing solution
Critical appraisal questions Underline your answer

PUBH6005_Assessment Brief 3 Page 1 of 8

ASSESSMENT BRIEF
Subject Code and Title PUBH6005: Epidemiology
Assessment Assessment 3: Critical Appraisal
Individual/Group Individual
Learning Outcomes This assessment addresses the following
learning outcomes:

1. Assess levels of evidence and make
ecommendations
2. Interpret data arising from
surveillance and research studies,
including rates and ratios
3. Understand the difference between
association and causation, statistical
and public health significance
4. Critically evaluate epidemiological
studies, including potential for bias,
confounding and chance e
ors
Submission Due Sunday following the end of week 11 at
11:55pm
AEST/AEDT*

Weighting 40%
Total Marks 100 marks

*Please Note: This time is Sydney time (AEST or AEDT). Please convert to your own time
zone
(eg. Adelaide = 11:25pm).

PUBH6005_Assessment Brief 3 Page 2 of 8
Context:
This assessment requires you to apply the knowledge and skills gained in all the
modules to undertake a critical appraisal. You will need to appraise 3 articles of a topic
and research question given to you by your facilitator.

1. Search the li
ary database to find three studies that answer your research
question. All three studies must be of different study designs. For instance, you
could include case control, cohort and RCTs. These studies do not have to prove
their hypothesis or agree with each other. Please note that marks will be
deducted if all identified papers are of similar study.

2. Critically appraise all three articles you found. Your answers are to be written in

091119pubh-6005-template-assessment-student-copy-dgudbz0u.docx pubh-6005-olzmqlbw.pdf

Anju Lata · Accepted Answer

Running Head: Healthcare Associated Infections 
Healthcare Associated Infections 		2
SUBJECT: PUBH6005
ASSESSMENT 3: Critical Appraisal 
SUBMITTED TO: 
SUBMITTED BY: 
CRITICAL APPRAISAL
TOPIC: HEALTHCARE ASSOCIATED INFECTIONS 
Research Question: How can we assess the effectiveness of ongoing global interventions to prevent the healthcare associated Infections?
Objective: To evaluate the efficiency of interventions to prevent and control healthcare associated infections and associated disease burden.
Introduction
Healthcare Associated Infections (HAIs) are the infections which are acquired by the patients during their hospital stay (Infection Prevention & Control Consortium Australia [IPCCA], 2017)
.They are also known as Nosocomical Infections and originate through infectious agents like bacteria, fungi, virus, or parasites. Every year more than 180000 patients get infected through HAIs, which prolongs their hospital stay and imposes additional burden of 2 million days of hospitalization over the healthcare system of Australia (Mitchell, Shaban & Macbeth,2017). Australia, on an average is exposed to more than 126 surgical site infections every year which costs greater than $5 million additional burden on the health care system (Australian Commission on Safety and Quality in Healthcare, 2019). Each year, more than 165,000 healthcare associated infections occur in Australia (Clinical Excellence Commission, 2019). Also, there is no national surveillance system in Australia, due to which there are issues in assessing and recording the disease burdens due to HAIs (Mitchell et al., 2017).
The study explored Google Scholar database to retrieve relevant journals over the topic of research. Out of fetched articles, I selected three peer reviewed journals for my critical appraisal. The three journals are: Randomized Control Trial, Cohort and Case Control Study.
Methods
The case control study performed by Lu et al.(2018) conducted a survey of a hospital at Sichuan Province in China. The research assessed the hospitalization costs and length of stay of the patients infected through HAIs, by collected data from Medical Insurance Reforms and prevalence Survey. The study evaluated the binary and continuous outcomes through Wilcoxon matched pairs signed rank tests and X2 test. The outcomes within the two groups were compared using Multiple Regression.
In Randomized Control Trial, European CDC method was used to conduct point prevalence study. The trial was organized in 19 Public sector hospitals for acute care. HAIs were assessed using standard algorithm in a two stage cluster. The data was sampled randomly for the inpatients admitted at the ICU wards and Acute wards.
The cohort study used non concurrent design to assess the length of hospital stay and increased risk factors for the mortality of inpatients. The incidence of lab based HAUTI was diagnosed for 4.5 years at large healthcare settings. The analysis of empirical data was done using IBM SPSS 2.0, with help of Charlson Comorbidity Index.
Results
Lu et al (2018) found that the HAIs at different sites of infection cause different level of burden over the economy. The case fatality rate, the length of stay and median cost of hospital admissions and stay was higher for the HAI patients than for non HAI patients. The study found significant difference in median between the matched pairs.
The study by Russo et al. (2019) showed the rate of prevalence of HAIs at hospitals ranges from 6% to 17%. The study found that the primary types of HAIs at the hospitals are urinary tract infection, pneumonia and infection of surgical site. These three types of HAIs together constitute 64% of HAIs. Around 10.3% patients also exhibited the presence of multidrug resistant pathogen.
The study by Mitchell et al (2016) found that the women were at greater risk of susceptibility to death due to Hospital Acquired Infections than the men. The infected patients were at greater risk of dying due to HAIs than the patients without any infection.78% of the HAI patients showed a high WBC count in urine (greater than 50 cells/ 106/ litre). Antimicrobial susceptibility was tested for the patienst having HAIs due to at least one pathogen. The study found that more than 3126 were accountable for causing the HAI infection among the inpatients. Out of these infections, 55% infections were caused by E.coli infection while the pathogens of Klebsiella species were attributed to causing 12.8% HAI infections.
Critical Appraisal of three articles as per the CASP checklist
	Table 1 Case control study:  A multi-center nested case-control study on hospitalization costs and length of stay due to healthcare-associated infection
	Critical appraisal questions
	Underline your answer
	Did the study address a clearly focused issue?
	Yes/No/Unclear
	Evidence:  The study evaluated the cost of hospitalization and length of stay at hospitals because of Healthcare Associated Infection on the basis of prevalence survey and reforms of china’s medical insurance. The study referred to preventive Action plan for HAIs conducted in China from 2012-2015. The measures in this action plan included departmental Organisation and management,  hand hygiene, management of intubation associated infections, management of high risk departments, isolation, sterilization and disinfection, waste water management, hospital layout, workflow, medical waste and management of medical supplies and disinfection equipment. The cases were patients who were exposed to HAIs during the hospitalization. Just 10 cases were randomly selected on the basis of prevalence survey.
Through the study,

Table 1 Cross-sectional study: (Insert the title of the paper you are appraising) Critical appraisal questions Underline your answer 1.Were the criteria for inclusion in the sample clearly defined?...

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