Critical Appraisal: Effectiveness of Rapid Response System (Article Critique Sample)
1. INTRODUCTION, including: a) Question and citation for found article to be appraised. b) Question and citation for set article to be appraised. c) Evidence that an appropriate appraisal tool has been chosen for each article
Only use the chosen CAT as a guide so that, rather than resembling a ‘checklist’, the critical appraisal addresses key criteria.
PLEASE KEEP THE TWO APPRAISALS SEPARATE.
2. Detailed CRITICAL APPRAISAL of FOUND ARTICLE that includes: a) Critical appraisal of methodology according to specific criteria for evidence type (see Table 1, specific criteria) b) Critical appraisal of results according to specific criteria for evidence type (see Table 1, specific criteria) c) Discussion of relevance of article with regard to: i. its findings in general (clinical importance) ii. your original question (IN HOSPITALIZED PATIENTS DO RAPID RESPONSE TEAMS COMPARED TO HAVING NO RAPID RESPONSE TEAMS REDUCE PATIENT MORTALITY AND IMPROVE PATIENT OUTCOMES DURING THEIR HOSPITAL STAY?) d) Overall demonstration of understanding about theoretical concepts intrinsic to the type of research undertaken in the article being appraised (shown by appropriately referenced critique throughout the appraisal)
‘Appraisal 1’ Quantitative study ( Rapid response systems: a systematic review and meta-analysis ...Maharajet al. Critical Care (2015) 19:254 DOI 10.1186/s13054-015-0973-y ) of approximately 1000 words.
3. Detailed CRITICAL APPRAISAL of SET ARTICLE that includes: a) Critical appraisal of methodology according to specific criteria for evidence type (see Table 1, specific criteria) b) Critical appraisal of results according to specific criteria for evidence type (see Table 1, specific criteria) c) Discussion of relevance of article with regard to: i. its findings in general (clinical importance) ii. the original PICO/PIO search question d) Overall demonstration of understanding about theoretical concepts intrinsic to the type of research undertaken in the article being appraised (shown by appropriately referenced critique throughout the appraisal)
‘Appraisal 2’ Qualitative study (Kehl, K. A., & Gartner, C. M. (2010). Can you hear me now? The experience of a deaf family member surrounding the death of loved ones. Palliative Medicine, 24(1), 88-93. doi: 10.1177/0269216309348180) of approximately 1000 words.
Evidence type Critical appraisal of methodology Critical appraisal of results
A. PRIMARY EVIDENCE
Quantitative intervention study i. Clarity/focus of research question ii. Randomisation iii. sequence/blinding of group allocation iv. group similarities v. participant follow-up vi. analysis vii. sample size/power viii. ethical issues i. Type of data, intervention effect (eg; binary/continuous; mean; SD; OR; ARR; NNT; etc) ii. precision (eg, confidence intervals, p) Quantitative diagnostic accuracy study i. Clarity/focus of research question ii. reference standard iii. verification bias iv. incorporation bias v. review bias vi. participant disease status and spectrum bias vii. test protocols viii. sample size/power ix. ethical issues i. Type of data (eg; sensitivity; specificity; predictive values; positive/negative likelihood ratios; ROC curve) ii. precision (eg, confidence intervals) Quantitative prognostic study i. Clarity/focus of research question ii. selection bias iii. inception cohort iv. participant characteristics v. prognostic factors vi. outcome measures vii. follow-up length, completion & lost participants’ characteristics viii. sample size/power ix. ethical issues i. Type of data ii. time points iii. pattern of change iv. precision (eg, confidence intervals) v. adjusted analysis for prognostic factors
Qualitative study i. Clarity/focus of research question ii. setting, recruitment, participants and sample size description iii. researcher perspective, relationship to participants & impact on data collection/analysis iv. rigor of method/s of data collection and analysis v. congruency of decision-making vi. ethical issues i. Depth and detail ii. grounded in data iii. representation of participant diversity iv. interpretation relative to other studies v. validity checking vi. plausibility and congruency with methodology.
Evidence type Critical appraisal of methodology Critical appraisal of results B. SECONDARY EVIDENCE Quantitative systematic review i. Clarity/focus of research question ii. adequacy of the search process iii. issues of publication bias iv. inclusion/exclusion criteria v. method of appraisal vi. number of assessors vii. reproducibility of the method viii. risks of bias that may be incorporated into the review findings ix. ethical issues i. decision to combine results and why, referring to clinical, methodological and statistical heterogeneity of included studies ii. how the study results were combined iii. presentation of data and statistical significance (eg, forest plots, WMD, NNT, risk ratios, sub-group analysis) iv. precision of results (eg, evidence from forest plots such as confidence intervals) Qualitative Systematic Review i. Clarity/focus of research question ii. adequacy of the search process iii. issues of publication bias iv. inclusion/exclusion criteria v. method of appraisal vi. number of assessors vii. reproducibility of the method viii. risks of bias that may be incorporated into the review findings ix. ethical issues i. decision to combine and why, referring to similarities/differences between included studies ii. how the study results were combined iii. presentation of data and significance (eg, themes, lines of action,) iv. precision of results (eg, evidence of rigor, reflexivity, transparency, coherence, plausibility and/or credibility)
The assignment will comprise an Introduction (approx. 500 words) and two equally weighted sections, of 1000 words each.
The Introduction should indicate exactly which articles are being appraised (provide citations), the PICO/PIO questions that the articles are answering and their respective CATS. You may then organise the two appraisals in any way that you like, but please do not include structured abstracts in the appraisal. Keep direct quotes to a minimum and instead paraphrase.
Institute of Affiliation
In critical appraisal process, the evidence based practice is presented about a given issue. Its principal aim is to identify methodological flaws in the literature and provide consumers of research data the opportunity to make informed decisions about the quality of research evidence. The process ensures that carefulness and a systematic examination of the research to judge its trustworthiness, its value, and appropriateness in a particular situation. Critical appraisal is regarded to be an essential element of evidence based in the field of medicine. For example, in this case, the principal evaluation of the rapid response systems was discussed and also the challenges faced by the deaf when the loved ones die. When the process is conducted using a fundamental criteria, for instance, the methodology of acquiring data and analysis is considered to be the key in leading to get an amicable solution to the issue. Other aspects considered are the relevance of the research question, does it add anything new and also whether the study addressed the key potential sources of bias (Stewart &Parmar, 1996).
In this paper, two articles have been considered for critical appraisal. The first article is about the effectiveness of rapid response system. It focuses on what will happen to the patients when the system works efficiently or entirely fail to work. For example, in this case, it was found that if the system is not monitored well, then the health of those in ICU keeps on deteriorating. The article was written by three scholars, Ritesh Maharaj, Ivan Raffaele and Julia Wendon. The aim of the article was to establish the effectiveness of the rapid response system, and whether they are associated with a reduction in hospital mortality and cardiopulmonary arrest. Also, it focused on whether the presence of a physician in the rapid response system is significantly associated with a mortality reduction (Maharaj, Raffaele, & Wendon, 2015). The second article is about the challenges the deaf face in the case they have lost the loved ones who are mainly the member of the family. It was written by Karen A. Kehl, Ph.D., RN, ACHPN and Constance M. Gartner to identify critical challenges the deaf people have encountered when loved ones die at the University of Wisconsin in Madison. The research was based on the experience of the deaf person who lost a loved one. In this case, Robert was found to be a victim and therefore was interviewed. Robert was regarded since he was the only college educated older deaf male who could use the American Sign Language well hence communication process was not a barrier to the process. He was interviewed about the challenges he faced interacting with the health care system as three of his loved ones were dying. Approval for the study was received from the Social Sciences institutional review board at the University of Wisconsin-Madison. The methods considered in the first article apprised was majorly looking at the statistics particularly the effect the system had caused when it came to using. The second section approach involved the use of a victim person who may give the accurate reflection of the challenges encountered (Dacey, ER, Wilcox, Doherty M, &Boyer., 2007).
Article One: RSS
In the first case rapid response system teams were set to ensure the effectiveness of the scheme, whether effective or ineffective. According to the research conducted by various scholars, the health status of many patients may deteriorate to an unexpected extent of ICU admission if the RRS systems cannot be monitored well (Liberati, et al., 2009).The study aimed at establishing the effectiveness of the use of the scheme. It was also to check whether the closer presence of a specialist in the system significant...
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