Critiquing Quantitative Research, Research Paper Example

General Information

The article being critiqued is entitled “Intensive Nursing Care by an Electronic Follow-up System to Promote Secondary Prevention After Percutaneous Coronary Intervention” and is authored by several individuals, including Xin Hu, RN, Xiuqin Zhu, RN, Yuqi Liu, MD, and Lei Gao, MD” (Hu et al., 2014). The affiliation of these authors are the Institute of Geriatric Cardiology and Medicine Department in addition to the Chinese PLA General Hospital in Beijing, China. Based on this information, an effective interdisciplinary team was established to investigate this issue. Because registered nurses worked on this research together with a team of physicians, it establishes a view of the topic that could be applied in a broad range of medical settings. All individuals involved in this project are well qualified and hold university or hospital appointments, indicating their level of experience in their respective fields. The article was published in the Journal of Cardiopulmonary Rehabilitation and Prevention, which is an appropriate journal for this particular topic.

Abstract

The abstract of the article provides a sufficient summary of the work done. A majority of nursing research publications require that the abstract does not exceed 250 words (OJIN, 2015). Furthermore, the abstract should provide a general summary of background information, the research question, hypothesis, materials and methods, results, conclusion, and occasionally the future directions for research (OJIN, 2015). The function of the abstract is to quickly provide researchers and medical professionals with the information they need to determine whether the research article is of value to their practice and research. Thus, it is important for the study to be summarized in a manner that will allow the professional to make this decision. Reading the abstract will allow this individual to know whether it would be valuable for him or her to read the remainder of the article. Because reading an entire journal article is time consuming, it is valuable for authors to create abstracts in a manner that will allow the reader to quickly discern this information (OJIN, 2015).

In this research article, the authors break this portion of the paper into several sections, including the purpose, methods, results, and conclusions, which is typical of a medical journal of this style. Further, the authors placed too much of the results information into the results section of the abstract. The purpose of the abstract is to provide readers with a concise understanding of the type of research conducted in addition to major findings that are relevant to a particular research study (Pitkin et al., 1998). However, this study includes a large amount of statistical summary in the results section of the abstract that can better be described in the body of the paper. This allowed me to believe that the statistical methods would be more in depth in the results section of the paper, allowing me to gain a greater understanding of the results of the study that was performed as a consequence. Furthermore, these findings are consistent with the methodology described in the materials and methods section of the abstract. This was therefore an example of an ineffective results inclusion in the abstract because it was too complete. I was expecting to need to continue reading the research paper to find more information about the relationship described by the authors, but this was not the case. Furthermore, the way that the results section was placed made me think that the article would be more descriptive than it is in reality. It would have been preferential for the results to have been summarized in this section without using excessive statistical notation in order to show relationships instead of statistical figures that may not be relevant if the individual has not read the sections of the paper that came before the results. The inclusion of this dense amount of data makes it challenging for an individual reading the abstract to quickly ascertain what he or she needs to know about the results, forcing the focus to be on the statistical significance of the findings. On the other hand, the purpose of the article, “To investigate the effectiveness of an intensive nursing care electronic follow-up system for cardiovascular risk management after percutaneous coronary intervention (PCI)”, is summarized succinctly as are the methods and conclusions (Hu et al., 2014). Based on this information, the title is accurately descriptive of the project conducted. However, it would have been beneficial for the research team to have included a shorter abstract to ensure that individuals that are interested in their research topic are better able to scan through the abstract and determine whether the study will be relevant for their specific needs. Abstracts could range between 100 and 200 words, or have approximately 250 words to reflect in depth research. It is the responsibility of the author to determine which abstract style effectively reflects his or her publication goals in order to ensure that the reader does not have to consume more information than necessary. The average researcher intends to spend about 30 seconds on each abstract, so it is beneficial for the author to make the abstract as concise as possible to help these individuals achieve this goal (Blake et al., 1993). Abstracts that are deemed too bulky and may be a waste of time are likely to be ignored, which will prevent the research from using this information in their own study which is detrimental to the original author who benefits when his or her article is cited (OJIN, 2015). Thus, it would be beneficial for this author to have provided an abstract that contains less words in order to enable the reader to spend less time on reading the abstract itself and dedicating more time in general to determining whether use of this article would be valuable to the research that he or she is trying to conduct.

Introduction

The introduction of the paper is brief, but it succinctly provides the reader with the necessary background concerning coronary heart disease (CHD). Typically, the introduction includes information such as the background necessary for the reader to understand the research at a basic reading level that is free of scientific jargon, rationale for the research question by presenting gaps in the known knowledge of the field, a research statement, a hypothesis, and occasionally, additional information regarding how the study is designed, although this is not necessary or effective in most cases (Austin, 2002). The section opens by explaining what the disease is and continues to demonstrate statistics related to the incidence and mortality of the illness. This is an effective use of the introduction section because it is essential to provide background information on the topic and connect the current research to a gap that is present in the field or literature (Houser, 2015). Specifically, the researchers explain that even though there have been significant improvements regarding CHD in terms of technology, there is still a need to decrease the prevalence of the disease and continue developing effective therapeutics and techniques to better manage these patients. Since the purpose of the study is to demonstrate the need for an electronic follow-up system, the rationale that the researchers provide is an effective way of introducing the need for such a system. Furthermore, this component of the introduction is presented in an effective manner. Most introductions are expected to present information in a manner that individuals that are not professionals in the field would be able to understand (Austin, 2002). The authors take care to use simple language and to clearly define terms so that individuals in any field will be able to understand the information that this section contains. Given that the topic presented is a concern among medical professionals and information technology professionals, it is advantageous for the authors to explain their study’s background information in the manner presented. This will allow these professionals to use this information in a more meaningful way.

The last information contained in the introduction reiterates the purpose of the research so that the reader can be brought back to the focus of the article. Since the intention of the following section is to discuss the research methodology used, this is an effective way to help remind the reader about what the research design intends to prove.

Methods

In the methods section, it is critical for researchers to provide a clear and concise set of instructions that would allow other researchers to complete the same research protocol in a manner that is discussed. However, this section is occasionally compromised when researchers do not want their colleagues to complete a similar study or follow up study because this contradicts the interests of the research team, who may benefit by conducting these studies themselves ahead of publication of their colleagues (Houser, 2015). Since the research setting is a competitive environment, it is valuable to consider that there are many ulterior motives with regards to publishing that tend to show in this section of the paper (Zeiger, 1991). Leaving out key steps and methods is a detrimental practice and should therefore be avoided because these actions lack academic integrity. This paper upholds academic integrity because all relevant methods are reported, making it an effective methods section.

The authors provide a summary of the methods used in the study before explaining each component of the methodology in greater detail. This is a useful organizing technique because it allows a majority of readers to have instant access to the information that they may be looking for (Houser, 2015). Furthermore, it allows the reader to gain an understanding of which aspects of study design will be discussed in greater depth in this section. The materials and methods in the abstract should provide a general overview of the techniques and steps that will be taken in this research, while an explanation of these techniques are expanded upon in the methods section of the research (Hulley et al., 1988). Last, it is important to consider that the methods section is what allows the researcher to determine the validity of the study. If the recruitment methods are not biased, the sample size is adequate, and other factors regarding the efficacy of the study are noted, the research can determine to what extent he or she is able to rely on the information that is presented (Houser, 2015).

Specifically, the methods section should be framed with the understanding that these steps are taken to answer the research question (Houser, 2015). The materials used and methodology implemented should therefore not deviate from the purpose of the research. If this occurs, then it could be said that the methodology is not accurate, thereby having a negative impact on the validity of the research. The methods section should also justify the experimental design to demonstrate that each step of the method is being done for a reason, thus avoiding bias and directly answering the research question posed in the introduction (Houser, 2015). Last, this information must be provided in a concise stepwise manner to ensure that interested individuals with the appropriate resources can repeat these steps if needed (Bergner et al., 1991). This description should also include what statistical steps were taken to analyze the data, which allows researchers to determine whether the appropriate statistical knowledge was applied during the analysis (Houser, 2015).

In this particular study, it is important to emphasize that the researchers recruited 840 individuals to the research study, which is one of the first facts that is mentioned. This is an adequate sample size for this type of study because the statistical tests conducted from its use are more likely to have a high statistical power. Following this statement, the researchers identify how these individuals were recruited to the study. It is helpful for the reader to understand this process because it helps disclose any potential biases at the beginning of the paper instead of leaving the reader to consider any shortfalls of the study following the act of reading it to completion.

In the “study design” section, the authors immediately disclose that their study is a prospective randomized trial. Furthermore, their control group and experimental group were equal, with 420 patients in each category. Randomization was a computer generated process to ensure that there was no human bias involved in the randomization process. A majority of the methods section would be easily understandable by an individual that is not a professional in the field, which adds an interesting aspect to this article. This is an admirable approach because it makes it easier for students and nurses in training to understand what they are reporting in the literature. Thus, these professionals could reasonably apply an understanding of this research to their professional practice, thus accomplishing the suggestions that the authors set forth to promote.

Figure 1 is utilized to summarize the concepts presented in the methods section, which helps assist individuals that have a better time understanding information when it is shown in graphical form. Based on the information presented in this diagram, we can see that all 840 patients were consented at the beginning of the study before they were provided with a questionnaire to assess information at the baseline. These individuals were then randomized into the “control group” and the “intensive group”, in which sample size was 420 for each group. After a one year follow-up period, there was a high response rate; 401 individuals from the control group responded to the follow-up questionnaire, while 406 individuals in the intensive group responded to the follow-up questionnaire. Some participants were lost to follow-up due to change of address, loss of contact, or death. This impacts the study because the loss of information is typically a biased event (Houser, 2015). Some individuals are more likely to withdraw from studies compared to others due to a range of factors, including socioeconomic status, race, gender, and more. Thus, when these individuals are lost to follow up, it is challenging to determine what the results of the experiment would be like if these data points were included (Houser, 2015). It is therefore necessary for researchers to exclude some of this information from their analysis because they do not have complete findings to work with. Others respond inappropriately by attempting to predict what the data might have been and then use it anyway. Doing so creates an inappropriate understanding of the results, so it is valuable for this practice to be avoided (Song et al., 2010). Even though being presented with a large loss to follow up is challenging, it is important for these individuals to consider that it would be even more detrimental to the validity of their study to fabricate results.

In this study, it was specified that endpoints include achievement rate of good blood lipids, use of medication, and self-management abilities. Overall, this indicates that the authors adequately made use of figure 1 because it summarized a majority of information that an individual would need to know while looking through this research paper. Furthermore, the information highlighted justifies the methodology used while demonstrating that the study was effective due to the high percentage of participants that completed the follow-up questionnaire. It is apparent that the authors were concerned with the ability of the reader to understand the information presented, and they responded appropriately by providing a clearly labelled and designed flow chart to help readers understand the methods section of the paper.

Importantly, the researchers also detail the characteristics of the electronic follow-up system utilized. According to the authors, “An electronic follow-up management system, developed with Delphi procedures, was used. The electronic follow-up system consisted of the following 6 modules: data collection module, follow-up module, secondary prevention module, query module, reports module, and statistics module” (Hu et al., 2014, p. 1). It is beneficial to include this information so that parties that are interested in replicating the results or applying this method in practice can do so in a manner that is more reflective of the actual procedure used. To achieve a similar means, figure 2 demonstrates the algorithm used for the follow-up visits in each group. This is beneficial knowledge because the researchers would be able to replicate this procedure step by step. This information is clearly provided to the reader both in step form and in paragraph form. Thus, it would not be necessary for an interested researcher to contact the original authors to uncover missing steps in the research protocol; all necessary information is present. The authors are incentivizing this method to be used in the health care field, which emphasizes the value that the authors think their research holds for other interested parties. Even the statistics software utilized is described in detail so that interested researchers can utilize the same version of SPSS used by the original research team.

Results

In the results section, one typically expects to find the data of the experiment without an extensive discussion of the data’s meaning (Houser, 2015). As such, a presentation of processed data in the form of figures and tables is appropriate. Furthermore, it is expected that these figures and tables are self-explanatory (Le Gall et al., 1993). Based on the figure and table description and the information provided within it, the reader should be able to quickly determine trends (Houser, 2015). This is not the case in some research studies, in which complex techniques and equipment are being used. However, it is useful for researchers to only present information that is readily identifiable by the reader, in a manner that does not require them to have a special understanding of the research or the technology used (Houser, 2015). In some instances, however, keeping the information simple is challenging if additional information presented may not be meaningful to the experiment being conducted. The research team performed a series of calculations regarding the data that they received from the experiment, and this analysis is complete. However, its presentation in paragraph form is overwhelming to the reader, producing an effect similar to the one observed in the results portion of the abstract. It is beneficial for the analysis to be complete, but the paragraph form presentation is not effective. Fortunately, the researchers also produced several figures and tables to help summarize the results more effectively. Table 1 shows a complete summary of the baseline clinical characteristics that the patients presented at the beginning of the study. Likewise, table 2 shows the risk factor controls at baseline and at 12-months followup with a series of summary statistics also present. It is important to emphasize that although the information presented in this latter table effectively summarizes the findings of the study, it is placed in an unexpected location within the article. Table 2 is a component of the discussion section, when it would be expected to be a part of the results. It is possible that it was placed at the bottom of the page for aesthetic purposes, however, this makes the summary of the results and/or discussion more confusing for the reader. Overall, it would have been beneficial for less results to have been explained in paragraph form and for more tables to have been shown instead.

Discussion

It is expected that the discussion section should not simply contain a restatement of the results, but to go a step beyond the findings and discuss the implications of these results with regards to practical applications and confirmation or denial of the hypothesis of the experiment (Houser, 2015). Evidence should be provided in order to demonstrate why the hypothesis should be confirmed or refuted (Houser, 2015). Many discussion sections relate the findings to theory and knowledge by creating a more comprehensive understanding of the results as they relate to knowledge that already exists in peer-reviewed literature (Austin, 2002). Last, future experiments and suggestions should be provided to allow the reader to gain an understanding about the future intentions of the authors, in addition to what they would like to do in future experiments or what they would like other researchers with more resources to do in order to contribute to the existing knowledge related to the field. Occasionally, this section contains information about study limitations, but some researchers choose to forgo this inclusion because it makes their study weak (Houser, 2015). However, it is valuable to include this information because it allows researchers to have a better understanding of the factors that may damage the validity of the study and what could be done in the future to avoid these concerns.

The discussion section adequately relates the results of the study to findings that are already present in the literature to help the reader gain a better understanding of the context of the results. The most relevant problem discussed in the literature is that while patients are hospitalized, they are likely to comply with their medication requirements. However, this is likely to change when they are discharged from the hospital and nonadherence rates tend to skyrocket. Reasons for this lack of compliance often include a diminished understanding of the importance of compliance. The study demonstrated that gaps in knowledge could be filled by using a combination of current techniques in addition to electronic software technology. Overall, the authors argue that there are many practical uses for this technology so it is reasonable to implement it in health care practice. These claims are valid and that it would be beneficial to do so in a majority of care settings.

A primary limitation of the study is that it recruited patients from only one health care center, which makes it less reasonable to generalize the results to the overall population. It is also important to consider that the study was conducted in China, so there may be intrinsically different health characteristics of the patients that could confound the results or potentially make them not applicable to populations living in the United States and Europe. Health care systems tend to be diverse in different countries, so it is important to consider the diverse effects that could be seen across the world. It was not possible to research this understanding in this single study, but it would be valuable to investigate this relationship on a broader scale to determine whether these results are generalizable to the world population. Thus, the authors implore their fellow scientists to continue engaging on research related to this topic so they can gain more certain understandings of the data in a manner that will allow them to contribute more effectively to evidence based practice.

Conclusion

The conclusion succinctly defines the purpose and major findings of the study (Austin, 2002). It is expected that the conclusion section will also be brief in order to allow the researchers to summarize the understandings that they have drawn from the study (Houser, 2015). The conclusion states what the authors believe that their scientific contribution to the field has been as a consequence of the research. In this particular study, it may have been beneficial for more aspects of the conclusion to have been included in the abstract to lessen the word count and to ensure that the presentation of the results component would have been more succinct.

Overall Impression

Overall, the authors effectively presented their research in a manner in which a majority of individuals are able to readily understand the information presented and to replicate the results accordingly. As such, it is challenging to determine who the audience for this particular article is. While it would seem that it is aimed at nurses, it is also possible that it is aimed at physicians and students as well. Aside from the presentation of the article, the authors researched a topic that is pertinent to the medical field today. Many professionals are growing concerned about how they can improve the quality that their institutions are able to offer. Technology seems to be a clear answer to this question for some. Even though there is promise in the realm of technology, it is necessary for us to understand how to integrate the use of technology into practice in a meaningful way. The authors of this article provide us with some interesting insight with regards to how to accomplish this, in addition to noting relevant next steps for their research which may provide us with additional understanding in the future.

This article is useful because it is presented in a manner that allows researchers to add to it or to alternate methodologies to determine what combinations of technology use or patient follow-up techniques might be the most effective. Thus, it is reasonable for researchers to replicate this study using patients in the United States to determine whether it would be worthwhile to continue investigating the method posed. While some hospitals and research institutions may wish to acquire more information before implementing this technique into practice, it is important to recognize that such implementation would serve as evidence-based practice and therefore help professionals determine whether the technique should be kept or whether improvements should be made. Since the field of health care is in a constant state of improvement, these authors beneficially contributed to practice. It is likely that many practitioners and researchers will encounter this article and at minimum, consider incorporating some of the ideas presented into their personal practice.

References

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