Step-By-Step Guide to Critiquing Research, Research Paper Example

General Information

The article being critiqued is entitled “Intensive Nursing Care by an Electronic Followup 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, it appears that 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 appears to provide a sufficient summary of the work done. This portion of the paper is clearly broken into several sections, including the purpose, methods, results, and conclusions, which is typical of a medical journal of this style. However, it appears that 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. 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. 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 followup 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, it also appears that 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.

Introduction

The introduction of the paper is brief, but it appears to succinctly provide the reader with the necessary background concerning coronary heart disease (CHD). 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. 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 followup 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. 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 not just a concern among medical professionals, but information technology professionals as well, it is beneficial that the authors used this type of introduction to present the need for their study because it allows people from diverse fields to be able to access the information that this article contains and they are now able to use it 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

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. Furthermore, it allows the reader to gain an understanding of which aspects of study design will be discussed in greater depth in this section. In particular, 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. A lot of the methods sections that I have read in the past include a lot of technical jargon, but the authors prefer to avoid this style of writing, only using complex vocabulary when it is necessary to do so to explain scientific ideas in detail. 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 appears 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 in to the “control group” and the “intensive group”, in which sample size was 420 for each group. After a one year followup period, there was a high response rate; 401 individuals from the control group responded to the followup questionnaire, while 406 individuals in the intensive group responded to the followup questionnaire. Some participants were lost to followup due to change of address, loss of contact, or death. Last, the graphic indicates that the evaluation 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 followup 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 followup system utilized. According to the authors, “An electronic followup management system, developed with Delphi procedures, was used. The electronic followup system consisted of the following 6 modules: data collection module, followup module, secondary prevention module, query module, reports module, and statistics module (Hu et al., 2014)”. 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 followup visits in each group. This is beneficial knowledge because it appears that 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. It appears that 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

It appears that the research team performed a series of calculations regarding the data that they received from the experiment, and this analysis appears complete. However, its presentation in paragraph form appears to be 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. It appears that 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

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. It appears that 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.

Conclusion

The conclusion succinctly defines the purpose and major findings of the 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.

References

A majority of the references used in this study were recent publications, although a large portion of the articles included were published more than five years prior to the release of this article. Interestingly, some articles were used from 1997, which may not have been necessary considering the large amount of recent literature that has been published concerning heart health. Furthermore, implementing technology into the health care setting is more of a recent concern, so articles older than 2000 may not be relevant for such an article. Technology has evolved at a rapid rate during the last several decades, as has the information that we currently hold about medicine. Thus, it is more beneficial for recent research articles to use primarily sources from within the last five years. While an exception to this rule can be made if the research is an original study or a pioneering article, the authors primarily used older articles, indicating that the information used could potentially be out of date.

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 followup 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 recognized 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

Coughlan, M., Cronin, P., Ryan, F. (2007). Step-by-step guide to critiquing research. Part 1: quantitative research. British Journal of Nursing, 16(11).

Hu, X., Zhu, X., Liu, Y., Gao, L. (2014). Intensive Nursing Care by an Electronic Followup System to Promote Secondary Prevention After Percutaneous Coronary Intervention. Journal of Cardiopulmonary Rehabilitation and Prevention, 34: 396-405.