Article Appraisal and Review

This article provides an appraisal and review of a research article on evidence-based practice in healthcare. It discusses the challenges faced by nurses in selecting and appraising research articles and evaluates the chosen article using the CONSORT review checklist. The article addresses the title and abstract, introduction, methods, results, and discussion sections, highlighting the strengths and limitations of the study. Overall, the article is considered to be of high quality.

Running head: ARTICLE APPRAISAL AND REVIEW
Article appraisal and review
Name of the student:
Named of the university:
Author note:

1
ARTICLE APPRAISAL AND REVIEW
Table of Contents
Introduction:...............................................................................................................................2
Article assessment and review:..................................................................................................2
Title and abstract:...................................................................................................................2
Introduction:...........................................................................................................................3
Methods..................................................................................................................................4
Results:...................................................................................................................................5
Discussion:.............................................................................................................................6
Other information...................................................................................................................7
Conclusion..................................................................................................................................8
References..................................................................................................................................9

2
ARTICLE APPRAISAL AND REVIEW
Introduction:
One of the greatest innovation in the health care practice scenario is the evidence
based practice which has revolutionized the entire care service delivery scenario, by both
quality and safety. The evidence based practice by far is the most effective care planning and
implementation framework which not only improves the care quality but also enhances the
patient centred ness of the care service delivery. Evidence based practice allows the nurses or
any other care professionals to incorporate the most recent and valid data into practice so that
the care being delivered is up-to-date and secure at all times (White, Dudley-Brown &
Terhaar, 2016). Although, the evidence based practice is also associated with many
challenges, one vital challenge is identification of which articles are to be included and which
ones are to be excluded.
In this regards, the newly appointed nurses that just graduated and transitioning into
practice face the highest amount of challenges in selecting or appraising the quality of the
article before incorporating it in the care facility. Hence, it is crucial for the nursing
researchers to have a clear ideation of how to analyse the research articles and assess their
quality so that they can be incorporated into evidence based studies (Grove & Gray, 2018).
This paper will attempt to explore and assess the quality of an RCT article taking the
assistance of CONSORT review checklist (CONSORT Group, 2010). The chosen RCT
article is “Can live music therapy reduce distress and pain in children with burns after wound
care procedures? A randomized controlled trial” by van der Heijden et al. (2018).
Article assessment and review:
Title and abstract:
The first section of the CONSORT review is to review the title and abstract of the
article. The title of the research article is apt, clear and succinct (CONSORT Group, 2010). A

3
ARTICLE APPRAISAL AND REVIEW
very important criteria for the title of the article according to the CONSORT review is
mentioning randomized control trial in the title itself, so that the readers can identify it easily
and it is easier for researching specific study designs for the topic. In this case, the authors
have mentioned the study to be a randomized control trial in the title itself which is
commendable. Considering the abstract of the article, the content is concise and summarizes
the article successfully (van der Heijden et al., 2018). Another crucial aspect for a good
quality randomized control trial is to compartmentalize the abstract part of the article as well
to provide ease to the readers to capture the verdict of the study without having to read the
whole paper or meticulously search the paper for one particular section. This article has an
abstract which is compartmentalized into four sections, objective, methods, results and
conclusion. Hence, in this aspect as well the article addresses all criteria to be a high quality
evidence (Hirschi & Selvin 2017).
Introduction:
Introduction serves as the gateway for any research paper, it is the first section that a
reader reads after the abstract. LoBiondo-Wood and Haber (2014) have discussed the crucial
need for introductions to be written in clear and easy to understand manner, along with
attracting the readers and capturing their attention so that they read the rest of the article.
Hence, the CONSORT review checklist also addresses the quality of introduction of the
paper as a separate section. In this case, the introduction is extensive with robust discussion
of information pertinent to the topic being reviewed in the paper. The justification and
rationale for the need for carrying out the study is provided, which is clear and easy to
interpret for the readers. Although, it is unclear whether an adequate scientific explanation of
the justification and rationale is provided (van der Heijden et al., 2018). Although, the
objectives of the article is clearly written which undoubtedly a very important component.
Although a clear hypothesis, which is an iconic part of a high quality evidence, is missing in

4
ARTICLE APPRAISAL AND REVIEW
this case. Hence, aside from these two cons, the introduction of the research article by the
authors is of high quality and addresses all of the criteria required to be a reliable article to be
incorporated easily into evidence- based practice.
Methods:
For any research study, one of most important aspects of components is the methods
of the research article. It is crucial for the methodology to be accurate and precisely following
each and every step, which is why this section of the CONSORT review checklist is the most
extensive, divided into various sub- topics (Leung, 2015). The first topic discusses the trial
design, whether the study has clearly provided a thorough account of the steps followed. First
and foremost, it has to be mentioned in this context that the trial design is very meticulously
discussed in the article, with design although there is lack of any information provided to the
readers regarding the allocation data.
Regarding eligibility criteria of participation selection there is a separate section
devoted to discussing Sampling and recruitment that the eligibility criteria and the target
population selected is explained in extensive detail. Along with that alike any other high
quality research evidence, the setting and format of the study and with participant selection is
discussed in detail providing a clear insight to the readers of the article. the setting and
location with data was collected is also mention clearly, which was the bones unit of the Red
Cross Memorial Hospital located in Cape Town of South Africa in the articles which is
undoubtedly a commendable aspect of the authors and the research study design (van der
Heijden et al., 2018).
The next section of the methodology appraisal is intervention and the authors in this
article have segregated the separate section for discussing the interventions. The intervention
in this case have been life music therapy which was provided to the selected participants
directly after wound care procedure. The intervention was standardized before providing to

5
ARTICLE APPRAISAL AND REVIEW
the participants and an extensive account of exactly how and when the intervention was
provided to the intervention group and how the control group was treated is also clearly
mentioned in the article (LoBiondo-Wood et al., 2017).
The next segment is outcome and in this case the author have pre-determined the
primary and secondary outcome which is also clearly mentioned in the article. The primary
outcome in this case have been level of stress Where are secondary outcome have been level
of pain which was also adjust it to different confounders. Lastly no changes were made to the
outcome measurements after the commencement of the article after the end of the study. The
sample size has been 150 which is small considering a randomised control trial and the
sample size is determined on the basis of presuming a 15% dropout rate, although there is no
information available on interim analysis or stopping guidelines (Ingham-Broomfield, 2014).
A simple random sequence generation table was used for randomisation although there is no
information available on the exact allocation sequences and any blocking size. 18
randomisation allocation sequence concealment is carried out to protect the authenticity and
validity of the article and primary statistician carried out the randomization, a primary
researcher enrolled the patient, who also trained an independent researcher for scoring.
Blinding of the investigators was carried out too, and this statistical analysis is also carried
out.
Results:
The next section of the CONSORT review is focussed on the results of data findings
that the article has generated (CONSORT Group, 2010). Data findings by far is the most
important part of the research study, which culminates to the exact need for which the study
had been designed and completed. The first question on the checklist discusses about the
participant flow. In this case, for each group, the numbers of participants who were randomly
assigned, received intended treatment, and were analysed for the primary outcome

6
ARTICLE APPRAISAL AND REVIEW
successfully. Along with that, for each group, losses and exclusions after randomisation,
together with reasons, and excluded had been children with a hearing impairment or low level
of consciousness (Grove & Gray, 2018).
The second section of the result review is emphasized on recruitment. For the dates of
recruitment of the participants, a date range of October 2014 to November 2014 was
mentioned by the authors (van der Heijden et al., 2018). Although no dates regarding follow
up data was provided, which can be considered as one of the cons. Although, no information
was provided regarding ending the trial or discussing the impact of the baseline data.
Although, a distinct table discussing the primary demographics and characteristics of the
baseline data. The next section is focused on numerical analysis, and as per the article for
each group, number of participants included in each analysis and analysis is original assigned
groups was successfully carried out. The next section discussed Outcomes and estimation.
For each primary and secondary outcome, results for each group, and the estimated effect size
and its precision was calculated and discussed in detail. Moreover, 95% confidence interval
range had been 0.23 to 0.45 as well. Although, there is not enough information or data
available on whether the binary outcomes, presentation of both absolute and relative effect
sizes is recommended (van der Heijden et al., 2018). The next section for review is ancillary
analysis, although in this article, the authors have successfully carried out subgroup analyses
and adjusted or discussed the exploratory harm, although not enough information has been
provided in detail.
Discussion:
Another extremely important and crucial aspect of any research study is the
discussion. It has to be mentioned that the discussion part of the research article provided an
in depth analysis of the results obtained and compares it with available data on the similar

7
ARTICLE APPRAISAL AND REVIEW
topic to help readers understand the impact of the research study on the area of concern
(Boswell & Cannon, 2018). It is also the section where the implications of the data findings is
discussed with both supporting and argumentative analyses, which also gives the readers a
clear idea of the validity of the study and whether the results are replicable, reliable and
should be replicated in evidence based practice or not. The discussion review section of the
CONSORT checklist is divided in three specific subdivisions. The first subdivision is
limitation which discusses the trial limitation, presence of potential bias or imprecision in the
study along with possible multiplicities of the data findings. The research study has a separate
section for discussing the strengths and limitations of the research study which eases the
process of understanding for the readers, hence it is undoubtedly commendable (van der
Heijden et al., 2018). The possible limitation of the research as discussed by the authors
include the fact the child, parents and care worker were all aware of the camera during the
study, which could have Influenced their behaviour and resulted in potential bias.
Physiological parameters are considered inappropriate in case of children with burns, hence
the data collection method that utilized the same is a notable limitation of the design. Also,
only a small group of children from the sample population were old dough for self-reporting
the distress or pain, which could have potentially affected the accuracy of the data findings.
Although, to control and minimize bias, care has been taken to perform blinding of the
independent researchers assessing the video footage which is undoubtedly commendable
(Connelly, 2014). Lastly, there is no enough information available on the multiplicity of the
findings. Considering generalizability of the findings, although there is mentioning of internal
validity, there is not information on the external validity, although applicability is discussed.
Although, interpretation has been consistent with results as the balance between harms and
benefits is discussed in detail in the study (Ingham-Broomfield, 2014).
Other information:

8
ARTICLE APPRAISAL AND REVIEW
The last section of the review checklist is other information which discusses the
funding, resources and registration of the research study. The trial mentions being registered
at pan African clinical trial registry with a registration number as well. In terms of protocol, a
burns unit protocol was used, although it is unclear whether it can be accessed externally. The
source of funding in this research study had been by Erasmus medical centre of the
Netherlands, although television funders and other support is not discussed in detail (van der
Heijden et al., 2018).
Conclusion:
On a concluding note, the CONSORT review of the checklist helped in identification
of the strengths and limitation of the article successfully. The authors have taken additional
care in almost every aspect of the study and hence, the study is successful in addressing
almost all of the criteria of the checklist. Although, critically analysing the CONSORT article
review checklist itself, even though the checklist is extensive and addresses each of the
minute aspects of the article, it has failed to incorporate ethical consideration, which is a vital
aspect for any research study involving human subject. Aside from this one limitation, the
review checklist had been successful in assessing the quality of the article successfully and it
can be considered that aside of a few limitations, this RCT study is a high quality evidence.

9
ARTICLE APPRAISAL AND REVIEW
References:
Boswell, C., & Cannon, S. (2018). Introduction to nursing research. Jones & Bartlett
Learning.
Burls, A. (2014). What is critical appraisal?. Hayward Medical Communications.
Connelly, L. M. (2014). Ethical considerations in research studies. Medsurg Nursing, 23(1),
54.
CONSORT Group. (2010). CONSORT 2010 checklist of information to include when
reporting a randomized trial. JAMA, 304(1), E1.
Grove, S. K., & Gray, J. R. (2018). Understanding nursing research: Building an evidence-
based practice. Elsevier Health Sciences.
Hirschi, T., & Selvin, H. C. (2017). Delinquency research: An appraisal of analytic methods.
Routledge.
Ingham-Broomfield, R. (2014). A nurses' guide to quantitative research. Australian Journal
of Advanced Nursing, The, 32(2), 32.
Ingham-Broomfield, R. (2014). A nurses' guide to quantitative research. Australian Journal
of Advanced Nursing, The, 32(2), 32.
Leung, L. (2015). Validity, reliability, and generalizability in qualitative research. Journal of
family medicine and primary care, 4(3), 324.
LoBiondo-Wood, G., & Haber, J. (2014). Nursing Research-E-Book: Methods and Critical
Appraisal for Evidence-Based Practice. Elsevier Health Sciences.
LoBiondo-Wood, G., Haber, J., Cameron, C., & Singh, M. (2017). Nursing Research in
Canada-E-Book: Methods, Critical Appraisal, and Utilization. Elsevier Health
Sciences.
van der Heijden, M. J., Jeekel, J., Rode, H., Cox, S., van Rosmalen, J., Hunink, M. G., & van
Dijk, M. (2018). Can live music therapy reduce distress and pain in children with

10
ARTICLE APPRAISAL AND REVIEW
burns after wound care procedures? A randomized controlled trial. Burns, 44(4), 823-
833.
White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2016). Translation of evidence
into nursing and health care. Springer Publishing Company.