Critical appraisal of an article using the CASP tool

Running head: RESEARCH FOR CLINICAL PRACTICE
Critical appraisal of an article using the CASP tool
Name of the Student
Name of the University
Author Note

1RESEARCH FOR CLINICAL PRACTICE
Article analysed:
Jennings, N., Gardner, G., O'reilly, G. and Mitra, B., 2015. Evaluating emergency nurse
practitioner service effectiveness on achieving timely analgesia: a pragmatic randomized
controlled trial. Academic Emergency Medicine, 22(6), pp.676-684.
1. Did the trial address a clearly focused issue? Yes Can’t tell No
2. Was the assignment of the patients to treatment randomized? Yes Can’t tell No
Randomisation refers to the process of randomly allocating individuals or sample for a
particular research activity or across particular intervention or treatment groups (Hróbjartsson et
al. 2014). The study design was a pragmatic one that was based on a randomized controlled trial,
with the aim of evaluating the effects of nurse practitioner service. The patients who presented
symptoms related to pain were randomly assigned in the research study in two different groups
namely, standard ED medical care and NP care. Randomisation of 260 patients resulted in
allotment of 128 patients to the standard care group, and 130 to the NP care group. Use of a
computer random number generator facilitated the process of random sampling and helped in
removing selection bias between the two different patient groups.
Concealed allocation encompasses the procedure that is often implemented in
randomized controlled trials, which involves blinding of individuals who screen and separate the
candidates into two or more groups (Pocock 2013). The primary investigators who played an
essential role in data analysis were blinded to the intervention allocation. There was no mention
of concealing the sequence from the patients or the researchers. The researches indicated that

2RESEARCH FOR CLINICAL PRACTICE
both the staff involved in treating the sample, and all participants were completely aware of the
intervention procedure. Thus, adequate efforts were not taken to prevent selection bias.
3. Were all of the patients who entered the trial properly accounted for at its conclusion?
Yes Can’t tell No
Randomised controlled trials are often stopped early if the researchers identify limited
likelihood of identifying eventual success of the intervention or treatment (Hróbjartsson et al.
2013). Furthermore, randomized controlled trials are also stopped earlier than the proposed time
for apparent benefits that are found to receive greater attention, thereby affecting clinical
practice. The primary outcome measure of the trial related to evaluating patient proportion who
received analgesia within 30 minutes, of being attended by the care givers. There was no
mention of stopping the trial early or reducing the time that was initially proposed for
implementation of the intervention.
In the research study, the researchers compared the recruited sample in terms of the two
groups to which the participants were randomly assigned. The final outcomes made a
comparison of the patients who had received analgesia, 30 minutes after being visited by the
standard care group, and that of the NP group. Thus, the participants or patients were analysed in
the two groups to which random allocation had initially taken place.