Critical Appraisal of a Study on Risk Factors for Total Knee Replacement and Total Hip Replacement
Added on 2022-11-13
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Running head: CRITICAL APPRAISAL
CRITICAL APPRAISAL
Name of the student
Name of the University
Author Note
CRITICAL APPRAISAL
Name of the student
Name of the University
Author Note
1CRITICAL APPRAISAL
Question 1:
1a) Authors conducted the study in order to understand and obtain knowledge about whether the
risk of total knee replacement (TKR) and total hip replacement (THR) due to osteoarthritis are
associated with reproductive history, hormone replacement therapy, oral contraceptives use or
not. Moreover, age, age at menopause, menopausal status and age at menarche are also
associated with the risk of the TKR and THR or not is also assessed in this study by the authors
(1). The study also focused on the understanding about the confounding factors for the risk of the
TKR or THR situations among the women. The study is mostly based on the negative factors
affecting the health condition of the women with above mentioned issues. However, the authors
could not be able to conclude the study as the findings were not validated and there are different
factors affecting the results as well.
1b) The study is based on the risk factors and the association of several aspects with the TKR
and THR. Hence, the study would be helpful in the knowledge development about the causal
factors of TKR or THR (1). It can be highlighted as the advantage of the study. On the other hand
the study took a long period of time which can be highlighted as the disadvantaging factor.
Moreover, the sample size, prospective population based design and objective measurements are
the advantageous factors as well for this study. On the contrary, large number of causal effects,
validation error of the osteoarthritis and homogenous population are the disadvantageous effects
of the study. Thus, it can be stated that the large sample size is the prominent aspect that can be
highlighted as the advantage of the study whereas, the not validated data and also the large
number of variables are the negative factors that can be termed as the disadvantage of the study.
1c) The non-response can affect the study results in various ways. The primary effect of the non-
response is the increase of the survey bias or the response bias (2). The non-response can also lead
Question 1:
1a) Authors conducted the study in order to understand and obtain knowledge about whether the
risk of total knee replacement (TKR) and total hip replacement (THR) due to osteoarthritis are
associated with reproductive history, hormone replacement therapy, oral contraceptives use or
not. Moreover, age, age at menopause, menopausal status and age at menarche are also
associated with the risk of the TKR and THR or not is also assessed in this study by the authors
(1). The study also focused on the understanding about the confounding factors for the risk of the
TKR or THR situations among the women. The study is mostly based on the negative factors
affecting the health condition of the women with above mentioned issues. However, the authors
could not be able to conclude the study as the findings were not validated and there are different
factors affecting the results as well.
1b) The study is based on the risk factors and the association of several aspects with the TKR
and THR. Hence, the study would be helpful in the knowledge development about the causal
factors of TKR or THR (1). It can be highlighted as the advantage of the study. On the other hand
the study took a long period of time which can be highlighted as the disadvantaging factor.
Moreover, the sample size, prospective population based design and objective measurements are
the advantageous factors as well for this study. On the contrary, large number of causal effects,
validation error of the osteoarthritis and homogenous population are the disadvantageous effects
of the study. Thus, it can be stated that the large sample size is the prominent aspect that can be
highlighted as the advantage of the study whereas, the not validated data and also the large
number of variables are the negative factors that can be termed as the disadvantage of the study.
1c) The non-response can affect the study results in various ways. The primary effect of the non-
response is the increase of the survey bias or the response bias (2). The non-response can also lead
2CRITICAL APPRAISAL
to the increase in the variance as the expected sample size and response would be reduced.
Moreover, the risk ratio and the odds ratio of the study would be changed as well. Thus it can be
stated that the statistical values of the survey would be affected due to the reduction of the
sample size. On this context it can also be stated that the result would be biased due to the non-
response of the participants. Moreover, the context of the research should follow the research
guidelines and also try to maintain the participant number in order to develop accurate result
without any bias.
1d) The HUNT2 and HUNT3 study populations helped in the knowledge development about the
reproductive history and the association of this factor with the risk of the TKR and THR (1). The
covariates such as the HRT also evaluated with the questionnaire for interviewing these two
populations. However, the large amount of covariates affected the result as the association could
not be identified properly with the age, parity, hormonal therapy and use of OC. On the other
hand after excluding 1183 people from the sample there are participants with missing
information as well which can also be termed as a disadvantage in terms of this large sample
population (1). This missing data affected the result as well. Hence, the advantages are the idea
development about the association between the reproductive history and other confounding
factors and the TKR and THR. On the contrary the disadvantage is the unidentified association
between the age, parity, hormonal therapy and use of OC due to large number of covariates.
Question 2:
2a) The 1183 women undergone joint replacement before selection has been excluded as there
are presence of missing data (1).
2b) Bilateral oophorectomy in premenopausal women induces premature menopause. Women
with ovarian preservation if undergo hysterectomy induce the risk of premature menopause to
to the increase in the variance as the expected sample size and response would be reduced.
Moreover, the risk ratio and the odds ratio of the study would be changed as well. Thus it can be
stated that the statistical values of the survey would be affected due to the reduction of the
sample size. On this context it can also be stated that the result would be biased due to the non-
response of the participants. Moreover, the context of the research should follow the research
guidelines and also try to maintain the participant number in order to develop accurate result
without any bias.
1d) The HUNT2 and HUNT3 study populations helped in the knowledge development about the
reproductive history and the association of this factor with the risk of the TKR and THR (1). The
covariates such as the HRT also evaluated with the questionnaire for interviewing these two
populations. However, the large amount of covariates affected the result as the association could
not be identified properly with the age, parity, hormonal therapy and use of OC. On the other
hand after excluding 1183 people from the sample there are participants with missing
information as well which can also be termed as a disadvantage in terms of this large sample
population (1). This missing data affected the result as well. Hence, the advantages are the idea
development about the association between the reproductive history and other confounding
factors and the TKR and THR. On the contrary the disadvantage is the unidentified association
between the age, parity, hormonal therapy and use of OC due to large number of covariates.
Question 2:
2a) The 1183 women undergone joint replacement before selection has been excluded as there
are presence of missing data (1).
2b) Bilateral oophorectomy in premenopausal women induces premature menopause. Women
with ovarian preservation if undergo hysterectomy induce the risk of premature menopause to
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