Critical Appraisal of Two Research Papers

Running head: CRITICAL APPRAISAL
CRITICAL APPRAISAL
Name of the Student
Name of the university
Author’s note

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Paper A
Singer, A.J., Taira, B.R., Chisena, E.N., Gupta, N. and Chipley, J., 2008. Warm
lidocaine/tetracaine patch versus placebo before pediatric intravenous cannulation: a
randomized controlled trial. Annals of emergency medicine, 52(1), pp.41-47.
a) This paper has brought about a comparison between the use of a warm
lidocaine/tetracaine patch and placebo for treating pain in paediatric patients. The
hypothesis drawn by the author is that the pain will be reduced by at least 15mm. The
straightforwardness of the title would help the reader to understand the topic of
discussion of the title at a go. It also helps the readers to understand the target population
(pediatric) and the context of the paper (comparison between placebo and lidocaine
patch) and where the trial will take place. Furthermore, the abstract of the paper had been
segregated in to study objectives, methodology, results and findings and the discussions
helping the readers to understand the entire topic without reading the entire paper. While
writing a paper there are some basic steps that are required to be followed. The writing
should have been initiated with some context along with a background information
guided by an informative rationale, with some explanation regarding the scope and the
hypothesis of the topic. A systematic approach that has been followed in the introductory
part for linking the evidences. However, on running a search on the database, it could be
found that the author had probably missed some of the studies. This could have been
improved by including up to date scientific literatures. The objectives of the study has

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been articulated properly, which is advantageous because the entire study is supported by
hypothesis, which would allow the researcher to understand the finding when two groups
are concerned.
b) The study design chosen for this study is double blinded, placebo treated and randomised
controlled. Randomised double blinded placebo controlled studies are always considered
as gold standards of the epidemiological studies and turns to be a good evidence of the
caution (Misra 2012). This report has been found to be complying with the CONSORT
RCT protocols , regarding the abstracts, analysis and introduction. A clearly structured
report is always commendable as it guides the readers in a prompt way. The paper has
made a double blinded trial for reducing the bias. Double blinded trials are normally used
to prevent the occurrence of any bias, because of the placebo effect (Misra 2012).
However, there had been some irrelevant facts that has been shared in this report,
such as the different methods available for reducing the pain by IV cannulation in both
paediatric and children. However, there are sections where the author had given some
information about the patch and the some of the terms used might be difficult to
comprehend. The author should have mentioned all the key terms for a clear
understanding of the interventions that has been used. A thorough description could have
been included in the introductory part itself.
c) The description of the population is not adequate enough. Some of the necessary
information were missing such as the location, the average age of the children and the
health condition. Due to this the result cannot be generalised to a population that is
resembling this population. This can be amended by the determining the population and
mentioning about the factors like age, weight, socioeconomic status. Absence of certain

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important information were also felt, like the place where the trial has been conducted,
the staff-patient ratio, the infrastructure of the hospital or the type of care It was
providing (Primary, secondary and tertiary).
Other important information like, which nurse has given the intervention and
his/her qualification information was lacking. The importance of these information lies in
the fact that these affects the internal validity of the trial (Yilmaz 2013). Other
information that could have been added are the environmental details like the structure of
the rooms where the interventions has been provided, the availability of the parents and
the lighting. These information could have mattered as these influence how the students
would respond to the intervention. The generalisation of the study findings and
replication to some other settings can be corrected by providing a detailed information
about the nurse who had cannulated the study group and the situation where the study has
been performed.
d) This study followed a proper inclusion and exclusion criteria as adoption of a proper
inclusion and exclusion criteria helps in the elimination of the confounding variables. For
example, for testing the effectiveness of a drug it is important that patients have clinical
conditions that might contraindicate with the drug, should be excluded from the study.
This paper has followed a convenient sampling, although convenient sampling might not
represent the general population and can lead to selection bias. The age range that has
been chosen for this study is large representing the entire population. A large sample
helps in providing confidence to a research. Sample bias might have been caused but it
has been prevented in this study due to the large population ( Perneger et al., 2016).
Allocation of the participants has been done maintaining privacy and confidentiality. A