Heart Disease Telemonitoring Study

This assignment details a comprehensive study using telemonitoring devices to improve services for chronic heart failure patients. It emphasizes the importance of ethical standards, equal treatment, and effective solutions. The study involved 197 patients with positive results showing improved fluid intake, self-care, adherence, and self-efficacy. Another related research focused on finding new treatments and providing satisfaction to lower-level heart patients.

PART 3.1 APPRAISAL OF YOUR RANDOMISED CONTROLLED TRIAL (Please consider
the word limit for each question, 13 marks )
Assessing the quality of the available evidence has also been a key focus this semester. Use the
CASP tool for RCTs below to appraise the quality of your selected RCT.
Section A: Are the results of the trial valid?
Screening Questions
1. Did the trial address a clearly focused issue?
Yes No Can’t tell
Justify your answer: (Max 50 words)
 Yes, population through collect patients randomly then allocate the group of patients
for intervention.
 The organisation prepare a postal questionnaires for patients the outcome of
experiments is increase self care and adherences. In the self efficacy not any
improvement. After that comparing the result to standards to find out reasons.

HINT: An issue can be ‘focused’ In terms of
 The population studied
 The intervention given
 The comparator given
 The outcomes considered
2. Was the assignment of patients to treatments randomised? (Max 50 Words)
Yes No Can’t tell
Justify your answer:
 Yes, the assessment of heart patients to treatments randomised
because there were randomly collect 382 heart patients then allocate
197 persons of group for intervention.
 These experiments of allocation sequence is concealed in the form also
patients did not had any knowledge about that.
HINT: Consider
 How was this carried out?
 Was the allocation sequence concealed from
3. Were all of the patients who entered the trial properly accounted for at its conclusion?
(Max 50 words)
Yes No Can’t tell
Justify your answer:
 These experiments are properly accounted that was not trial stopped
early.
 There were divided heart patients in two groups after the experiments
patients analysed in the same group which they were randomised.
HINT: Consider
 Was the trial stopped early?
 Were patients analysed in the groups to which they were randomised?
4. Were patients, health workers and study personnel ‘blind’ to treatment? (Max 50 words)
Yes No Can’t tell

Justify your answer:
 Yes, Heart patients, health workers and study personnel were blind to treatment
because through the organisation provide various treatments as experiments so they
could be blindly trust on that.
 Because they did not have any information and knowledge about new interventions.
HINT: Think about
 Patients?
 Health workers?
 Study personnel?
5. Were the groups similar at the start of the trial? (Max 50 words)
Yes No Can’t tell
Justify your answer:
 Yes, there were group of persons are similar at the starting point of trial is collected 382
persons in which 137 persons are allocated by intervention.
 Age of these persons approximately 75 and more than. In which 59% are male and 64%
were lived with a partner.
HINT: Look at
 Other factors that might affect the outcome such as age,
 sex, social class
 researchers and patients?
6. Aside from the experimental intervention were the groups treated equally? (Max 50
words)
Yes No Can’t tell
Justify your answer:
 Yes, During the experiment of intervention so there were equally treat to all persons by
the health organisation.
 By which there is not create bias nature with patients and they will get more
satisfaction by organisation's employees in the effective manner.

Section B: What are the results?
7. How large was the treatment effect? (Max 150 words)
Justify your answer:
 Experiment result effects were measured by Critical Appraisal skill Programmes. There is
also use tele- monitoring systems to asses the symptoms of patients by which nurses are
easy to know and identify them.
 Its help to take effective decision and determine the actual effects of various
experiments on heart patients. There is basis differences in self care is (p=0.001) and self
efficacy is (p=0.024) its increase 0.9 on 15 point of scale and self care increased 1.5 on
10 point of scale this improvement only applied on experimental group.
 But those persons are taking usual care so their is not having any improvements. In the
self efficacy having no major difference after 3 and 6 months. Fluid intake is 0.019 in 3
months and 0.086 in 12 months. Adherence of patients in 3 month is 0.023 and in 12
month is 0.037.
HINT: Consider
 What outcomes were measured?
 Is the primary outcome clearly specified?
 What results were found for each outcome?
8. How precise was the estimate of the treatment effect? (Max 100 words)
Justify your answer:
 Treatment effect estimated by tele monitoring devices there is also use Critical Appraisal
skill Programmes. Researcher are most confident for experiments.
 By these intervention self care become (p= 0.024) and self efficacy is (p= 0.024), after
the intervention self care increased 1.5 is increased on 10 point of scale and in self
efficacy having no any major differences. Also fluid intake in 3 month is 0.019 it become
in 12 months is 0.086. and adherence of patients is 0.023 in 3 months and in 12 months
it become 0.037.
HINT: Consider
 What are the confidence limits?
Section C: Will the results help locally?

9. Can the results be applied in your context? (or to the local population?) (Max 100 words)
Yes No Can’t tell
Justify your answer:
 Yes, the collected result of the intervention and experiment will be
applied in the effective manner. In the experiment covert all over the
patients related to heart failure disease.
 By these experiments through collect positive result like increased self
care and adherences but there is no any improvement in self efficacy.
So on the basis of this result it can be applied on local population of
the country.
 By using these new treatments may be resolve heart diseases and give
them proper satisfaction to them.
HINT: Consider whether
 Do you think that the patients covered by the trial
 are similar enough to the patients to whom you will
 apply this?, if not how to they differ?
10. Were all clinically important outcomes considered? (Max 50 words)
Yes No Can’t tell
Justify your answer:
 Yes, the major clinically result by improved fluid intake is in 3 months is 0.019 and in 12
months become 0.037.
 After that collect information by self reports of patients. In which clarify self- efficacy
and self-care. Its help to take decision and identify appropriate treatment of disease.
HINT: Consider
 Is there other information you would like to have seen?
 If not, does this affect the decision?
11. Are the benefits worth the harms and costs? Yes Can’t tell No (Max 100 words)
Justify your answer:
 Yes, through the health and social care organisation apply new experiments on heart
patients. All these were success its provide better solution regarding heart problems but
through the organisation increased charges and cost of the treatments.
 This intervention result help to improve self-care, adherence and knowledge as well as
increase cost of treatments. By the hospital have to provide safety and security facility,
hospital admission cost and so more.

 Its require to understand patients problem in the effective manner and according to
that provide treatments to them with full information.
HINT: Consider: Even if this is not addressed by the review, what do you think?
PART 3.2 APPRAISAL OF YOUR QUALITATIVE ARTICLE (please consider the word limit
for each question, 10 marks )
Use the CASP Appraisal for Qualitative Research below to decide whether the information
presented in your paper is trustworthy and truly reflective of the participant’s voice.
SCREENING QUESTIONS
1. Was there a clear statement of the aims? ☐Yes ☐ Can’t tell ☐ No
HINT: Consider
 What was the goal of the research?
 Why it was thought important?
 Its relevance
Your comment: (max 50 words)
 Yes, The aim of the research is to understand patients health related problems and issues. Its important to provide tele- monitoring services to patients to resolve chronic heart
failure(CHF) as well as providing this services at all nearest clinics for patients to resolve
problems easily.
2. Is a qualitative methodology appropriate? ☐Yes ☐ Can’t tell ☐ No
HINT: Consider
 If the research seeks to interpret or illuminate the actions and/or subjective experiences of research participants
 Is qualitative research the right methodology for addressing the research goal?
Your comment: (max 50 words)
 Yes, qualitative methodology through got better solution of chronic heart failure disease
by using tele monitoring device on heart patients.

 This method help to achieve goals and objectives of the research. This aim of this method
is understand personal experience, subjective views and practices of customers.
3. Was the research design appropriate to address the aims of the research? ☐Yes ☐
Can’t tell ☐ No
HINT: Consider
 If the researcher has justified the research design (e.g. have they discussed how they decided which method to use)?
Your comment: (max 50 words)
 Yes, in this research were used qualitative research design.
 Its help to achieve goals and objectives of the research and provide better treatments to
heart patients those are affected by chronic heart failure problems.
4. Was the recruitment strategy appropriate to the aims of the research? ☐Yes ☐ Can’t
tell ☐ No
HINT: Consider
 If the researcher has explained how the participants were selected
 If they explained why the participants they selected were the most appropriate to provide access to the type of
knowledge sought by the study
 If there are any discussions around recruitment (e.g. why some people chose not to take part)
Your comment: (max 100 words)
 Yes, for this research collect 18 heart patients those are affected by heart diseases. For
recruit the patients by semi structured interview method by two post graduate persons.
 In which one is male and one is female. For handle the patients there are 5 professionals
those are working at different time scheduled. Interview were conducted face to face with
patients at their home or by telephone.
 This recruitment strategy appropriate to the achieve aims and objectives of this research
by which provide better and effective treatments to heart patients to resolve their
problems.
5. Was the data collected in a way that addressed the research issue? ☐Yes ☐ Can’t tell ☐
No

HINT: Consider
 If the setting for data collection was justified
 If it is clear how data were collected (e.g. focus group, semi-structured interview etc.)
 If the researcher has justified the methods chosen
 If the researcher has made the methods explicit (e.g. for interview method, is there an indication of how interviews
were conducted, or did they use a topic guide)?
 If methods were modified during the study. If so, has the researcher explained how and why?
 If the form of data is clear (e.g. tape recordings, video material, notes etc)
 If the researcher has discussed saturation of data
Your comment: (max 100 words)
 Yes, the collected data in a way that addressed the research issues. In this research was
use tele- monitoring device to collect information by patients as well as through the
health and social care organisation made.
 For this research conduct semi structured interview by which select 18 heart patients.
The information and data were collected by audio recode then coded thematically
analysis.
 To collect the appropriate result so there were using qualitative research method. Its
based on quality result of new experiments related to the heart patients. These new
experiments are help to provide better treatments to patients.
6. Has the relationship between researcher and participants been adequately considered
☐Yes ☐ Can’t tell ☐ No
HINT: Consider
 If the researcher critically examined their own role, potential bias and influence during
a) Formulation of the research questions
b) Data collection, including sample recruitment and choice of location
 How the researcher responded to events during the study and whether they considered the implications of any changes
in the research design
Your comment: (max 50 words)
 For new experiments applying on chronic heart failure patients so they were selected
semi structured interview by the researcher but they all are affected by the heart diseases.
 So through the researcher and team members did not create any bias nature between them
and equally provide treatments to patients.

7. Have ethical issues been taken into consideration? ☐Yes ☐ Can’t tell ☐ No
HINT: Consider
 If there are sufficient details of how the research was explained to participants for the reader to assess whether ethical
standards were maintained
 If the researcher has discussed issues raised by the study (e.g. issues around informed consent or confidentiality or how
they have handled the effects of the study on the participants during and after the study)
 If approval has been sought from the ethics committee
Your comment: (max 50 words)
 Yes, before start the research on heart patients so there is already set some ethical
standards by researcher those all are followed in the effective manner.
 During the apply new experiments on patients so by the employees of the organisation
does not create any bias nature and equally treat them.
8. Was the data analysis sufficiently rigorous? ☐Yes ☐ Can’t tell ☐ No
HINT: Consider
 If there is an in-depth description of the analysis process
 If thematic analysis is used. If so, is it clear how the categories/themes were derived from the data?
 Whether the researcher explains how the data presented were selected from the original sample to demonstrate the
analysis process
 If sufficient data are presented to support the findings
 To what extent contradictory data are taken into account
 Whether the researcher critically examined their own role, potential bias and influence during analysis and selection of
data for presentation
Your comment: (max 100 words)
 Yes, the data of research collected by various tools and to effectively analyse that there
are using qualitative method.
 Its provided actual result of new experiments. All result are analysed in the systematic
manner. To collect information from patients so there was use tele- monitoring device By
these find out the actual result of new experiments related to the heart patients.
 Collected result by the researcher were compared by the standard result then examine the
result and differences between them. Sufficient data related to this research support to
achieve goals and objectives.
9. Is there a clear statement of findings? ☐Yes ☐ Can’t tell ☐ No
HINT: Consider whether
 If the findings are explicit
 If there is adequate discussion of the evidence both for and against the researchers arguments
 If the researcher has discussed the credibility of their findings (e.g. triangulation, respondent validation, more than
one analyst)
 If the findings are discussed in relation to the original research question

Your comment: (max 100 words)
 Yes, the result of this research and statement is explicit in the nature. There is clearly
identify the the result and affects of new experiments on heart patients those are affected
by the chronic heart failure.
 Before applied experiments on this research so there were had arguments some are in
favour and other all are in against. To collect information and for proper analyse there
were using triangulation method that help to provide actual result of experiments.
 When applying the new experiments on heart patients may be that negatively impacting
on patients but in the other hand, it may be possible the result will positive.
10. How valuable is the research?
HINT: Consider
 If the researcher discusses the contribution the study makes to existing knowledge or understanding e.g. do they
consider the findings in relation to current practice or policy?, or relevant research-based literature?
 If they identify new areas where research is necessary
 If the researchers have discussed whether or how the findings can be transferred to other populations or considered
other ways the research may be used
Your comment: (max 100 words)
 This research is valuable in the nature, by which collect appropriate result that help to
provide new treatments to heart patients.
 The result of this research improved the knowledge level of employees as well as
patients. Heart patients will know about new techniques and treatments so they will use
to remove problems and issues relating to the heart.
 This research use full for lower level patients in the country. That provide better result of
heart disease and give them fully satisfaction.
PART 4 OVERALL SUMMARY
PART 4.1 PROVIDE AN OVERALL SUMMARY OF WHAT THESE TWO PAPERS
CONTRIBUTE TO ANSWERING YOUR RESEARCH QUESTION (400 words, 10 marks).
HINT: Consider
 What was your original clinical question?
 What information do you think is useful from these two articles?

 Do you think the information in the articles is unbiased?
 If the information from the articles helpful in answering your overall question?
 In this research to collect relevant result and information form patients so there were
asked some question to them. Through the organisation set an postal questionnaires to
them in which they can easy to full fill and give answers to all questions on the basis of
self experience, knowledge and self efficacy (Tiffen and England, 2011).
 This research help to find out new treatments and solutions of heart diseases and provide
satisfaction to patients. In the article define the heart patients those are affected by
various kind of heart diseases so by the health and social care organisation through apply
new interventions on them.
 This intervention applied on 197 heart patients and 185 patients were taking usual care by
the organisation. By which clearly and examined the result of them is self care and
adherence were improved but self efficacy did not having any major improvement. Heart
patients of also improved the fluid intake in 3 and 12 months.
 So result of these experiments or intervention related to the heart diseases are positive in
the nature. In the other one article conduct semi structured interview on persons by which
select 18 patients those are affected by the chronic heart patients (Booth, Schofield and
Tiffen, 2012).
 The result of this research were categorised in five themes information, support,
reassurance; compliances and dependence; charges and challenges. The aim of this
research is understand view of patients and professional on the acceptability that help to
provide better and effective services to patients.
 There were used tele monitoring device that help to resolve chronic heart failure. Before
start the experiments oh patients through the researcher set some ethical standards for
organisational employees those have to follow by them. So that's why during the
intervention there were not create any conflicts and bias nature between patients.
 In which equally treat them and effectively provide best treatments to them. This research
were conducted in the systematic manner and the main objective/ goals of this is to find
out new treatments and solutions of heart disease that will be applying on local
populations of the country (Boud, Cohen and Sampson, 2014).

 The collected result is the positive in the nature so it help to give better satisfaction to all
heart patients. This research use full for lower level patients as well as its improve
knowledge about new treatments with proper faith.
PART 4.2 SYNTHESISING THE EVIDENCE (300 words, 7 marks).
Finally, you need to summarise the evidence that relates to your clinical questions in plain
language as if you were explaining the rationale for your clinical decision making to a patient
within your care.
 Best research evidence is based on client values and situation as well as own clinical
expertises. Mainly this research applied on heart patients those were collected randomly
then allocate the groups of them.
 The major objective and goals of the reach is find out something new and effective
solution of heart problems. By this research collected positive result because in which
improved fluid intake of heart patients.
 There are 197 patients on applying intervention and 185 patients were taking normal care
through the organisation. In which self care, adherence and self efficacy improved of 197
patients but other patients in no having any improvements those are taking usual care
through the health and social care organisation. These intervention of collected result and
evidences of improvements by tele – monitoring device and postal questionnaires.
 By these method and tool give actual and reliable result and information related to the
particular heart patients. Postal questionnaires were filled up by patients on the basis of
their self experience and knowledge.
 The another one article research conducted on 18 heart patients by which 7 is female and
11 is male. There are using tele monitoring device to resolve heart patients. This research
conducted only for to find out new solution and applied new heart treatments on patients
that help to resolve problems and give them proper satisfaction to them.
 In the other hand, this research is based on interventions those related to heart patients. Its
help full for lower level patients they can use these treatments to resolve problems with
proper satisfaction.

 To collected the positive result from this research so before start the research set some
effective ethical standard that's why during the experiments there did not create bias
nature with heart patients equally treat by the organisation to all patients.

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