Evidence Based Practice

Evidence Based Practice
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Assignment 1
Section A :
1. Yes. In the current trial, focused issue related to the quality of life (QOL) of the patients
with cancer treatment has been addressed. Outcome of the intervention completely depends
on the targeted population, validated methodology and measured outcome. In this trial,
patients with cancer treatment should be recruited to assess the improvement of quality of life
of the survivors of colorectal cancer patients. Quality of life of patients with different types of
cancers would affect differently (Nayak et al., 2017). Hence, it is necessary to recruit patients
with specific types of cancers for accurate assessment of the quality of life. Henceforth,
survivors of the colorectal cancer recruited in this study. Recruitment of participants with the
different types of cancers would not have provided relevant outcome related to the research
question. In randomized control trial, specific intervention needs to be given to address the
clinical question. Home-based personalised exercise programme was assigned to all the
participants in the intervention group. However, participants in the control group were not
assigned to home based personalised training programme. Moreover, flexible exercise
programme was assigned to participants depends on their capability to do exercise. Assigning
flexible exercise programme to participants would be helpful in getting accurate outcome
without any harm or discomfort to the participants. Incorporation of the control group is
necessary in this controlled trial because it would be helpful in getting confirmation about the
improvement due to personalised exercise programme (Bisschop et al., 2015). In this
controlled trial, both primary and secondary outcomes were assessed. Primary outcomes in
the controlled trial are very critical because these outcomes are helpful in arriving exact
outcomes of the trial which address specific research question. Moreover, primary outcome
should be measured using validated scale which would be helpful in producing valid and
robust results. In this study, Functional Assessment of Cancer Therapy-Colorectal (FACT-C)
scale was implemented to assess quality of life. FACT-C scale consist of subscales like
physical, functional, emotional and social/family well-being and a colorectal cancer subscale.
This scale would be helpful in the assessment of all the activities together and it would be
helpful in establishing correlation among all the activities. Correlation among all the
activities would be helpful in assessing overall QOL of the participants (Liu et al., 2018).
Secondary outcomes should be clearly differentiated from the primary outcomes; however,
these should be support as evidence for the primary outcomes. If primary outcomes are not
lending evidence support to primary outcomes; there would not be any relevance to the
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secondary outcomes (Vetter and Mascha, 2017). Secondary outcomes measured in this study
were satisfaction with life, depression, anxiety, fatigue, cardiovascular fitness, body
composition and flexibility. All these parameters extend support to the primary outcomes;
moreover, all these parameters were assessed using validated scales.
2. Yes. In this trial, colorectal cancer survivors were recruited from the Cross-Cancer Institute
(CCI) in Edmonton, Alberta. All the participants were recruited based on certain eligibility
criteria. Hence, it would be helpful in the recruitment of participants with the similar
characteristics. Recruitment of the participants with similar characteristics would be helpful
in reducing variability of the results (Chevan and Haskvitz, 2015). Participants were
randomised using random table method. However, method was not fully explained in the
paper. Detailed explanation of the method would have been helpful in assessing
appropriateness of the method of randomisation (Somers et al., 2017). Allocation of the
participants and methodology implemented in this study were explained to both researchers
and participants. Information related to the study was provided to the participants in the form
of information package ‘Notice of Research Study’.
3. Recruited participants were accounted for the results and conclusion at the end study.
Exercise and control group participants with 89.9 and 93.9 % respectively were retained till
the end of the study (Courneya et al., 2003). This retention can be considered as good
retention for getting necessary outcome from the study. Number of participants during the
study design usually decided based on the probable outcome of the study (Bower et al.,
2014). Hence, retention of participants is important aspect in the randomised control trial
because conclusion of the trial depends on the number of participants. Analysis of the
outcome of the intervention and control group participants performed separately because it
helped in differentiating effect of intervention.
4. No, patients and study personal were not blinded to the intervention. However, certified
fitness consultants were blinded to the study. Blinding in the study is important aspect
because blinding helps in avoiding biasness in the outcome of the study. Study personal,
study director and statistician in this trial should have blinded to the obtained results because
final outcome and conclusion of the study depends on the study director and statistician. It
can be argued that there is no bias in the outcome of this study because results analysis was
performed by employing different statistical analysis methods (Mansournia et al., 2017).
Participants bias in this trial cannot be overlooked because some of the collected data was
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subjective data. Hence, participants should have blinded in this study. It is highly possible
that there would be biasness in the subjective data collection.
5. Yes. In this study, two groups like intervention and control group were assigned. Average
age of the participants in both the groups is approximately similar. However, % males were
approximately 10 % more in control group in comparison to the exercise group. Married
participants were approximately 13 % more in exercise group in comparison to control group.
Education status was 11 % more in control group as compared to the exercise group. Family
income was approximately 12 % more in exercise group as compared to the control
(Courneya et al., 2003). However, most of the factors except age would not affect outcome of
this trial. Hence, participants can be considered as similar at the start of the study. Duration of
illness and medical data is approximately similar in both control and exercise group.
However, total duration of exercise per week is more in exercise group as compared to the
control group. Hence, adaptation to the exercise would be faster in control group. It would
exhibit more favourable outcome in terms of QOL in control group in comparison to the
exercise group. Similar duration of exercise in both the groups would have demonstrated
more accurate effect of exercise on the QOL of in cancer patients.
6. Yes. Except intervention like home-based personalised exercise programme to the exercise
group, both the groups were treated equally. Fitness test was carried out to both the control
and exercise group. Fitness test was carried out by the certified fitness trainer (Courneya et
al., 2003). However, only exercise group was blinded to the fitness test. Fitness test is
important aspect in this trial because outcome of this trial is based on the exercise related
QOL (Navigante &, 2016 Morgado). Exercise is mainly dependent on the fitness of the
individual. Fitness necessary for the exercise mainly depends on the factors like strength,
endurance, flexibility and balance (Buffart et al., 2018). Hence, fitness is necessary for the
QOL improvement.
Section B :
7. In this study, primary QOL outcome like FACT-C was assessed. Different secondary QOL
outcomes like satisfaction with life, anxiety, depression, fatigue, FACT-G, trial outcome
index, physical well-being, social/family well-being and colorectal cancer subscale were
assessed. Moreover, secondary fitness outcomes like treadmill time, resting heart rate, sum of
skinfolds, body mass index and flexibility were assessed. Assessment of these parameters
would be helpful in the assessment of different aspects like physical, functional, emotional
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