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Evidence Based Practice Part I Answer One- Validity of the Trial

   

Added on  2020-04-07

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UNIVERSITY:NAME STUDENT ID:COURSE CODE COURSE NAMEASSIGNMENT Evidence Based Practice

Evidence Based Research PracticePart IAnswer One- Validity of the Trial - Yes Most interactive aspect in conducting health research is participating in clinical trials which patents volunteer themselves to participate in the test and ensure the test of efficacy and safety as new medical interventions, (Baily, 2008). In this case study article the trial experiment addresses the population of interest which are the hypertensive patients. Effectiveresearch incorporates the use of data and biological aspects collected for disease assessments.The intervention given here include the uses of drugs like antihypertensive drugs and subjecting the patients in the research to different exposures and assessing their reaction, (CHSR, 2008). The outcomes under this study have been established after the completion of the study the outcomes have been compared with the general population. Thus I agree that thetrail study focused on the trail issue with regards to the population being investigated which are the hypertensive patients suffering and ailing from hypertension. Normally great deals of this research entail the analysis of the data, biological samples, (Braunstein et al, 2008). Now days the research process is conducted through human samples as subjects just like the case in the study. These clinical trials have shown positive result due to the treatment being offered to the patients. They help in advancing medical care and ensure that right decisions and treatments are utilised.Answer Two- Randomisation of patients- YesRandomization in research has been used as the process of making something in random without following any particular format or way. Random process has been established as the process of sequence variables whose outcomes do not follow any particular probability distribution. In experimental research it entails allocating experimental unit’s across the different groups, (Domanski & Mackinla, 2009).In this research article , randomization process has been undertaken through the allocated drug assignment with the key aspects being the two drug regimes under study or being investigated in the study. Randomization has been found to reduce the chances of confounding factors occurrences through equalising factors or the independent variables that may not be accounted for in the initial stage of experimental design process, (Suresh, 2011).In the article double blinding of randomization process was practised during the trial periods, however after the trial period elapse, the patients were unblended to the treatment assignment. Of the 42, 418 subjects, a total of 33, 357 were randomly assigned to hypertension drug regiment Chlorthalidone. It is evident that the researcher was privy to theserandomised subjects and treatment effect being subjected t them.Page | 2

Evidence Based Research PracticeAnswer Three – Accountability of trail subjects at closure -YesThe trial began with treatment of the different groups to different tests and follow up visits were taken at 1,3,6,9 and 12 months and then after every four months later. It is notable that outcomes were analysed using the intent to treat approach. After the final close out in the year 2002, the treatment was discontinued and the participants subjects were unblended with regard to treatment task. In this article subjects were not just left alone. Interestingly, subjects were followed even after four years after the completion of study. The method utilised for the post trial follow upswas done using National Death index, social Security Administration and Center for Medicare and Medicaid services so as to get accurate data.The groups were analysed to the previous randomisation groups. This was evident with the analyses of the baseline characteristics which were compared after the four years and the initial characteristics of the subjects. Data of 36 months were utilised in follow up visits for the subjects in the treatment strata. Hence with this kind of accountability for the subjects it was easier for in identification and follow up purposes of the subjects, (Zweben et al 2009). Thus with this kind of follow , the study subjects are worth contributing for further studies as the subjects characteristics were kept on trail for such a long time thus ability of correlating hypertensive disease with other state of health of the patients and its correlation to treatment purposes. Thus this aspects follows effective planning of research protocols, effective data collection, systematic tracking criteria for subjects which ensures high follow ups was adopted, (Woolard et al 2004).Answer four- Blind treatment- PartlyNormally subjects in controlled clinical set up trials often gain experience in studying the provided treatment they receive through building the efficacy level through raising awarenesslevels. However in contrast patients or subjects in blinded control do not learn after they are included into research what they are being treated for in the study, (Kafantaris et al 2004). Hence the aspect of ensuring that subjects are kept in blind spot throughout the entire phase isa key element aspect of methodological process in research process. In the research article the patients have blind treatment hence they don’t know what they are being given as the medical treatment for coronary heart disease and it s reduction in the long run. However, there is no assurance that the health care personnel in the study have been bothblind treat. Further the research personnel have not been blinded for the treatment of the subjects. The researchers are aware of the treatment to the two groups provided with Page | 3

Evidence Based Research Practicetreatment in the study. Studies have shown that keeping the researchers and medical service providers blinded to the treatment is key aspect in clinical research practice, however they is need to inform the subjects and medical providers after research may not be beneficial as it may pose risks and exacerbations of symptoms, thus affecting continual treatment process, (Bladder 2005).Answer Five – Similarity of groups - YesRandomised controlled trails have been found out to be most efficient methods of determining cause and effect of relationship that exists between intervention and outcome. This enables in strengthening the strength of the research process. Its strength normally lies inthe randomisation criterion followed which is unique to the kind of research, (Concarto et al, 2000). In randomised trials subject are randomly assigned to groups which were evident in this research article. Random allocation is geared towards ensuring that intervention and control groups are similar in all basis. The treatments in this case are treatment with similaritybut produces different effects. To ensure this corresponding similarity of the subjects, all participants in the study were women and men aged over 55 years with either stage 1 or stage 2 hypertensive. All the subjects had either one additional coronary heart disease factors. Other aspects of similarity were not highlighted in the research paper. The key aspect of the rearch article is the randomisation effect which ensures that intervention and control groups are similar in all aspects. Answer 6 – Treatment of groups -YesThe underpinning aims of scientific research are geared at contributing to development of human knowledge and the rigorous planning and information processing. It entails aspects of investigation, observations and experiments which uses variety of tools such as group’s treatments. Group treatment in scientific assessments controls enables the Assesment of the different effects of tested factors in the experimental study, (Gersten et al., 2005). In the research article, the groups were given equal treatments in the sense that one group was given amildopine and similar number of participants was treated with lisinopril, thus this concludes that the groups were treated equally. Answer 7 – Treatment EffectOutcomes effects of treatment process included the analysis of intent to treat approach outlined four outcomes. the four major outcomes under investigation included all cause mortality, fatal and non fatal stroke, combined coronary heart disease and combined Cardiovascular diseases others included end stage renal diseases, cancer diseases occurrencesPage | 4

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