Part 1: (Initially undertaken on your own).

Part 1: (Initially undertaken on your own)
Show the structured PICO question of the study
P- Young adults (18-25-year-old) who are a daily smoker and
try to get rid of smoking
I – Text message-based smoking cessation intervention
program(SMS USA)
C- Smoking quitter control group (Researchers focused on
improving sleep and fitness habits together with the help of
messages for influencing to quit smoking )
O- improvement in smoking cessation rate with two
outcomes, such as primary and secondary outcomes:
Primary outcome: Continuous abstinence from smoking for
three months
Secondary outcome: reducing the habit of smoking to five or
fewer cigarettes from the quit day at four weeks post quit
program confirmed by the significant other groups. In these 4
weeks, 7 days of point prevalence abstinence would be
observed.

COMPONENT RATINGS
A) SELECTION BIAS
(Q1) Are the individuals selected to participate in the study likely
to be representative of the target population?
1. Very likely ✔
2. Somewhat likely
3.Not likely
4. Can’t tell
Provide your explanation:
Ans. Very likely
The research population has focused on a specific set of participants aged 18 to 25 years. The
research consists of elements related to community, age, race, medical record and laboratory reports.
The study involves criteria matched target population with a whole set of people. The research is not
selection biased as the target population has been mentioned. Selection bias is an error, which is
dependent on a specific type of data and can distort the entire research analysis. If the research has
selection biasness, the baseline characters are considered first in the research objective (Certo et al.,
2016, p.7).
This study is a pilot study and conducted in the preliminary level or smaller scale. Researchers favour
short studies as these types of studies are used to simplify the assessment of data and calculations
related to researches (Zahn et al. , 2019, p.85).
The participants were selected through an online advertisement, and 1916 participants were found
with the associated eligibility. 211 among them were eligible for the criteria. 101 participants were
randomly allocated in the group of intervention by computerised method, and the 63 participants were
placed in the control group. However, 47 candidates did not complete the registration process and quit.
The small sample size is easy to handle and manipulated, but it is also a limitation for the researcher.
Small sample size sometimes does not give the desired or very prominent outcomes, which happens to

the study (Ybarra et al. , 2013, p. 1389).
The study involves random sampling method. The positive side of this sampling method is to reduce
biasness in the sample collection; as a result, each sample has an equal opportunity of distribution and
probability for participating in the research. There are numerous sorts of random sampling can be found
in scientific researches such as simple random sampling, unrestricted random sampling, systematic
random sampling, stratified random sampling, cluster random sampling, and multistage random
sampling. However, the researchers of the study did not mention any specific sampling process.
Researchers also assured about the minimal bias based on the baseline characteristics (Ybarra et al. ,
2013, p.1393). Assessment of eight of the final participants was conducted manually.
(Q2) What percentage of selected individuals agreed to participate?
1. 80 - 100% agreement
2. 60 – 79% agreement
3. less than 60% agreement 
4. Not applicable
5. Can’t tell
Provide your explanation:
After collecting the participants from the advertisements, researchers find 1916 people. Then
eligibilities were assessed, and total of 585 people are selected. Among them 284 young people, only 90
refused to complete the registration method. There were 211 participants selected by random sampling.
101 persons were allotted in the intervention group, and 63 were located in the control group. The
allocation was proposed by computerised adaptive randomisation program. 47 participants were
prematurely terminated after randomisation as they did not complete the enrolment process. The data

shows less than 60% of initial participants are involved til the end.
RATE THIS SECTION STRONG MODERATE WEAK
See dictionary 1 2 3 
Provide your explanation:
Ans. 3 (weak)
The segment can be rated as weak. The reason for measuring the part as moderate as 100% of the
participants was not to participate, and there are some other parameters such as sex and age of the
participants. Among 1916 person, only 211 were eligible for the further participation of candidates in
the study. There are two groups, such as intervention and the control group. 47 participants were finally
excluded, and only164 participants were involved in the survey (Ybarra et al. , 2013, p.1388). It can be
said that the selection bias is poor in the research, as two criteria do not match. The representation of the
sample of the selected population in the study is inadequate.
The randomised control trial has faced many challenges in collecting the data and recruiting the
participants in a particular study. The problems regarding the data collection are responsible for
significant statistical outcomes. The absence of the participants is another problem faced by the
researchers. The process of data collection can be costly for the study and time consuming also.

B) STUDY DESIGN
Indicate the study design
1. Randomised controlled trial 
2. Controlled clinical trial
3. Cohort analytic (two-group pre + post)
4. Case-control
5. Cohort (one group pre + post (before and after))
6. Interrupted time series
7. Other, please specify:
8. Can’t tell
Was the study described as randomised? If NO, go to Component C.
Yes
Author used randomised control method and he applied some words such as randomly
assigned and randomization process.
If Yes, was the method of randomisation described? (See dictionary)
Yes
The author describes an allocation sequence 2:1.
If Yes, was the method appropriate? (See dictionary)

Yes
Provide your explanation:
The research is based on the Randomized Control Trial. This trial is associated with the two arms
randomised control trial with adaptive randomisation. The adaptive randomisation is related to both
intervention groups and control groups. The groups are selected in terms of the participants’ gender and
their smoking rates (heavy or light) (Ybarra et al. , 2013, p.1394).
The randomised control trial is mostly used to avoid the biasness in the data collection from the
participants. The cause-effect relationship has been recognized between the intervention group and
resulted in the outcome of the research (Navas-Carretero & Martinez, 2015, p. S55). Avoidance of
biasness is the most effective result, which makes the researchers choose the RCT analysis. The
biasness can be avoided in the intervention and the control group (MacLeod & Clarke, 2015, p. 68). The
sequence generation is the rule of intervention allocated to specify according to several random
processes (de Jong et al., 2016, p.660).
The computer-based adaptive randomisation process did allocation of the participants for minimising
the possibilities of imbalance in the study groups regarding smoking and the gender of the smokers.
Initially, 101 participants were selected in the intervention groups, and the 63 participants are selected
in the control group. The randomisation is the specific scheme in which the probability of treatment or
the clinical assignments can change according to the clinical manifestation (Cattaneo, Frandsen &
Titiunik, 2015, p.15). The advantages regarding the covariant with the influential factors of the

covariant for the control trial.
RATE THIS SECTION STRONG MODERATE WEAK
See dictionary 1 2 3
Rate of the section is strong. Every method was mentioned clearly, but the interventions cannot be
predicted. The control trial methods have some spontaneous result, which cannot intervene by the
investigator. The authors stated that they used a computerised adaptive
randomisation program; difficulties emerged with the randomisation program, so
the authors manually assign the last eight participants to balance allocations. The
adaptive randomisation control process includes sequential concealments. The
allocation concealment defines as the process, which consists of the study groups
to protect the data from biasness (Clark, Fairhurst & Torgerson,2016, p.3). The study is
based on the computer-based program in randomising the participants. The study
will analyse the participants with randomised control trial, which helped the
participants in an objective, systematic and highly controlled manner. The author
has chosen the adaptive randomisation method in the randomised control trial.
C) CONFOUNDERS
(Q1) Were there important differences between groups prior to the intervention?
1.Yes 
2. No
3. Can’t tell

The following are examples of confounders:
1. Race 
2. Sex 
3. Marital status/family
4. Age
5. SES (income or class)
6. Education 
7. Health status
8. Pre-intervention score on outcome measure
Provide your explanation:
Ans. Yes
Confounding factors are one of the essential aspects of epidemiological studies. Confounding factors
are often acting as the distortion factor for the researches. The dissimilarities between groups before the
intervention were determined (Ybarra et al. , 2013, p.1394). There are some cofounders associated to
the study such as income class, pre-intervention measures, but the cofounder related to the higher
studies are not emphasised. Education is an important factor in quitting smoking. It can be observed that
a true collection of the participants were carried out. The factors associated with the confounders are
determining areas of research analysis. The confounder factors can be detected, but biasness and