EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH
To Prepare:
Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)
Part 3A: Critical Appraisal of Research
Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
Part 3B: Critical Appraisal of Research
Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.
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Evaluation Table
Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 3A: Critical Appraisal of Research
| Full APA formatted citation of selected article. | Article #1 | Article #2 | Article #3 | Article #4 |
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| Evidence Level *
(I, II, or III)
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| Conceptual Framework
Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).**
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| Design/Method
Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria). |
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| Sample/Setting
The number and characteristics of patients, attrition rate, etc. |
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| Major Variables Studied
List and define dependent and independent variables |
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| Measurement
Identify primary statistics used to answer clinical questions (You need to list the actual tests done). |
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| Data Analysis Statistical or
Qualitative findings
(You need to enter the actual numbers determined by the statistical tests or qualitative data). |
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| Findings and Recommendations
General findings and recommendations of the research |
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| Appraisal and Study Quality
Describe the general worth of this research to practice.
What are the strengths and limitations of study?
What are the risks associated with implementation of the suggested practices or processes detailed in the research?
What is the feasibility of use in your practice? |
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Key findings
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Outcomes
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| General Notes/Comments |
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- Level I
Experimental, randomized controlled trial (RCT), systematic review RTCs with or without meta-analysis
- Level II
Quasi-experimental studies, systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysis
- Level III
Nonexperimental, systematic review of RCTs, quasi-experimental with/without meta-analysis, qualitative, qualitative systematic review with/without meta-synthesis
- Level IV
Respected authorities’ opinions, nationally recognized expert committee/consensus panel reports based on scientific evidence
- Level V
Literature reviews, quality improvement, program evaluation, financial evaluation, case reports, nationally recognized expert(s) opinion based on experiential evidence
**Note on Conceptual Framework
- The following information is from Walden academic guides which helps explain conceptual frameworks and the reasons they are used in research. Here is the link https://academicguides.waldenu.edu/library/conceptualframework
- Researchers create theoretical and conceptual frameworks that include a philosophical and methodological model to help design their work. A formal theory provides context for the outcome of the events conducted in the research. The data collection and analysis are also based on the theoretical and conceptual framework.
- As stated by Grant and Osanloo (2014), “Without a theoretical framework, the structure and vision for a study is unclear, much like a house that cannot be constructed without a blueprint. By contrast, a research plan that contains a theoretical framework allows the dissertation study to be strong and structured with an organized flow from one chapter to the next.”
- Theoretical and conceptual frameworks provide evidence of academic standards and procedure. They also offer an explanation of why the study is pertinent and how the researcher expects to fill the gap in the literature.
- Literature does not always clearly delineate between a theoretical or conceptual framework. With that being said, there are slight differences between the two.
References
The Johns Hopkins Hospital/Johns Hopkins University (n.d.). Johns Hopkins nursing evidence-based practice: appendix C: evidence level and quality guide. https://www.hopkinsmedicine.org/evidence-based-practice/_docs/appendix_c_evidence_level_quality_guide.pdf
Grant, C., & Osanloo, A. (2014). Understanding, selecting, and integrating a theoretical framework in dissertation research: Creating the blueprint for your house. Administrative Issues Journal: Education, Practice, and Research, 4(2), 12-26.
Walden University Academic Guides (n.d.). Conceptual & theoretical frameworks overview. https://academicguides.waldenu.edu/library/conceptualframework
IDENTIFYING RESEARCH METHODOLOGIES
Halima Isah
Master of Science in Nursing, Walden University
NURS 6052: Essentials of Evidence -Based Practice
Dr. Tavernier
September 17, 2023
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Matrix Worksheet Template
Use this document to complete Part 1 of the Module 2 Assessment, Evidence-Based Project, Part 1: Identifying Research Methodologies
| Full citation of selected article | Article #1 | Article #2 | Article #3 | Article #4 |
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Braz, L. G., Braz, D. G., Cruz, D. S., Fernandes, L. A., Módolo, N. S., & Braz, J. R. (2009). Mortality in anesthesia: A systematic review. Clinics, 64(10), 999-1006. https://doi.org/10.1590/s1807-59322009001000011
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Ng-Kamstra, J. S., Arya, S., Greenberg, S. L., Kotagal, M., Arsenault, C., Ljungman, D., Yorlets, R. R., Agarwal, A., Frankfurter, C., Nikouline, A., Lai, F. Y., Palmqvist, C. L., Fu, T., Mahmood, T., Raju, S., Sharma, S., Marks, I. H., Bowder, A., Pi, L., … Shrime, M. G. (2018). Perioperative mortality rates in low-income and middle-income countries: A systematic review and meta-analysis. BMJ Global Health, 3(3), e000810. https://doi.org/10.1136/bmjgh-2018-000810 | Endeshaw, A. S., Kumie, F. T., Molla, M. T., Zeru, G. A., Abera, K. M., Zeleke, Z. B., & Lakew, T. J. (2023). Incidence and predictors of perioperative mortality in a low-resource country, Ethiopia: A prospective follow-up study. BMJ Open, 13(5), e069768. https://doi.org/10.1136/bmjopen-2022-069768 | Talabi, A. O., Ojo, O. O., Aaron, O. I., Sowande, O. A., Faponle, F. A., & Adejuyigbe, O. (2021). Perioperative mortality in children in a tertiary teaching hospital in Nigeria: A prospective study. World Journal of Pediatric Surgery, 4(1), e000237. https://doi.org/10.1136/wjps-2020-000237 | |
| Why you chose this article and/or how it relates to the clinical issue of interest (include a brief explanation of the ethics of research related to your clinical issue of interest) | The article was selected since it is focused on the selected issue on perioperative and anesthesia-related mortality. During surgery, patient safety is of grave concern. Understanding the factors leading to mortality could help in improving overall practices and health outcomes. The article is also critical to the selected clinical issue as it provides insights to the incidences and causes of mortality in theater. Ethically, researching perioperative and anesthesia-related deaths is needed to improve the quality of care provided to patients and identify areas in need of further improvement. | The peer review source was selected as it helps in addressing the issue of perioperative mortality. The focus in this article is perioperative mortality in low-income and middle-income nations. The article is relevant to the study since it indicates that perioperative mortality is an indicator of the strength of a surgical system in a country. Understanding the perioperative mortality rate is critical to improve surgical care and overall patient outcomes in settings with limited resources. From an ethical perspective, the research highlights the need to improve the quality and safety of surgical care in low and middle-income countries where surgical services are hardly accessed. | The peer-review source was selected as it addresses the selected clinical problem. The study is relevant to the issue as it evaluates the incidence and identifies predictors of perioperative mortality in the adult age group within a given hospital subset. Understanding elements leading to perioperative mortality in the setting is needed to improve surgical care and overall patient outcomes. From an ethical perspective, there is need for targeted treatment for patients at a high risk of perioperative mortality.
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The article was chosen since it addresses the selected clinical issue. The study focuses on perioperative mortality in the context of pediatric patients at a tertiary facility in Ethiopia. The article is relevant as it seeks to determine the perioperative mortality rates and identify predictors of mortality in a surgical cohort of pediatrics. Understanding these elements helps improve surgical care and patient outcomes for children scheduled for surgery. From an ethical viewpoint, the research expands on the challenges and areas of improvement in pediatric surgical care.
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| Brief description of the aims of the research of each peer-reviewed article | The study is a systematic review that seeks to evaluate the incidences and causes of perioperative and anesthesia-related mortality. | The research aims at estimating the perioperative mortality rate in different surgical procedures in low- and middle-income nations. | The main aim of the research is to evaluate the incidence of perioperative mortality and determine some of the factors that could predict it among adults scheduled for surgery at Tibebe Gihon Specialized Hospital in Northwest Ethiopia.
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The main aim of the study is to determine the incidence of in-hospital perioperative mortality in pediatric surgical facilities.
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| Brief description of the research methodology used Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific. | The methodology used in the study is systematic review. The authors conducted different searches in Medline and Scielo data bases in search for relevant studies on the topic. 33 trials and data were acquired. The data obtained was subjected to analysis that helped in yielding the given conclusions. | The methodology used is systematic review of studies published from 2009 to 2014. The studies should have reported perioperative mortality for different surgical procedures in low and middle-income nations. The authors obtained data from each study and conducted a pooled evaluation to estimate the perioperative mortality rate by the form of procedure. The study used random effects meta-analysis of proportions and Freeman-Tukey double arcsine transformation to stabilize any variances in the estimates. | A single-center prospective follow-up study was conducted. The study comprised of 2530 participants aged 18 and above and underwent surgery at the facility. The outcome measures were time to death. It was measured in days from postoperative time up to the 28th day after surgery.
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A prospective study was the main methodology used. Precisely, the researchers used children ranging in age from newly born to 15 years who underwent surgery from May 2019 to April 2020. The outcome of the surgery was determined, and incidences of perioperative mortality calculated.
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| A brief description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected. | The strength of this methodology is the comprehensive evaluation of several studies. As a consequence, this leads to a situation where there is a robust overview of perioperative and anesthesia-related deaths. Systematic reviews have minimal bias and subjectivity as they provide a broad perception on the problem. However, the reliability and validity of the findings is hinged on the data analyzed in the articles chosen in the review and overall quality of the research. | The strength of using the systematic review is a comprehensive evaluation of large number of studies. The meta-analysis provides strategies to provide strong estimates. The article emphasized the need to improve safety for surgical care in low and middle-income nations.
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The methodology has some strengths, including the fact that it provides insights to the selected problem under evaluation as the data is collected over time. A large sample size enhanced reliability of findings. The analysis identifies predictors of postoperative mortality and could inform different strategies for patients at risk.
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A prospective design allows for the collection of real-time data on pediatric surgical patients. The study provides insights to perioperative mortality rates in the context of pediatric surgical centers. Predictors of mortality have been identified that could be targeted when designed strategies and formation of solutions.
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| General Notes/Comments | The study is critical in providing valuable insights on the selected topic.
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The study is a form of systematic review used in conjunction with meta-analysis that helps in improving reliability and validity of the findings gathered. | The study sheds more light on patients at risk of perioperative mortality for effective treatment strategies.
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The study is critical in showing the prevalence of perioperative mortality rate among pediatrics.
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