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Introduction
The application of critical appraisal tools to evaluate the validity of research conclusions has gained acceptance in modern research settings. Appraisal tools are mainly used in medicine and allied professions. In these fields, evidence-based practice is of utmost importance to patients. Critical appraisal guidelines often appear as a checklist used to assess a particular study. Appraisal tools are commonly used in settings that rely on evidence. The tools assess the applicability of results to a similar but larger setting (Crombie 1996). They offer a straightforward and all-inclusive checklist that can be employed in evaluating the rigor and reliability of a research paper. Appraisal tools focus on the authors, objectives of the study, research question, methodology, data analysis, discussion, and recommendations. This paper will critically examine an appraisal tool in terms of its completeness and applicability. The paper will also discuss the limitations of the appraisal tool and limitations of the paper not identified by the appraisal tool. It will conclude by analyzing the applicability of the tool to the research approach in the paper.
Critical examination of the Appraisal Tool is fundamental because it enables the assessment of relevance and quality of the study. It helps in the identification of information redundancy and overload. Critical appraisal of any research paper is necessary for a complete assessment of the results. The strengths and limitations of the research methodology are also evaluated by appraisal tools. Any bias can also be detected and necessary corrective measures are taken.
A rating scale for the appraisal of research paper
The appraisal tool did not provide a comprehensive approach to the analysis of the paper. For example, the rating scale has only three responses (yes, no, and not clear) (Dzewaltowski et al. 2009). This indicates that it relies on absolute responses only. However, the appraisal tool included a section on proof of the validity of the topic in question and proved to be dependable in this regard. The questions are not specific to the research paper in question. There is a substantial inconsistency that restricts the items that can be mentioned in the critical appraisal tool. Most questions appear to be a summary of the expected outcome. It is difficult to tell what each question is testing. The objective of the appraisal tool appears to change from one question to the other.
Limitations of the appraisal tool
There are several limitations in the paper which are not identified by the appraisal tool. There is no clear statement in the article describing the objectives of the study. The research objectives have a bearing on the outcome of the study. The study does not sufficiently describe the research question. Without a research question, the course of research may be diverted. The article does not provide a thorough review of the literature. A literature review is an important component of scientific studies. Review of literature enables the consumer of research to make certain decisions. A consumer may compare the findings of the current research with the existing data. The articles that were reviewed were not thoroughly analyzed. This section would have provided the methods used by the previous researchers in the field of study. A thorough analysis of methods is necessary because it enables researchers to judge whether their research brought new evidence to the field or it strengthens existing research. The appraisal tool failed to point out this problem. There should have been a section in the appraisal tool focusing on this information.
Though the paper reports on the sample size, it does not provide information on whether there was a pre-study sample size calculation. Sixteen schools with a population of 1582 students were sampled (Dzewaltowski et al. 2009). How the researchers arrived at the sample size is not reported. The appraisal tool does not have a section to test this information. This information is useful to the consumer because it indicates whether the sample was representative of the whole population. This is particularly important when making generalizations.
Applicability of the appraisal tool
This appraisal tool does not have a section on potential benefits and harm to subjects. Potential harm and benefits should be reported in research. It enables the subjects to make informed choices before participating in the study. The section is also required when research is intended to be utilized clinically. Clinicians should review this section before they implement any research findings. Because this information is missing, the clinical implication of the study is not clear.
The appraisal tool is generally inadequate. It lacks some crucial sections that would support its clinical reliability. For example, it fails to identify the limitations of the study. The study does not explicitly describe the problem being addressed. The study does not have a formulated question backed by an appropriate case study. The current study is more of a qualitative study than a quantitative study. The appraisal tool is not entirely suitable for a qualitative study. The findings of the study are not entirely depicted as fully credible (Chalmers et al. 1981).
The findings of the research do not seem relevant even to the selected population and conclusions are drawn may not be transferable to other study samples. The sample population is comprised of members of different races. It is difficult to gauge whether results from this study can be relied on when dealing with subjects drawn from a single race. The study was conducted in a developed country. Therefore, conclusions may not apply to subjects living in a developing country. The research is not recent and this might pose challenges regarding its current relevance. The paper was not published in a major journal. This limits the reliability of the findings therein. The conclusions are haphazard and do not entirely interpret the results in an accurate manner (Graham, Calder, Hebert, Carter, Tetroe 2000). Additional analysis to determine whether other variables could have affected outcomes is not reported in the study. The appraisal tool does not have a section to test this fact.
Application of research to practice
The application of research findings to clinical practice is governed by several factors. Before any research findings are used to make decisions in clinical settings, they should have been subjected to rigorous testing (Campbell, Hotchkiss, Bradshaw & Porteous 1998). New evidence should be appraised using an appropriate tool. Appraisal tools should focus on the relevance of the topic, the objective of the study, the research question, the results, and the recommendations. The research should answer a current clinical problem. The sample population should have similar features with the patients expected to benefit from the study. Generalizations can only be made when the patients are likely to benefit from an intervention. The current study being appraised appears not to have met most of these requirements. For example, a report on potential harm to the subjects is not made in this research. The lack of this information has made the findings suspicious. However, of importance in the current study is the fact that the study concerns behavior modification. The study did not employ any invasive techniques. The findings cannot be applied to practice because of this fact. The research does not appear to solve any clinical problem concisely. This makes it difficult for the consumer of research to judge whether the results are credible. This article was not published in a leading journal. This compounds the first problem. If the article had been published in a reputable journal the consumer of research would have no difficulty adopting the research findings into practice.
Another impediment to its application in the absence of sound recommendations and limitations faced during the study. The study does not end as is the practice when conducting scientific research by recommending a follow-up study to validate its findings. Because the authors did not state the limitations they faced during the study, the reader is unable to know the circumstances surrounding the study. The circumstances may be regarded as confounders depending on the type of research.
The study gives conclusions and recommendations at the end. This is a common research practice. However, in research with clinical implications, a clinical pathway should be offered (Nyberg & Marschke 1998). The paper should end with clear and concise recommendations that can be adopted. Clinical recommendations should be listed starting with the most important to the least important. The level of evidence should also be listed alongside each recommendation. This enables the reader to gauge the extent to which a recommendation was validated.
Another challenge to the application of research to practice is time. Research is conducted within a certain time frame. Once the time has elapsed the findings will be relevant for a limited time. Characteristics of the target population change over time. Therefore, past research may not apply to current situations. The current research under review was conducted several years ago. Therefore, its findings no longer apply. After several years, old research loses value due to the emergence of new evidence. Research findings are usually regarded as accurate if no new research has been conducted. Research findings that are older than ten years are not reliable.
Conclusion
In conclusion, the application of critical appraisal tools to evaluate the validity of research conclusions has gained acceptance in modern research settings. Appraisal tools are used in clinical settings to test the validity, reliability, and applicability of research findings. The appraisal tool used to appraise the article had several limitations. It lacked certain important sections. For example, the tool did not critically examine the methodology. In addition, the tool did not sufficiently interrogate the research question to establish its relevance to current problems. The tool did not have a section to critically appraise the results and the data analysis methods. The limitations of the paper not identified by the tool include a lack of a concise objective and research question. The paper did not also report on potential benefits and harm ascribed to the research. Generally, the research is difficult to implement. This is because of several factors including unclear recommendations. The recommendations should be presented alongside their level of evidence.
References
Campbell, H, Hotchkiss, R, Bradshaw, N & Porteous M 1998, Integrated care Pathways , Br Med J, vol. 316, pp. 133137.
Chalmers, T et al. 1981, A method for assessing the quality of a randomized control trial , Control Clin Trials, vol. 2, no.1, pp. 3149. Web.
Crombie, I 1996, The pocket guide to critical appraisal , BMJ. Web.
Dzewaltowski, D et al. 2009, Healthy Youth Places: A Randomized Controlled Trial to Determine the Effectiveness of Facilitating Adult and Youth Leaders to Promote Physical Activity and Fruit and Vegetable Consumption in Middle Schools , Health Education and Behavior, vol. 36, no. 3, pp. 583600.
Graham, I, Calder, L, Hebert, P, Carter A, Tetroe J 2000, A comparison of clinical practice guideline appraisal instruments , Int J Technol Assess Health Care, vol.16, pp. 10241038.
Nyberg, D & Marschke, P 1998, Critical pathways: tools for continuous quality improvement , Nurs Adm Q, vol. 17, pp. 6269.
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