Qualitative Research Assignment Paper

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Qualitative Research Assignment Paper

Choose a research study related to your project proposal and published within the past 8 years. Critically evaluate and critique it using one of the CASP (Critical Appraisal Skills Programme) checklists included – “CASP-Cohort Study-Checklist,” “CASP-Qualitative-Checklist,” or “CASP-RCT-Checklist.”

Using the CASP checklist applicable to the type of research study you are evaluating, critically evaluate each aspect of the chosen research study, providing evidence and reasoning to support your evaluation. Identify strengths and weaknesses, discuss the implications of the findings, and suggest areas for improvement or further research. Qualitative Research Assignment Paper

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Notes about checklists:

FOR ALL CHECKLISTS: You must fill in the “comments” box for ALL questions (unless otherwise noted below). The comments should be in sentence format and should follow the rules of scholarly writing, good grammar, sentence structure, etc. Comments must be at least one (1) full sentence in length.

CASP-RCT Checklist:
In each question, you will select your answer AND provide a sentence explaining why you chose the answer you chose.
OMIT questions 10 and 11.

CASP Randomized Controlled Trial Standard Checklist:

11 questions to help you make sense of a randomized controlled trial (RCT)

Main issues for consideration: Several aspects need to be considered when appraising a randomized controlled trial:

Is the basic study design valid for a randomized controlled trial? (Section A)

Was the study methodologically sound? (Section B)

What are the results? (Section C)

Will the results help locally? (Section D)

The 11 questions in the checklist are designed to help you think about these aspects systematically.

How to use this appraisal tool: The first three questions (Section A) are screening questions about the validity of the basic study design and can be answered quickly. If, in light of your responses to Section A, you think the study design is valid, continue to Section B to assess whether the study was methodologically sound and if it is worth continuing with the appraisal by answering the remaining questions in Sections C and D. Qualitative Research Assignment Paper

Record ‘Yes’, ‘No’ or ‘Can’t tell’ in response to the questions. Prompts below all but one of the questions highlight the issues it is important to consider. Record the reasons for your answers in the space provided. As CASP checklists were designed to be used as educational/teaching tools in a workshop setting, we do not recommend using a scoring system.

About CASP Checklists: The CASP RCT checklist was originally based on JAMA Users’ guides to the medical literature 1994 (adapted from Guyatt GH, Sackett DL and Cook DJ), and piloted with healthcare practitioners. This version has been updated taking into account the CONSORT 2010 guideline (http://www.consort-statement.org/consort-2010, accessed 16 September 2020).

Citation: CASP recommends using the Harvard style, i.e., Critical Appraisal Skills Programme (2021). CASP (insert name of checklist i.e. Randomised Controlled Trial) Checklist. [online] Available at: insert URL. Accessed: insert date accessed.

©CASP this work is licensed under the Creative Commons Attribution – Non-Commercial- Share A like. To view a copy of this licence, visit https://creativecommons.org/licenses/by-sa/4.0/

Critical Appraisal Skills Programme (CASP) www.casp-uk.net Part of OAP Ltd

Study and citation:

Treasure, M., Daly, B., Cao, S., Fu, P., Hong, A., Weinstein, E., Surdam, J., Meropol, N. J., & Dowlati, A. (2021). A randomized controlled trial of structured palliative care versus standard supportive care for patients enrolled in phase 1 clinical trials. Cancer Medicine, 10(13), 4312–4321. https://doi.org/10.1002/cam4.3971 Qualitative Research Assignment Paper

Section A: Is the basic study design valid for a randomized controlled trial?

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1. Did the study address a clearly focused research question?

CONSIDER:

·           Was the study designed to assess the outcomes of an intervention?

·           Is the research question ‘focused’ in terms of:

•     Population studied

•     Intervention given

•     Comparator chosen

•     Outcomes measured?

 Yes                       No                        Can’t tell

o     o      o

 

The study sought to answer the question of whether there was a significant difference between structured palliative care and usual supportive care for the symptom burden, adverse events and quality of life for cancer patients participating in phase 1 clinical trials.

The question identified the population as cancer patients, intervention as structured palliative care, comparator as usual supportive care, and outcomes measured as study duration, symptom burden, adverse events and quality of life.
2. Was the assignment of participants to interventions randomised?

CONSIDER:

•           How was randomisation carried out? Was the method appropriate?

•           Was randomisation sufficient to eliminate systematic bias?

•           Was the allocation sequence concealed from investigators and participants?Qualitative Research Assignment Paper

 

 Yes                       No                        Can’t tell

o     o      o

 

Randomization was carried out for the intervention and comparator groups.

The method was appropriate as it ensured that all participants had the same probability of being included in any group. The allocation concealment eliminated systematic bias.
3. Were all participants who entered the study accounted for at its conclusion?

CONSIDER:

•           Were losses to follow-up and exclusions after randomisation accounted for?

•           Were participants analysed in the study groups to which they were randomised (intention-to-treat analysis)?

•           Was the study stopped early? If so, what was the reason?

 

 Yes                       No                        Can’t tell

o     o      o

 

All the participants who entered the study were accounted for at its conclusion. The study was conducted to its conclusion. 85 patient participants were enrolled, and 80 patient participants completed the study. 46 caregiver participants were identified of which 46 consented to participate in the study.

 

Section B: Was the study methodologically sound?

 

4.  

·         Were the participants ‘blind’ to intervention they were given?

·         Were the investigators ‘blind’ to the intervention they were giving to participants?

·         Were the people assessing/analysing outcome/s ‘blinded’?

 

 Yes                       No                        Can’t tell

 

o     o      o

 

 

o     o      o

 

o     o      o
5. Were the study groups similar at the start of the randomised controlled trial?

CONSIDER:

·       Were the baseline characteristics of each study group (e.g. age, sex, socio-economic group) clearly set out?

·       Were there any differences between the study groups that could affect the outcome/s? Qualitative Research Assignment Paper

 Yes                       No                        Can’t tell

o     o      o

 

The baseline characteristics were similar, with no differences noted that could affect the outcomes.

 

6. Apart from the experimental intervention, did each study group receive the same level of care (that is, were they treated equally)?

 

CONSIDER:

·      Was there a clearly defined study protocol?

·      If any additional interventions were given (e.g. tests or treatments), were they similar between the study groups?

·      Were the follow-up intervals the same for each study group?

 Yes                       No                        Can’t tell

o     o      o

 

There was a defined study protocol that had similar treatment for the participants, except for those in the intervention group receiving structured palliative care while those in the comparator group received standard supportive care. The follow-up intervals were the same for all groups.

 

                                                             Section C: What are the results?

 

 

7. Were the effects of intervention reported comprehensively?

 

CONSIDER:

•          Was a power calculation undertaken?

•          What outcomes were measured, and were they clearly specified?

•           How were the results expressed? For binary outcomes, were relative and absolute effects reported?

•           Were the results reported for each outcome in each study group at each follow-up interval?

•          Was there any missing or incomplete data?

•          Was there differential drop-out between the study groups that could affect the results?

•           Were potential sources of bias identified?

•           Which statistical tests were used?

•           Were p values reported?

 

 Yes                       No                        Can’t tell

o     o      o

 

The effects of the intervention were comprehensively reported. Calculations were conducted for the significance. In addition, the outcomes were measured and specified with the results expressed in binary outcomes that compared the intervention against the comparator. There was no missing or incomplete data and the dropout rate did not affect the results. The randomization helped to minimize bias. Statistical tests were conducted, particularly t-test, chi-square test, and multivariate regression. The p-value was reported.
8. Was the precision of the estimate of the intervention or treatment effect reported?

CONSIDER:

•           Were confidence intervals (CIs) reported?

 

  Yes                       No                        Can’t tell

o     o      o

 

Precision of the estimate of intervention effect was not reported.
9. Do the benefits of the experimental intervention outweigh the harms and costs?

CONSIDER:

·           What was the size of the intervention or treatment effect?

·           Were harms or unintended effects reported for each study group?

·           Was a cost-effectiveness analysis undertaken? (Cost-effectiveness analysis allows a comparison to be made between different interventions used in the care of the same condition or problem.)Qualitative Research Assignment Paper

 Yes                       No                        Can’t tell

o     o      o

 

The patients subjected to structured palliative care performed better than their counterparts subjected to standard supportive care. Although the results are not statistically significant, (p=0.55), structured palliative care reported reduced symptom burden and adverse events, and improved quality of life when compared to usual supportive care.

 

Section D: Will the results help locally?

 

 

 

10. Can the results be applied to your local population/in your context?

 

CONSIDER:

•           Are the study participants similar to the people in your care?

•           Would any differences between your population and the study participants alter the outcomes reported in the study?

•           Are the outcomes important to your population?

•           Are there any outcomes you would have wanted information on that have not been studied or reported?

•           Are there any limitations of the study that would affect your decision?

 Yes                       No                        Can’t tell

o     o      o

 

These results can be generalized for cancer patients receiving care. That is because the characteristics of the study participants are representative of cancer patients thereby making the results generalizable for cancer patients. In addition, the study was conducted in Cleveland thus making the results generalizable for the USA. Although the study is generalizable, the small sample size limits its application as it makes it difficult to determine if the outcomes are true findings. Qualitative Research Assignment Paper
11. Would the experimental intervention provide greater value to the people in your care than any of the existing interventions?

CONSIDER:

·           What resources are needed to introduce this intervention taking into account time, finances, and skills development or training needs?

·           Are you able to disinvest resources in one or more existing interventions in order to be able to re-invest in the new intervention?

 

 Yes                       No                        Can’t tell

o     o      o

 

Structured palliative care may provide greater value to patients when compared to standard supportive care.  It aggressively manages symptoms burden while addressing transitional and life goals of care in the context of life-limiting illness. The resources required is to available providers with the right skills and qualifications to provide the standard palliative care.
   

 

 
APPRAISAL SUMMARY: Record key points from your critical appraisal in this box. What is your conclusion about the paper? Would you use it to change your practice or to recommend changes to care/interventions used by your organisation?  Could you judiciously implement this intervention without delay?

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The article provides a valuable resource on the importance of structured palliative care. It reveals improved outcomes for patients. The randomization helps to improve the results’ validity. However, the small sample size raises concerns on whether the outcomes are true findings. Still, the study is useful for gaining knowledge on areas that palliative care can targeted to improve patient outcomes, particularly in addressing symptom burden, adverse events and quality of life among patients with life-limiting illnesses.

Qualitative Research Assignment Paper