Rapid Critical Appraisal Questions Paper

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Rapid Critical Appraisal Questions Paper

Are the results of the study valid?
Were the subjects randomly assigned to the intervention and control groups?

A random assessment of articles was done to either an intervention (CBT) or control group.

Was random assignment concealed from the individuals enrolling the subjects?

Three raters randomly assigned articles to either the intervention (CBT) or control group and developed coding tree to compare ratings, reach a consensus and refine the coding.

C. Were the subjects and providers blind to the study group? Yes No Unknown

Based on the studies reviewed which were specifically randomized controlled trials, the participants generally knew to which group they had been assigned since the intervention groups had to put CBT into practice.Rapid Critical Appraisal Questions Paper

Were reasons given to explain why subjects didn’t complete the study?

Reasons were given as to why other articles which did not meet the inclusion criteria were excluded from the study.

Were the follow-up assessments long enough to fully study the effects of the intervention? Yes No Unknown

For most of the studies, the intervention was conducted for 3, 6 and 12 months, and this should be adequate time to have an impact on the outcomes of substance use

F. Were the subjects analyzed in the group to which they were randomly assigned?

None of the studies analyzed was specific to Hispanic or Black individuals despite initial efforts to separate subjects with a predominantly white sample from those which had a black/Hispanic sample and this compromises the fidelity of the interventions.

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Was the control group appropriate?

The study failed to account for the variance in how the intervention was used in the intervention group’s articles and this questions the appropriateness of both the comparison and intervention (CBT) group.

Were the instruments used to measure the outcomes valid and reliable? Yes No Unknown

The primary outcome was the effectiveness of CBT in reducing substance use disorders.Rapid Critical Appraisal Questions Paper

Were the demographics and baseline clinical variables of the subjects in each of the groups similar? Yes No Unknown

The researchers provided a table that showed the sample racial breakdown for every study. Although there was some variability, they had no statistical differences between groups.

What are the results?

How large is the intervention or treatment effect?

Outcome data was reported in different ways but the most important information is that the intervention (CBT) group did better than the control comparison group.

How precise is the intervention or treatment?

Based on the random effects meta-regression analysis, no significant effects were revealed with regards to study type, gender, format and number of CBT sessions. However, race (slope: -0.49; 95% CI: -.79 – -.20; p < .001), employment (slope: -0.01; 95% CI: .01 – -.02; p < .001), sample size (slope: .002; 95% CI: .00 –.00; p < .001), and study type (slope: -1.15; 95% CI: -1.39 – -.92; p < .001) were undeniably associated with effect size.

Will the results help me in caring for my patients?
Were all clinically important outcomes measured?

It would be necessary to measure the costs incurred since the stakeholders that initiated CBT did not eliminate their team code.

What are the risks and benefits of the treatment?

Will help reduce substance use and assist substance users to manage problems such as depression and anxiety. A major risk is that bad feelings that substance users associate with their problems will return.

C. Is the treatment feasible in my clinical setting? Yes No Unknown

Evidence suggests that CBT is an effective management approach for reducing substance use among both Hispanics and Non-Hispanics. Since there is administrative and staff support, adequate infrastructure and appropriate human resource, this treatment is undeniably feasible in my clinical setting.Rapid Critical Appraisal Questions Paper

What are my patients’ and their families’ values and expectations for the outcome and the treatment itself?

We will keep this in mind as we consider the body of evidence.

Reference

Windsor, L. C., Jemal, A., & Alessi, E. J. (2015). Cognitive behavioral therapy: A meta-analysis of race and substance use outcomes. Cultural Diversity and Ethnic Minority Psychology, 21(2), 300.

Rapid Critical Appraisal Questions for Systematic Reviews & Meta-analyses of Clinical Interventions Question

APA Reference:

VALIDITY
1. Are the results of the review valid?
a. Are the studies contained in the review randomized controlled trials?	Yes		No		Unknown
b. If not, were all relevant studies included in the review?	Yes		No		Unknown
c. Does the review include a detailed description of the search strategy to find all relevant studies?	Yes		No		Unknown
d. Does the review describe how validity of the individual studies was assessed (e.g., methodological quality, including the use of random assignment to study groups and complete follow-up of the participants)?	Yes		No		Unknown
e. Were the results consistent across studies?	Yes		No		Unknown
f. Were individual patient data or aggregate data used in the analysis?	Individual		Aggregate
g. Does the review include a description of how studies were compared using statistical analysis?	Yes		No		Unknown
RELIABILITY
2. What were the results?
a. How large is the intervention or treatment effect (OR, RR, effect size, level of significance)?
b. How precise is the intervention or treatment (CI)?
APPLICABILITY
3. Will the results assist me in caring for my patients?
a. Are my patients similar to the ones included in the review?		Yes		No	Unknown
b. Is it feasible to implement the findings in my practice setting?		Yes		No	Unknown
a. Do the pooled or combined results of the studies support the hospital’s values and goals of service delivery? (i.e., is it feasible to implement the findings in my practice setting?)		Yes		No	Unknown
c. Were all clinically important outcomes considered, including risks and benefits of the treatment?		Yes		No	Unknown
d. What is my clinical assessment of the patient and are there any contraindications or circumstances that would inhibit me from implementing the treatment?		Yes		No	Unknown
e. What are my patient’s and his or her family’s preferences and values about the treatment that is under consideration?		Yes		No	Unknown

Would you use the study results in your practice to make a difference in patient outcomes?

If yes, how?
If yes, why?
If no, why not?

Additional Comments/Reflections:

Recommendation for article use within a body of evidence:

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Rapid Critical Appraisal Questions for Systematic Reviews & Meta-analyses of Clinical Interventions Question

VALIDITY


1. Are the results of the review valid?
a. Are the studies contained in the review randomized controlled trials?	Yes		No			Unknown
b. If not, were all relevant studies included in the review?	Yes		No			Unknown
c. Does the review include a detailed description of the search strategy to find all relevant studies?	Yes		No			Unknown
d. Does the review describe how validity of the individual studies was assessed (e.g., methodological quality, including the use of random assignment to study groups and complete follow-up of the participants)?	Yes		No			Unknown
e. Were the results consistent across studies?	Yes		No			Unknown
f. Were individual patient data or aggregate data used in the analysis?	Individual		Aggregate
g. Does the review include a description of how studies were compared using statistical analysis?	Yes		No			Unknown
RELIABILITY
2. What were the results?
a. How large is the intervention or treatment effect (OR, RR, effect size, level of significance)?		Effect size g = 1.19, 95% significance level, CI: 1.05 – 1.33; p = .00).
b. How precise is the intervention or treatment (CI)?		CI: 1.05 – 1.33
APPLICABILITY
3. Will the results assist me in caring for my patients?
a. Are my patients similar to the ones included in the review?		Yes		No	Unknown
b. Is it feasible to implement the findings in my practice setting?		Yes		No	Unknown
a. Do the pooled or combined results of the studies support the hospital’s values and goals of service delivery? (i.e., is it feasible to implement the findings in my practice setting?)		Yes		No	Unknown
c. Were all clinically important outcomes considered, including risks and benefits of the treatment?		Yes		No	Unknown
d. What is my clinical assessment of the patient and are there any contraindications or circumstances that would inhibit me from implementing the treatment?		Yes		No	Unknown
e. What are my patient’s and his or her family’s preferences and values about the treatment that is under consideration?		Yes		No	Unknown

Would you use the study results in your practice to make a difference in patient outcomes?

Yes. In reducing and managing clients with substance use disorder since evidence suggests that CBT is an effective management approach in reducing substance use among both Hispanics and Non-Hispanics. Besides, in my practice setting, there is administrative and staff support, adequate infrastructure and appropriate human resource which makes this treatment undeniably feasible in my clinical setting.

Recommendation for article use within a body of evidence:

This article meets the inclusion criteria and is relevant to the topic of study. Therefore, it is highly recommended for use as evidence.Rapid Critical Appraisal Questions Paper

C. Were the subjects and providers blind to the study group? Yes No Unknown

F. Were the subjects analyzed in the group to which they were randomly assigned?

C. Is the treatment feasible in my clinical setting? Yes No Unknown

Additional Comments/Reflections:

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

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