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					                    Critical Review Form for Quantitative Studies

Student Name: Laura Vogtle                   Date: 1/10/04
Citation:
Kondo, T., Mann, W. C., Tomita, M., & Ottenbacher, K. (1997). The use of microwave
       ovens by elderly persons with disabilities. American Journal of Occupational
       Therapy, 51, 739 – 747.

                                                     Comments
STUDY PURPOSE:               Outline the purpose of the study. How does the study
Was the purpose stated       apply to your research question?
clearly?
 Yes                  X           The purpose of this research to demonstrate the
 No                                impact of microwave oven use on the appliances
                                    used in cooking, meal preparation duration and
                                    kinds of foods prepared in elderly persons with
                                    disabilities.

LITERATURE:                  Describe the justification of the need for this study.
Was relevant background
literature reviewed?               Described restrictions caused by arthritis and
 Yes                  X            visual impairments
 No                               Discussed impact of these restrictions on ability to
                                    cook
                                   Discussed popularity and use of microwave ovens,
                                    and their application as assistive technology.

DESIGN:                      Describe the study design. Was the design appropriate for
 Randomized (RCT)           the study question? (e.g., for knowledge level about this
 Cohort                     issue, outcomes, ethical issues, etc.)
 Single case design X
 Before and after                  This is a single subject study, withdrawal design,
 Case-control                       ABAB format. The design is appropriate because
 Cross-sectional                    there is no research about the use of these ovens in
 Case study                         elderly persons with a disability. Single subject
                                     design allows for an experimental approach to
                                     treatment in a pilot study format the will give
                                     information about the efficacy of the treatment.
                             Specify any biases that may have been operating and the
                             direction of their influence on the results.
                             We don’t know who did the random phone call checks,
                             which might have influenced the outcomes. The
                             researchers were from a grant-funded program in assistive
                             technology. The program may have used these subjects in
                             previous studies.
                                                     Comments
SAMPLE:                      Sampling (who, characteristics, how many, how was
N= 5                         sampling done?) If more than one group, was there
                             similarity between the groups?

Was the sample described     5 subjects, 4 women and 1 man, all over age 60.
in detail?                   Disabilities were arthritis; arthritis complicated by heart
 Yes                X       disease, asthma and residual from a stroke; impaired
 No                         mobility with pain, lower limb weakness, and fatigue;
                             pigmentary retinitis; diabetic retinopathy and glaucoma,
                             arthritic pain and heart disease. All were chosen from a
                             pool at University of New York at Buffalo. No subjects
                             had cognitive impairments.
Was sample size justified?   Describe ethics procedures. Was informed consent
 Yes                        obtained?
 NO
 N/A                 X      Not mentioned


OUTCOMES:                    Specify the frequency of outcomes measurement (i.e., pre,
                             post, follow-up)
                                  Outcome measures data was recorded daily and
                                     collected weekly throughout all four phases of the
                                     study
Were the outcome measures         Standardized assessments were not used to
reliable?                            measure outcomes.
 Yes             X               outcomes measured were; number of appliances
 No                                 used in meal preparation, the number of different
 Not addressed                      foods prepared, and the length of time spent on
                                     cooking.
                                  These outcome data were measured by frequency
                                     counts on number of appliances and kinds of
                                     foods; duration of meal preparation was timed by
                                     the participants. All data was reported by
Were the outcome measures            participants and checked by random reliability
valid?                               checks done by phone.
 Yes                        Reliability and validity: Reliability of participant reporting
 No                         was carried out by using phone calls to check on
 Not addressed    X         frequency of using cooking appliances, number of
                             different foods prepared, and length of time needed for
                             meal preparation. Correlation coefficients ranged from
                             .88-.99 for frequency of use,
                             .83 - .98 for different kinds of foods and .91 - .99 for
                             length of time it took to cook a meal.
INTERVENTION:                Provide a short description of the intervention (focus, who
Was intervention described   delivered it, how often, setting). Could the intervention be
                                                     Comments
in detail?                 replicated in practice?
 Yes                X
 No                       Subjects were given basic instruction in use, safety, food
 Not addressed            preparation and appropriate containers prior to
                           intervention. Intervention consisted of provision of a
                           microwave oven. Data collection was via subject
                           completed logs done on a daily basis. Data logged
                           included number of appliances used in meal preparation,
                           kinds of food prepared, and the duration of cooking time.
                           The same data was collected across all 4 phases. The first
                           A phase was for baseline data collection and the second A
                           phase was withdrawal of the oven. The B phases were the
                           times when the oven was placed in the home. Duration of
                           each phase was 3 weeks. Logs were collected on a weekly
                           basis. This intervention could have been easily carried out
                           in a clinical setting except for the random reliability
                           checks performed by phone call. Frequency of checks
                           was not reported, nor do we know who carried out these
                           checks.

Was contamination          Subjects were chosen from the same sample pool and
avoided?                   there is a slim chance some of them may have known each
 Yes                      other and discussed the research. If any of the subjects
 No                       received therapy services at SUNY-B, they may have
 Not addressed       X    heard about the research from therapists working there. In
 N/A                      the process of receiving training in microwave use, it was
                           possible subjects could have met each other or heard
                           therapists discuss the study.

Was cointervention         Subjects may have participated in senior nutrition centers
avoided?                   and received information on meal preparation there.
 Yes                      Family members may have known about the study and
 No                       encouraged/discouraged participants to use ovens. Three
 Not addressed        X   subjects had never used a microwave but two had.
 N/A                      Previous experiences may have affected their performance
                           in the study.
RESULTS:                   What were the results? Were they statistically significant
Were results reported in   (i.e., p <0.05)? If not statistically significant, was the
terms of statistical       study big enough to show an important difference if it
significance?              should occur? If there were multiple outcomes, was that
 Yes                      taken into account for the statistical analysis?
 No
 N/A                 X    Data analysis was carried out by graphing the data, use of
 Not addressed            descriptive statistics on each of the dependent variables,
                           and inclusion of means on each variable graph across all
                                                      Comments
Were the analysis method(s)   phases.
appropriate?
 Yes                 X       Study findings: Overall, the study demonstrated that
 No                          subjects needed less time to prepare a wider variety of
 Not addressed               foods. Study results were affected by illness to some
                              subjects and by life events. One subject who liked to cook
                              increased the time she spent cooking due to
                              experimentation with different foods. Subjects felt
                              microwave ovens were safer than regular ovens.
                              Shortening cooking times meant less time standing for
                              those participants who had weakness and pain in the lower
                              limbs.

Was clinical importance       What was the clinical importance of the results? Were
reported?                     differences between groups clinically meaningful? (if
 Yes                 X       applicable)
 No
 Not addressed               The outcomes of the study were clinically meaningful.
                              There was a marked difference in each of the dependent
                              variables between treatment and withdrawal phases of the
                              study.
Were drop-outs reported?      Did any participants drop out from the study? Why?
 Yes                         (Were reasons given and were drop-outs handled
 No                  X       appropriately?)

                              No dropouts, although several subjects were ill during the
                              study and unable to participate as much as others.

CONCLUSIONS AND               What did the study conclude? What are the implications
CLINICAL                      of these results for practice? What were the main
IMPLICATIONS:                 limitations or biases in the study?

Were conclusions              The study demonstrated a measurable affect of microwave
appropriate given study       ovens on meal preparation and diet of elderly persons with
methods and results?          disabilities. The outcomes could have been affected by
 Yes                   X     previous cooking experiences, the fact that subjects were
 No                          required to document information, making them more
                              aware of what they were eating. The sample size is small,
                              making generalizability to larger populations hard.


                                      REFERENCE
Law, M., Stewart, D., Letts, L., Pollock, N., Bosch, J., & Westmorland, M. (1998).
Critical review form for quantitative studies. Retrieved March 14, 2002, from
http://www.fhs.mcmaster.ca/rehab/ebp.

				
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