Quantitative Appraisal
Question
I have attached the article that has to be used in order to answer the questions, directions on top of page.
Quantitative Appraisal
Please summarize key elements of quantitative studies by providing relevant information in the template. Some studies may not include all of the elements in the template. Use short answers. Avoid quotation from the article.[1] If you aren’t sure how to put in your own words, consult with instructor.
NOTE:
● Your responses should only require short answers.
● Use your own words.
● Quotation from the article should be avoided if at all possible.
If you quote, you must use APA style for direct quotation 1. If you aren’t sure how to put in your own words, please consult with instructor.
1For guidelines / rules on paraphrasing or quotation, see APA Manual 7th ed. §§8.23-8.33, pp. 269-277 (American Psychological Association, 2019)
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APA Citation |
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Population (type[s] of patients or participants) |
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Intervention (therapy, treatment) or other Issue (e.g., exposure, etiology, risk or prognostic factor) |
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Comparison (i.e., is there a control or comparison group [treatment, exposure, etc.]? If none, check box) |
None ☐ |
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Outcome variable(s) or “endpoints”.[2] |
Primary: Secondary: If outcome variables not designated as primary vs. secondary please identify key variables (i.e., those most directly relevant to the study hypotheses or research questions): |
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Time frame for assessing outcomes[3] |
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Study Purpose |
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Description of the Setting(s) |
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Research Design[4] |
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Framework / Model / Theory (if identified by authors; if no specific framework, you can check none identified) |
None identified ☐ |
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Hypothesis/hypotheses (if stated or implicit[5]) or research question(s) if no hypotheses. |
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Sampling / Assignment |
Sample inclusion/exclusion criteria[6] Inclusion:
Exclusion: Sampling Method[7] Sample Size Was there more than one group? No ☐ Yes ☐ Was there a power analysis / sample size estimate? No ☐ Yes ☐ If more than one group, how were participants assigned? ☐Random Assignment ☐ Other method of assignment (existing groups, by location, etc.) If more than one group, how many participants in each group?
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How and when (at what time points) were study outcomes assessed?[8] |
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If questionnaires were used to measure study outcome(s) were reliability and validity reported? |
Reliability and validity of outcome measure(s) / instruments
Not reported ☐ |
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Data Analysis |
Main statistical approaches (check any applicable) Descriptive only ☐ Bivariate associations: Chi-square (c2) tests ☐ Fisher exact tests ☐ Correlation coefficients ☐ Factor analysis ☐ Comparing groups (means, medians, or distributions): Analysis of variance or covariance (ANOVA/ANCOVA) ☐ Kruskal-Wallis test ☐ paired t-tests ☐ Wilcoxon signed ranks test ☐ Repeated measures ANOVA/ANCOVA ☐ Regression: Multiple regression ☐ Logistic regression ☐ Hierarchical linear or Mixed Models ☐ Comparing proportions or rates: Odds ratios ☐ relative risk ☐ absolute risk reduction (ARR) ☐ Survival / time-to-event analysis : Kaplan-Meier (survival) curves ☐ Cox proportional hazards analysis / hazard ratios ☐ Log-linear analysis ☐ Other (e.g., nonparametric tests, sensitivity/specificity, etc.) |
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How was uncertainty around results of statistical tests reported? p-values ☐ confidence intervals ☐ both ☐ only as less than or greater than some threshold value for ‘statistical significance’ (e.g., ‘p < .05’ or asterisks) ☐ Were effect size estimates reported for results of statistical tests of key outcomes (e.g., for study hypotheses)? Yes ☐ No ☐ |
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Summary of Key Results (e.g., for study hypotheses or primary outcomes / endpoints)[9] |
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Clinical Importance of Findings[10] |
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Main strengths of the |
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Main limitations of the study |
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[1] If you quote, you must use APA style for direct quotation. See APA Manual 7th ed. §§8.25-8.33, pp. 270-277 (American Psychological Association, 2019)
[2] In “PICOT” The “O” does not refer to the results of the study. Rather, it refers to the main variables that the investigators will use to assess whether or not an intervention is effective or what the effects of an exposure are. Usually outcomes are stated in the Methods section of a research article. For example, in a study of an intervention for patients hospitalized for heart failure, outcomes might include length of hospital stay, death or occurrence of an adverse cardiovascular event during the hospital stay, or readmission within 30 days of discharge. In a study of a hazardous occupational exposure, outcomes might be occurrence (or time to occurrence) of some disease thought to be related to the exposure.
[3] In “PICOT” The “T” does not refer to the overall duration of the study. It refers to how long the interval between enrollment (or receiving a treatment) and assessment of outcomes for each participant. For example, in a study where the primary outcome is readmission to hospital within 30 days of discharge, “T” is 30 days.
[4] If no specific design identified, please refer to / use the “What Kind of Research Design” handout and at least try to narrow down and make an educated guess.
[5] Not all studies have (or state) hypotheses. Sometimes there are implicit hypotheses. For example, in a study of a new drug treatment for septic shock vs. placebo plus usual care in which in the primary outcome is in-hospital mortality, it is reasonable to infer that the investigators hypothesized mortality will be improved by the active treatment, even if they don’t come out and say it.
[6] Not all studies specify exclusion criteria that can be inferred from the inclusion criteria. For example if “adults at least 18 years of age” is an inclusion criterion, it is probably not necessary to state that “age < 18 years” is an exclusion.
[7] Sampling method is not the same thing as how participants are assigned to conditions. Sampling method has to do with how potential participants came into the study (e.g., convenience or consecutive sampling or stratified random sampling).
[8] E.g., “Health status was assessed with the SF-36 questionnaire at baseline and at 3 and 6 months post intervention.” OR “Mortality at 30 days post-admission was determined from electronic medical record.”
[9] If using this template for your critique assignment or final literature review paper, please focus on the results that are most relevant to the topic / problem / purpose of your paper.
[10] i.e., In your judgment, do the results matter clinically or for practice purposes? Or are they unimportant / too small to matter?
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Solution
Quantitative Appraisal
Please summarize key elements of quantitative studies by providing relevant information in the template. Some studies may not include all of the elements in the template. Use short answers. Avoid quotation from the article.[1] If you aren’t sure how to put in your own words, consult with the instructor.
NOTE:
● Your responses should only require short answers.
● Use your own words.
● Quotation from the article should be avoided if at all possible.
If you quote, you must use APA style for direct quotation 1. If you aren’t sure how to put in your own words, please consult with the instructor.
1For guidelines / rules on paraphrasing or quotation, see APA Manual 7th ed. §§8.23-8.33, pp. 269-277 (American Psychological Association, 2019)
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APA Citation |
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Population (type[s] of patients or participants) |
The participants of the study are mothers with newborns and have depression associated with the aftermath of childbirth. The study focused on mothers with postpartum depression 24 months after delivery in New Brunswick, Canada. |
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Intervention (therapy, treatment) or other Issues (e.g., exposure, etiology, risk or prognostic factor) |
Providing support to new mothers who suffer from depression after childbirth. The research aims to observe changes after staging the intervention by monitoring the patient’s postpartum depression to identify improvements. |
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Comparison (i.e., is there a control or comparison group [treatment, exposure, etc.]? If none, check box) |
None ☐ The experiment involves only mothers within 24 months after childbirth. All participants were in one group without a control or comparison group. |
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Outcome variable(s) or “endpoints”.[2] |
The main outcome is the change in postpartum depression levels. The key desirable outcome is to improve the conditions of mothers with depression through peer support from mothers who have had and successfully overcome postpartum depression. A decrease in depression levels during and after the experience indicated an effective intervention. Conversely, the same or increased levels of postpartum depression during and after the TBPS experience are aligned with inefficiency. |
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Time frame for assessing outcomes[3] |
The original timeframe for data collection was 12 weeks, with weekly calls with checks midway and at the end. However, it extended to an average of 13.9 weeks at the endpoint and 7.43 weeks as the midpoint. The difference was attributed to delays in telephone calls and contact. |
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Study Purpose |
The research aimed to establish the effect of peer support on mothers suffering from postpartum maternal depression. |
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Description of the Setting(s) |
The research primarily focused on mothers in New Brunswick, Canada. The province’s population was just slightly over 750,000 as per the 2011 national census. It was limited to mothers with depression and within 24 months from delivery. Participants were of diverse backgrounds and social statuses. The experience was disseminated via telephone; mothers that have overcome postpartum depression supported participants. |
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Research Design[4] |
The research was explicitly tailored for the cause-and-effect of the experience. It is designed to have one group of participants from start to finish. Participants are evaluated at intake, midway, and at the end to identify changes. There is no control group as it only evaluates changes that do not require a comparison group but a record of progress. |
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Framework / Model / Theory (if identified by authors; if no specific framework, you can check none identified) |
None identified ☐ No theory or framework was used in the study. |
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Research Questions |
The research questions are: ● Do an increase in social and peer support lower the level and symptoms of depression? ● If interventions increased over time? ● Are mothers and peers satisfied with the experience? ● Do the symptoms of depression and rates decline throughout the intervention.? |
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Sampling / Assignment |
Sample inclusion/exclusion criteria[5] Inclusion criterion was used with data collection and geographic and demographic variables. Two thousand four hundred fifteen mothers were screened for inclusion in the study. Unfortunately, the screening was only done in one province. Exclusion: Mothers outside the required parameters of the study were excluded due to ineligibility. The EPDS (Edinburgh Postnatal Depression Scale) was used. 2351 were ineligible after EPDS was run twice, some declined to be involved, and others were beyond 24 months after delivery. Demographics helped refine the selected participant’s eligibility for suitable and effective representation in outcomes and applications. Sampling Method:[6] Consecutive sampling method; eligibility evaluations were carried out for participation. Sample Size: 64 participants. Was there more than one group? No ☐ There was only one group before, during, and after the test. Was there a power analysis/sample size estimate? No ☐ There was no sample size estimate in this study. |
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How and when (at what time points) were study outcomes assessed?[7] |
The outcomes were assessed by evaluating the depression levels and symptoms. These assessments were made at the beginning of the study, midway through it, and at the end. Depression levels and symptoms were assessed using EPDS, and social support was assessed using SPS (Cox & Holden, 2003). |
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If questionnaires were used to measure study outcome(s) were reliability and validity reported? |
Reliability and validity of outcome measure(s) / instruments A trained research project nurse designed the intervention and trained peers to standardize the experience. The nurse collected the EPDS and SPS data for eligibility evaluation. EPDS (Edinburgh Postnatal Depression Scale) and SPS (Social Provisions Scale) were used in the research. ESPS is an effective tool for the evaluation of maternal postpartum depression. SPS collects data on social support. |
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Data Analysis |
Main statistical approaches (check any applicable) Descriptive only ☐ Yes, Descriptive statistics were used to define the sample and distribution of data in the research. The descriptive statistics for the research included percentages, means, and frequencies. Bivariate associations: Chi-square (χ2) tests ☐ Fisher exact tests ☐ Correlation coefficients ☐ Factor analysis ☐ Comparing groups (means, medians, or distributions): Analysis of variance or covariance (ANOVA/ANCOVA) ☐ Kruskal-Wallis test ☐ paired t-tests ☐ Wilcoxon signed ranks test ☐ Yes Repeated measures ANOVA/ANCOVA ☐ A Wilcoxon Sign Ranked Statistic analyzed the differences at different points in the study timeline during assessments Regression: Multiple regression ☐ Logistic regression ☐ Hierarchical linear or Mixed Models ☐ Comparing proportions or rates: Odds ratios ☐ relative risk ☐ absolute risk reduction (ARR) ☐ Survival / time-to-event analysis: Kaplan-Meier (survival) curves ☐ Cox proportional hazards analysis/hazard ratios ☐ Log-linear analysis ☐ Other (e.g., nonparametric tests, sensitivity/specificity, etc.) The Kendall tau test is a nonparametric test for correlation (Samara & Randles, 1988). It assessed how depression and social support were related. |
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How was uncertainty around the results of statistical tests reported? p-values ☐ confidence intervals ☐ both ☐ only as less than or greater than some threshold value for ‘statistical significance’ (e.g., ‘p < .05’ or asterisks) ☐ The specific p-values of statistical test results were provided in the analysis. All tests were based on a statistical significance with the p-value set at 0.05. Were effect size estimates reported for results of statistical tests of key outcomes (e.g., for study hypotheses)? Yes ☐ No ☐ Effect size estimates were not reported for key outcomes from statistical test results. |
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Summary of Key Results (e.g., for study hypotheses or primary outcomes/endpoints)[8] |
● The general observation from the research is an increase in social support throughout the intervention. ● Maternal postpartum depression rates declined below the general population averages. ● PPD was associated with the child’s health for some study participants. It obligates nurses to assess depression when interacting with mothers dealing with such mother’s child health complications. ● Study findings are consistent with the need for social and peer support for mothers with PPD. ● Current research domains are related to PPD beyond the first two years. Therefore, it is crucial to identify it early to help mothers cope and overcome PPD. |
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Clinical Importance of Findings[9] |
The study’s results are significant because they highlight the efficiency of telephone-based peer support as an intervention for PPD. Maternal postpartum depression is a problem that affects many mothers worldwide. Research shows that a child’s immediate environment impacts their development (Slomian et al., 2019). The first two years after childbirth are crucial to a child’s growth. It also coincides with the period the mother’s hormones stabilize and have a lot of mood swings. As a result, mothers must recover from it faster and nurture and care for their children better. |
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Main strengths of the |
The study aimed to evaluate the effectiveness of telephone-based peer support as an intervention to reduce maternal postpartum depression. In addition, this is to help develop early interventions for PPD to assist mothers in overcoming it. |
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Main limitations of the study |
The biggest shortcoming was the sample size. It is too small for superior results and findings to be established. In addition, data collection was limited, and there was no comparison group. |
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References
Cox, J., & Holden, J. (2003). Perinatal mental health: A guide to the Edinburgh Postnatal Depression Scale (EPDS). Royal College of Psychiatrists.
Samara, B., & Randles, R. H. (1988). A test for correlation based on Kendall’s tau. Communications in statistics-theory and methods, 17(9), 3191-3205.
Slomian, J., Honvo, G., Emonts, P., Reginster, J. Y., & Bruyère, O. (2019). Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Women’s Health, 15, 1745506519844044.
[1] If you quote, you must use APA style for direct quotation. See APA Manual 7th ed. §§8.25-8.33, pp. 270-277 (American Psychological Association, 2019)
[2] In “PICOT” The “O” does not refer to the results of the study. Rather, it refers to the main variables that the investigators will use to assess whether or not an intervention is effective or what the effects of an exposure are. Usually outcomes are stated in the Methods section of a research article. For example, in a study of an intervention for patients hospitalized for heart failure, outcomes might include length of hospital stay, death or occurrence of an adverse cardiovascular event during the hospital stay, or readmission within 30 days of discharge. In a study of a hazardous occupational exposure, outcomes might be occurrence (or time to occurrence) of some disease thought to be related to the exposure.
[3] In “PICOT” The “T” does not refer to the overall duration of the study. It refers to how long the interval between enrollment (or receiving a treatment) and assessment of outcomes for each participant. For example, in a study where the primary outcome is readmission to hospital within 30 days of discharge, “T” is 30 days.
[4] If no specific design identified, please refer to / use the “What Kind of Research Design” handout and at least try to narrow down and make an educated guess.
[5] Not all studies specify exclusion criteria that can be inferred from the inclusion criteria. For example if “adults at least 18 years of age” is an inclusion criterion, it is probably not necessary to state that “age < 18 years” is an exclusion.
[6] Sampling method is not the same thing as how participants are assigned to conditions. Sampling method has to do with how potential participants came into the study (e.g., convenience or consecutive sampling or stratified random sampling).
[7] E.g., “Health status was assessed with the SF-36 questionnaire at baseline and at 3 and 6 months post intervention.” OR “Mortality at 30 days post-admission was determined from electronic medical record.”
[8] If using this template for your critique assignment or final literature review paper, please focus on the results that are most relevant to the topic / problem / purpose of your paper.
[9] i.e., In your judgment, do the results matter clinically or for practice purposes? Or are they unimportant / too small to matter?
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