Critical Appraisal of a Randomised Controlled Trial (RCT)
Instructions:
• 1650 words
• Word count includes in text references (headings, subheadings and reference list, tables and appendices are NOT included in word count)
• APA 7th style
• Use 12 reference minimum. All reference must be no less than five years old
Outcome:
There is an increasing volume of published research now accessible to health professionals. Health professionals, such as nurses, require critical appraisal skills to assess the quality of evidence in order to safely influence clinical decision making. The overarching learning objective of this assessment task is to critically appraise the selected published Randomised Controlled Trials (RCT) and to apply the results to the relevant scenario.
• Critically appraise research using a relevant appraisal framework/s
• Critique, interpret, and apply study findings to a clinical practice scenario
• Clearly explain complex concepts and scientific knowledge in writing, when managing unfamiliar problems.
There are four key questions to be asked when completing an appraisal:
1. Does this study address a clearly focused question (Links to an external site.)?
2. Did the study use valid methods to address this question?
3. Are the valid results of this study important?
4. Are these valid, important results applicable to my patient or population a(scenario)?
Scenario 1
You are a maternal and child nurse working at a local council based in a metropolitan Australian city. You see mothers and their infants from a wide variety of socioeconomic and demographic backgrounds. Part of your role is to assess mothers for postpartum depression using the Edinburgh Postnatal Depression Score.
You are confident completing this assessment but referring patients to mental health services is challenging as there are long waiting lists. Your manager has heard of a new telephone service offering interpersonal psychotherapy to clients with depression. You decide to search the literature to see if such a service is suitable for women with postpartum depression.
You find the following article (article attached):
Article Name: Telephone-Based Nurse-Delivered Interpersonal Psychotherapy for Postpartum Depression: Nationwide Randomised Controlled Trial
Cindy-Lee Dennis, Sophie Grigoriadis, John Zupancic, Alex Kiss and Paula Ravitz. The British Journal of Psychiatry (2020). 216, 189–196. doi: 10.1192/bjp.2019.275
Very Important: Please Report and Interpret the Following Outcomes Within Your Appraisal:
1. Number of women with ongoing postpartum depression at 12 weeks and 24 weeks after the intervention as measured by the SCID (Primary outcome). SCID = Structured Clinical Interview for DSM-IV.
2. EPDS Edinburgh Postnatal Depression Scale at 12 weeks.
Instructions/Paper Format:
1. Present a concise summary of the Randomised Controlled Trial (RTC) and in the summary, include the study aim(s), the PICOT (Population/Patient, Intervention, Comparison, Outcome and Time) elements of the study and the critical appraisal framework you will use, on this case – we are using the CASP tool (approximately 450 words)
2. Use A Critical Appraisal Framework (Use the CASP Appraisal Tool – In your appraisal you should consider the following: (approximately 400 words)
o Randomisation of study participants
o Allocation concealment
o Blinding of participants, healthcare professionals and study investigators
o Similarity of groups at the start of the trial
o Attrition/ loss to follow up
o Intention-to-treat analysis
o Equal treatment of groups
o Provide an overall summary judgement statement of the validity of the study.
3. Describe and discuss the results of the study, reporting the specific outcome listed for each scenario above. Please include: (approximately 400 words)
o Adequacy of sample size to determine an effect
o Interpretation of the size of the treatment effect for the primary outcome
o The precision of the treatment effect for the primary outcome
o Statistical significance of the primary outcome
4. Based on the validity of the study and strength of the results, discuss the possible application of the evidence to the scenario provided. (approximately 400 words).
