Briefly summarize and report the statistic and discus whether the assumptions of the test were met and if the type of data was appropriate for the statistical test?
It is evident that in academic writing, authors have to follow conventional forms so that the scholars are able to interpret what the study is all about. At the same time, the scholarly article writings also frequently preside over the variety of style as well as tone the author have to employ if the article is to be satisfactory to others in the similar field. If the nature of the study is practical oriented, that is, it dealt with data, then the author must have to represent the study by mentioning what data they have employed what strategy they have followed to conclude their findings etc. So, it is necessary to assess the article with considering several parameters to understand whether the article is providing sufficient information towards the scholars. With this aim, the above mentioned article is chosen and analyzed with respect to several sub points.
To assess the chosen article, here the entire critical evaluation study has been subdivided into six broad sections. The details of each of the sections are described as below:
After reviewing the study executed, it is noted that the researchers of this study mainly emphasized on analysis of the effectiveness as well as the efficiency of traditional stroke care pathway and comprehensive stroke care pathway. To do so, they have used a list of statistical tests. As the study incorporates both parametric and non-parametric data, both kinds of tests were employed here.
The researchers employed student’s t-test to assess the parametric data gathered for this study. There are twelve variables utilized in this study. The mean of all these variables for both the groups was compared using this specific test (Härdle & Simar, 2012).
This particular test has been employed as an alternative of the independent sample t-test. Here, non-parametric data gathered for this study were utilized (Heckard, Utts & Utts, 2012).
This particular test has been employed to identify whether the selected two groups have an association with other or not and if associated then significant or not (Hu, Liu & Lin, 2013).
This particular test has been employed to assess the relationship between functional independence measure efficiency lengths of stay in ASU for both the control group (Kobayashi, Mark & Turin, 2012).
It is noted that clinical research practice supports medical treatment continues to develop and get better. Under such circumstances, stroke care units have utilized a range of stroke treatment models like acute care, rehabilitation care and comprehensive stroke care. The use of any specific stroke treatment model largely depends on the patient’s scenario. Besides, there are also differences in care among these models (Jung & Jung, 2013). Reviewing this study, it can be said that the study is mainly aimed to judge the efficiency as well as effectiveness of traditional stroke care pathway against comprehensive stroke care pathway. In this context, it is also noted that while selecting these two control groups, they have defined the comprehensive stroke care as the combination of acute and rehabilitation stoke care. On the other hand, both acute and rehabilitation stroke care remained separate in care of traditional stroke care model.
It is also the fact that the researchers have employed a list of statistical test to attain the objectives of this study. The conclusion drawn by the researchers indicates that in both the control group, acute and rehabilitation stoke care remained efficient as well as effective one. But, if the comparison measure has been considered, then it can be said that comprehensive stroke care model has shown greater functional efficiency in against the traditional stoke care model. In other words, the study has concluded that while giving stoke care, the health professionals needs to consider both the acute as well as rehabilitation care together to attain better result (Miner, 2012).
As mentioned, in the above section the researchers have employed four different tests to attain the objectives of the study. In each tests, they have used certain specific statistics. The student’s t-test and the Mann–Whitney U-test have shown that mean and standard deviation of each of the variables were employed as the statistical tools (Sprinthall, 2012). In case of Chi-square test, probability value or the P value has been considered as the statistical tool (Speziale & Carpenter, 2011).
On the other hand, during the linear regression analysis, first of all median and inter-quartile range or IQR have been employed here to explain whether both traditional stroke care model and comprehensive stroke care model have demonstrated significant FIM efficiency or not. The correlation or the r-squared value also has been employed as the statistical tool to reveal the association between FIM efficiency and LOS spent in the ASU.
Prior to executing this research work, the researchers have defined the sample inclusion criteria as study design (fig 1 of the article). It has clearly depicted how the sample will be collected and who will be the final respondents in each control groups. At the same time, it is also noted that all the respondents are randomized using Stata 11 computer program software beforehand analysis of the data collected.
Again, in order to measure the outcome in terms of efficiency and efficacy, certain assumptions also made by the researchers. In the context of efficacy, FIM scores are being taken into consideration, which are gathered during discharge of patients and 90 days post discharge follow up.
On the other hand, to measure the efficiency, two points are considered here. First of all, total length of stay (LOS) of each of the patients in every hospitals selected are measured. Then FIM efficiency has been measured using the below mentioned formula:
FIM efficiency = change in FIM score / total length of stay
As per the article, it can be said that the researchers have gathered data from four participating hospitals. Initially, the research has been considered total 47 patients as the sample of this study. Among these 47 patients there were 25 males and 22 females as mentioned in the result section. However, later it is found that among these there are four patients who have withdrawn their name from the study during the ASU phase and at the same time two from rest of the participants died. Finally, after going through other exclusion criteria, 20 patients were considered as the final sample of this study for comprehensive stroke care model. On the other hand, 21 patients were considered as the final sample of this study for traditional stroke care model.
Here, the study has shown that in comprehensive stroke care model, the range of the age of the selected patients was 55 to 88 with mean age 73.5 years. Similarly, in case of traditional stoke care model, the range of the age of the selected patients was 34 to 99 with mean age 72.6 years. This clearly indicates that the deviation of age for comprehensive stoke care model was more than the traditional stroke care unit.
As mentioned above, the researchers have collected data in two specific intervals, one during discharge of patients and other one 90 days post discharge follows up. Now, the results as described by the researchers indicate that they have found significant improvement in effectiveness of comprehensive stroke care model in against the traditional stoke care model. However, during the post 90 days follow up, the study did not find significant difference in both effectiveness levels (Strokeassociation.org, 2015).
Again, when efficiency level has been measured, then it is found that the length of stay of patients in comprehensive stroke care model is more than 5 days less against the length of stay of patients in traditional stroke care model. In this context, the study has also depicted that if the participants who died and withdrawn their participations are included in the results, and then such difference will increase by 1.62 days.
Finally, when, FIM efficiency has been taken into account, then it can be said that the researchers have found enough evidences to conclude that the comprehensive stroke care model have better FIM efficiency level than traditional stroke care model. Taken for consideration, the study has shown that the median value of the FIM efficiency score of comprehensive stroke care model was 1.60 with inter quartile range 0.87 – 2.81. On the other hand, the median value of the FIM efficiency score of comprehensive stroke care model was 0.82 with inter quartile range 0.27 – 1.57. This indicates that the FIM efficiency was 95% better in case of comprehensive stroke care model in compared to traditional stroke care model (Tung, 2013).
While performing any specific study, displaying results appropriately is an essential aspect as it helps the reader to relate the discussion along with the findings of the study. The reader can also easily identify whether the findings are in line with the objective stated or not.
Here, the researchers have utilized both table and figures effectively to display the data gathered, data analyzed, etc. First of all, the study design mentioned as figure 1 in the article clearly explored how the data were gathered and what is the final sample size. The researchers here described these as well as presents graphically, which helps the reader to understand it clearly (Organization, 2012). So, it is the major strength of the study. At the same time, it is also noted that data calculation table presented in this study has depicted the values that are required for this study. It is the fact that each of the tests that have been employed here includes several sub tables. However, the researchers did not put all these tables in the result section. Instead, they have summarized the tables and put in such a way that supports the readers to understand what values have been considered when discussing any specific point. So, this is also strength of this study. Again, when linear regression analysis has been performed to assess the relationship between functional independence measure efficiency lengths of stay in ASU for both the control group, there is requiring identification of the trend as well as the correlation value. In this context, it is noted that the researchers have utilized graphical presentations which clearly depicts the trend as well as correlation value. Therefore, it can be concluded that the researchers effectively utilized the figures to display the results. As a consequence, the researchers have shown the findings of the study appropriately that supports the objectives of the study.
Conclusion:
Thus, to conclude, it can be said that while the aim of this study is to measure the efficiency as well as effectiveness of traditional stroke care pathway against comprehensive stroke care pathway; the findings of the study appropriately shows that there is a significant improvement in comprehensive stroke care model. In other words, the study has effectively incorporates the aspects that must have to consider to reach meaningful conclusion. The researchers have accurately identified each and every small aspects related to the study to conclude such results. Thus, it can be said that the study is an effective one. The effective use of statistical test, tools, etc also supports the researchers to draw such meaningful conclusion.
It is noted that while performing any study, the researcher has to exclude certain aspects due to the limitations of the study. However, it is essential to identify those limitations prior to executing the research work. This will not only strengthen the existing research study, but also supports the readers as well as other researchers who may use this study as the guidance or base point. Considering, this point, it can be said that the study has displayed a significant area of stoke care. While, in the contemporary scenario, where stroke is considered as one of the major concerns, this study no doubtly shows pathway to follow to avoid major issues related to stroke.
However, the fact is that the study considered patients only from four hospitals and the size of the sample is small enough considering the importance of the subject. So, prior to validate the findings of the study externally, there is requiring conducting this study in vast scenarios. If the results still shows that the comprehensive stroke care model where both the acute and rehabilitation care are combined together evidenced improved efficiency as well as effectiveness in compared to traditional stroke care model; then the study will improve the overall scenario much more accurately.
References
Cho, D. (2012). The Study on the Difference of Management Performance in Public Health Care Institution. The Korean Journal Of Health Service Management, 6(2), 133-140. doi:10.12811/kshsm.2012.6.2.133
Cho, D. (2012). The Study on the Difference of Management Performance in Public Health Care Institution. The Korean Journal Of Health Service Management, 6(2), 133-140. doi:10.12811/kshsm.2012.6.2.133
Cooper, H. (2011). Reporting research in psychology. Washington, DC: American Psychological Association.
Gambrill, E., & Reiman, A. (2011). A Propaganda Index for Reviewing Problem Framing in Articles and Manuscripts: An Exploratory Study. Plos ONE, 6(5), e19516. doi:10.1371/journal.pone.0019516
Härdle, W., & Simar, L. (2012). Applied multivariate statistical analysis. Berlin: Springer.
Heckard, R., Utts, J., & Utts, J. (2012). Statistics. Australia: Brooks/Cole, Cengage Learning.
Hu, M., Liu, Y., & Lin, J. (2013). Topics in Applied Statistics. New York, NY: Springer New York.
Jung, H., & Jung, K. (2013). A Study on the Suicidal Ideation and Self-esteem of Nursing Students. The Korean Journal Of Health Service Management, 7(3), 149-160. doi:10.12811/kshsm.2013.7.3.149
Kobayashi, H., Mark, B., & Turin, W. (2012). Probability, random processes, and statistical analysis. Cambridge: Cambridge University Press.
Miner, G. (2012). Practical text mining and statistical analysis for non-structured text data applications. Waltham, MA: Academic Press.
Organization, W. (2012). World Health Statistics 2012. Geneva: World Health Organization.
Simmons, B., Bland, M., & Wojciechowski, B. (2011). AP statistics 2012. New York: Kaplan Publishing.
Speziale, H., & Carpenter, D. (2011). Qualitative research in nursing. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Sprinthall, R. (2012). Basic statistical analysis. Boston: Pearson Allyn & Bacon.
Strokeassociation.org,. (2015). Stroke Treatments. Retrieved 9 August 2015, from https://www.strokeassociation.org/STROKEORG/AboutStroke/Treatment/Stroke-Treatments_UCM_310892_Article.jsp
Tung, W. (2013). Stroke Among American Indians and Alaska Natives. Home Health Care Management & Practice, 25(4), 176-178. doi:10.1177/1084822313484761
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