Research methodology articles Critique - Essay Example

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Article Critique/S Article 1: Sharma, J, Bhise, M, Singh, A et al (2005) Hemodynamic Measurements after Cardiac Surgery: Transesophageal Doppler Versus Pulmonary Artery Catheter The aim and intention of this particular study are absolutely clear as the authors intended to compare the traditional, established mode of hemodynamic measurements’ in post cardiac surgical care patients i.e…
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Download file to see previous pages Coronary Artery Bypass Grafting surgery (CABG), while being careful that none of them had compromised ventricular function, the latter condition speculated by the authors’ as an interfering factor, which might have affected correct interpretation of the data aimed to be gathered during the study. Although the sex ratio was skewered due to predominantly male patient selection, it did not matter as end point measurements included standard cardiac parameters unlikely to be biased by sex of the patient. On all 35 patients, measurements were manually obtained by independent investigators, blinded to each other for avoiding bias due to consultation, and the numerous parameters calculated to measure the cardiac output (CO). Similar data was obtained automatically by associated software with the transesophageal Doppler machine. Four readings from each patient taken at specific time intervals yielded 140 readings for comparison with data obtained using the Doppler technique. Although, according to authors’ this seems enough data for comparison, but it appears that such data needs to be collected from a larger number of participants and by some automated software instead of human observers to reduce chances of bias due to human error and variable observation capability of different investigators. The design seems appropriate as similar/detailed parameters were calculated for comparison and recognized/valid statistical software and calculation techniques were used in the study. The main comparison has been done with the values of diverse hemodynamic factors obtained by TDCO (Thermo Dilution Cardiac Output) and the TECO branded transesophageal Doppler software. The authors’ discovered a poor correlation between the two, prompting them to criticize the automated technique due to the pertinence and importance of these parameters in saving the life of patients undergoing such challenging cardiac surgery procedures. They have substantiated their results with similar poor correlation in other studies of the kind, at the same time claiming that their own study was first of a kind, as it was done on off pump CABG unlike others. The authors’ may have claimed poor correlation between measurement of hemodynamic factors taken by the two different techniques, but they have neglected the issue that all patients were under heavy sedation and subject to the side effects of numerous drugs that were administered to them, most likely by different technicians at diverse, independently suitable dose rates for each patient, which may have affected the parameters under study. The authors’ seem to have a biased attitude towards the automated technique, making them condemn the latter due to over reliance on the older, invasive technique, with which they might be more familiar. Modern diagnostic probes and software are sensitive and free from human error and can report such parameters correctly, in a non invasive manner, which can assist in less discomfort to the patient and saving precious lives. Moreover a poor correlation obtained as a result of Bland Altman statistical analysis does not automatically and always imply that there is agreement between the two methods. Article 2: Hadian, M, Kim H K, Severyn, D A & Pinsky, M R (2010). Cross-comparison of cardiac output trending accuracy of LiDCO, PiCCO, FloTrac and ...Download file to see next pagesRead More
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