Methodology of Comparing Quantitative Medical Tests - Assignment Example

?Part C The study on ‘Naturopathic Treatment of Rotator Cuff Tendinitis Among Canadian Postal Workers: A Randomized Controlled Trial’, had a quantitative methodology. The impact of the integrated use of acupuncture, dietary changes, and the use of a supplement as an effective semistandardized naturopathic intervention in the case of rotator cuff tendinitis was quantitatively evaluated by the study. The methodology followed was to compare quantitative medical tests to compare two treatment approaches for of Rotator Cuff Tendinitis ; naturopathic medicine against standard physical exercise treatment. The quality of any quantitative or qualitative methodology is primarily determined by the precision in selecting sample population. In this case, the sample population has to be a representative sample of patients with Rotator Cuff Tendinitis. As this study is constrained to postal workers, the sample population becomes more specific. The researchers selected the participants from the members of Canadian Union of Postal Workers. The approach in selecting the participants in research was different from other research studies. For example in the study on Development of an interprofessional competency model for healthcare leadership by Calhoun, J G. Dollett, L Sinioris, M E. Wainio, J A Butler, P W. Griffith, J R. Warden, G L (2008) , the selected sample size was a result of randomized selection from the whole population and it involved seventy to eighty representatives across the industry. However, in the current study, members of Canadian Union of Postal Workers were given the option of participating in the research. For arriving at the sample population, interested employees were invited to participate. This was done by distributing information sheets through postal offices. However, the eligibility criteria for these selected postal sites have not been mentioned in the paper. Analysing this methodology in arriving at the sample population, as all vital information including the purpose and background of the research were made available to the participants, the ethical side of the research has been taken care of. However, this process of selection based on consent and interest results in the non participation of many of the probable subjects of research. Thus the initial entry procedure limits the research from having a representative sample population. Moreover, the sample size of 85 was too small to represent the subject population. The allocation concealment in the initial phase of participant selection remains unclear. It has been mentioned that postal workers were selected from eligible postal sites. However, the criteria of this eligibility have not been mentioned in the paper. Moreover, the paper mentions that participants were primarily from Toronto. Thus it limits the research from reconfirming the variability across Canada. This must be read together with the fact that the title of the paper encompasses postal workers in Canada with Rotator Cuff Tendinitis. Further, in the secondary stage of population selection, ie , recruitment and the initial visit, thorough physical and medical examination was conducted to confirm the patient to have Rotator Cuff Tendinitis. This included height, weight, body mass index, sitting left arm blood pressure, and a range of shoulder range of motion, and orthopaedic tests. This increased the quality of the sample population as a representative sample. The coordinators who conducted these tests were blinded on the medical history of the patients. This increased the scientific credibility of the sample population. Other major criteria considered for the allocation concealment was the age group. As only participants of age in between 18 and 65 were considered, it was ensured that the effect of the interventions, in other terms the methodology of the research is not affected from the variation in age related physical status of the patients. This is important because if the patient is too young or too old, the response of their bodies to the intervention both naturopathic and physical exercise will vary from the sample population to a large extend. The admission protocol also assured that the participants had pain in at least one shoulder for the past 6 weeks. The baseline data after randomisation indicated similar results for all the participants confirming that the available sample was uniform in terms of the pre treatment data. This further suggests the efficiency of the research methodology as it assures the quality of the sample population. One major limitation in the research methodology was that the participants and the clinicians could not be completely blinded on the interventions. It must also be taken note that it is not medically and clinically advisable and possible to blind the patients and clinicians from the details of the treatment. However, in order to minimise the influence of this, the tablets and supplements were administered through tablets which appeared to be similar. The reference to naturopathic intervention administered to the patients in the current study has been made in a number of studies. Gunn (1996) has studied and confirmed in detail the efficacy perpendicular thrusting technique of needle insertion which has been used in the research. There are references to literature on the methodologies followed in physical exercise cited in the paper, which confirms the extensive research that the author has done on formulating the methodology. There were few adverse effects reported as a result of the interventions made by the study. However, these had not been severe to affect the quality of methodology. Data was collected through questionnaires which were patient centred. Similar methodology has been used by Paterson C, Britten N (2000) & Paterson C (2000). However, the fact that the participants were not completely blinded limits the accuracy of this patient centred data collection methodology. There is the risk of patient being biased to specific interventions due to varied reasons. Scientific statistical tools were used to analyse the data. Statisticians were blinded on the objective of the study to avoid bias. Thus it can be assumed that both computerised data processing and unbiased statistical expertise would have minimised errors. Part D: Conclusion The study on ‘Naturopathic Treatment of Rotator Cuff Tendinitis Among Canadian Postal Workers: A Randomized Controlled Trial’ concludes that naturopathic treatments which includes acupuncture, dietary changes, and Phlogenzym had positive impact on treating Rotator Cuff Tendinitis. It also concluded that the treatment had improved the quality of life in the work place which included positive influence on “physical function, bodily pain, general health, vitality, emotional and mental health markers, and patient-specific concerns” (Orest et.al, 2009). These conclusions prove that the study could partially address the objective put forth by the study. The objective of the study to evaluate the combined efficacy of naturopathic intervention in treating in Rotator Cuff Tendinitis has been addressed by the conclusion. However, the conclusions made are not representative to Canadian Postal Workers as the data only considered patients from a particular region of the country. The discussion part of the study has succeeded in analysing every detail of data available. A range of variables were considered while arriving at the conclusion. However, the study primarily being of quantitative in nature, the reliability of the qualitative conclusion suggested by the study is debatable. An example to this is the reference to the appreciation of the treatment at the workplace. The authors have referred to appropriate and adequate works to evaluate the observations made by the study and to arrive at the conclusion. The author referred to an explicit range of database and periodicals. A wide range was covered as literatures have been referred by the authors in the process of reviewing the outcomes of similar intervention made by other researchers. The conclusion of the research is in alignment with previous researches done on the subject. Similar observation on reduction in rotator cuff tendinitis using interventions with standardized physical exercises has been reported by Wilson & Best (2005). Though this suggests possibility of local application in clinics, the limitations of the study in terms of sample population demands further confirmation of its results. However, the results of the study will serve as reference for further research. Moreover, it has been noted by the authors that the results of this study in terms of access to care and ongoing treatment was appreciated considerably by the participants. This suggests that on further confirmation of the results through continued research, the results will have positive clinical implications in the treatment of Rotator Cuff Tendinitis. The scope of the study has to be further extended to workgroups other than postal workers. The scientific framework of the methodology followed confirms the reliability of the research. As the participants were well informed on the objective of the study and their consent was taken before confirming their participation, the ethical credibility of the research is reiterated. As the sample size is too less, further research will have to be undertaken to confirm the results. Thus the application of the research on local population needs further confirmation. Authors have mentioned in the paper that as naturopathic doctors’ decisions were limited, the external validity of the results is limited. Though there is no reference to the costing of the study, the benefits can be considered cost effective as the study was of a retrospective nature. . Calhoun, J G. Dollett, L Sinioris, M E. Wainio, J A Butler, P W. Griffith, J R. Warden, G L (2008) Development of an interprofessional competency model for healthcare leadership. Journal of Healthcare Management 53 (6), 375-391 Gunn C. (1996) The Gunn approach to the treatment of chronic pain: intramuscular stimulation for myofacial pain of radiculopathic origin. 2nd ed. London: Churchill Livingstone; 1996. Orest Szczurko, Kieran Cooley,Edward J. Mills, Qi Zhou, Dan Perri & Dugald Seely, (2009) Naturopathic Treatment of Rotator Cuff Tendinitis Among Canadian Postal Workers: A Randomized Controlled Trial Arthritis & Rheumatism (Arthritis Care & Research) Vol. 61, No. 8, August 15, 2009, pp 1037–1045 Paterson C, Langan CE, McKaig GA, Anderson PM, Maclaine GD, Rose LB, et al (2000) Assessing patient outcomes in acute exacerbations of chronic bronchitis: the measure your medical outcome profile (MYMOP), medical outcomes study 6-item general health survey (MOS-6A) and EuroQol (EQ-5D). Qual Life Res Vol. 9:521–7. Paterson C & Britten N (2000) In pursuit of patient-centered outcomes: a qualitative evaluation of the “Measure Yourself Medical Outcome Profile.” J Health Serv Res Policy, Vol. 5:27–36. Wilson J & Best T (2005) Common overuse tendon problems: a review and recommendations for treatment. Am Fam Physician Vol. 72:811–8. Read More