Analysis of Low-Dose Aspirin for Preventing Recurrent Venous Thromboembolism Article by Brighton - Essay Example

?This is a masters level health research paper critiquing the peer review and the medical imp, actions involved of the topic string medical evidence to dispute or agree with the article..I a, requesting th a writer with a health and medical background write this as this does not have clear examples of why exactly the peer review is correct or incorrect with specific medical examples on the topic written about Research paper Introduction Scientific research papers follow defined procedures and have specific elements in their documentations. Literature review on a research topic for identification of a problem statement, research methodology, procedure for implementing the methodology, data analysis, discussion of results, and conclusion are examples of elements and processes that develops a research paper. These elements and processes further determine validity and reliability of a research paper and are subject to review. This paper reviews the research paper, ‘Low-dose aspirin for preventing recurrent venous thromboembolism,’ authored by Brighton et al. and published in The New England Journal of Medicine’s November 2012 publication. The study investigated effects of low dose aspirin on recurrence of venous thromboembolism among patients with first episode of unprovoked venous thromboembolism and following exposure to first anticoagulant treatment. The study applied experimental design with 822 patients with a random sampling strategy. Recurrence occurred among 73 patients out of 422 of controlled group and 57 patients out of 422 of the treatment group. Aspirin also reduced secondary complications but the study identified lack of significant difference in bleeding instances (Brighton et al. 1979- 1987). Critique of the literature review The authors do not clearly articulate the study’s problem from literature review because the review fails to identify consistent knowledge gap to the problem. They fail to explore existing knowledge on the relationship between aspirin use and recurrence of venous thromboembolism in a comprehensive way that can justify the need for further research. The literature review also fails to identify and communicate a theoretical framework from which the study can be based. Its citation is however adequate as it identifies numerous sources that are consistent with the study’s core theme. Only a few of the cited sources are current, seven out of 22 having been published within five years from the article’s year of publication, a factors that discredits validity and reliability of developed background information from the literature review. This is because of possible effects of historical development on the study’s variables prior to the study. Selection of applied sources in the literature review is appropriately but the author’s position appear biased to effectiveness of aspirin on venous thromboembolism and the authors do not state any research question or hypothesis (Brighton et al. 1980). Critique of the methods Description of the research participants is adequate with extensive inclusion criteria such as age, sex, type of venous thromboembolism among other factors. Applied sampling approach, the probability based random sampling, is however weak in generating a representative sample but it is unbiased. Consideration of the selected sample size identifies lack of support for statistical power and offers a threat to the study’s reliability. In addition to the weaknesses, the authors do not provide for ethical approval from a review body and offers no measures for protecting research participants. Research procedures are not well defined to guide replication and validity and reliability of the study’s data collection strategy is not discussed. The researcher’s role is however defined by mere delimitation of the role of the involved healthcare facility in the study (Brighton et al. 1980). Critique of results The results sections offers a sufficient description of patients through their demographic factors and care based conditions such as age, sex, mass index, and duration for anticoagulation prior to sampling. Participation rate is also defined from identification of the number of participants who were ineligible and were dropped from the study. Descriptive statistics for the study’s variables are discussed and even though no research hypothesis exists, the results address the study’s objective of determining effectiveness of aspirin on venous thromboembolism recurrence. Percentage is the major descriptive statistics and is used to communicate participants’ basic information such as percentage of research participants by gender, percentage of participants with at least 30 BMI index, and percentage of participants who have close relatives suffering from the same health venous thromboembolism. Percentage is also predominantly used for the results to communicate observed rates of recurrence within the study’s groups and hazard rates. There is also sufficient application of tables and graphs in communicating differences between observations from treatment group and control group and the applications are consistent with the study’s objective. Inferential analysis of data communicated involved p-values for each analysis but no effect size is identifiable from the results (Brighton et al. 1982-1985). Critique of discussion section Discussion of the results is consistent with developed information in the literature review section and focuses on recurrence of venous thromboembolism and associated secondary outcomes. It explains possible unreliability of the results and identifies potential cause of errors towards the identified lack of aspirin’s significance on recurrence of venous thromboembolism. The discussion section also addresses methodological limitations but this is only limited to attrition factors. Limitations such as historical confound and maturation confounds, arbitrary sample size determination and possibility of a non-representative sample due to random sampling strategy are example of methodological limitations that the study should have explored. Despite deviation from previous studies and threats to reliability and validity of the study’s findings, the researchers do not identify implications for further research. Further, the researchers are not clear on the study’s implications to stakeholders. It does not explain possible application of the results by patients of venous thromboembolism to reduce vulnerability to recurrence of vulnerability to secondary factors. The researchers could have also explained possible applications of its findings by physicians and health care facilities to manage recurrence and secondary effects of the health complication (Brighton et al. 1985-1987). Overall evaluation The study identifies many weaknesses as pertains to a research paper. The researchers appear biased in their literature review to the opinion that aspirin is significant in reducing recurrence risks of venous thromboembolism and the discussion section reflect this bias as the researchers restate the position despite contrary results. The literature review also relies on outdated resources, does not identify a theoretical framework, and fails to establish problem of the research and research hypothesis. Application of randomized sampling strategy, failure to use power analysis in sample size determination, and lack of consideration for ethical issues further identify reliability and validity concerns over the study. The authors’ articulation of the study’s results is, however, professional but the weaknesses discredit the entire paper. I would therefore not use the article as an evidence source in my study. I also disagree with the article’s results that appear isolated from other results on the relationship between aspirin dosage and recurrence of venous thromboembolism. Prandoni, Noventa and Mian established significance of aspirin doses on reducing recurrence of venous thromboembolism and its bleeding consequences. The author’s position, being based on a triangulated study establishes higher-level viability and reliability that informs my position against the article for review (100-104). Robert et al. (p525- w157) and Rabinowitz (1), based on their empirical studies, also support effectiveness of low dose aspirin on reducing incidence of venous thromboembolism after initial unprovoked attacks and the contrary findings to those of the reviewed article identifies validity and reliability concerns, with the reviewed article, to support my position that disagrees with reviewed article. Works cited Brighton, Timothy, et al. “Low-dose aspirin for preventing recurrent venous thromboembolism.” New England Journal of Medicine 367.21 (2012): 1979- 1987. Print. Prandoni, P., Noventa, F. and Mian, M. “Aspirin and recurrent venous thromboembolism.” Phlebology 28.1 (2013): 99-104. Print. Rabinowitz, Ian. “2013-Aspirin rduced recurrence of venous thromboembolism (VTE) after a first-ever unprovoked VTE,” ACP Journal Club 157.8 (2012): 1. Print. Robert, Glyn, et al. “Effect of low-dose aspirin on the occurrence of venous thromboembolism.” Analysis of International Medicine 147.8 (2007): p525-w168. Print. Read More