The Analysis of the Hip Fracture in the Elderly Japanese Women - Book Report/Review Example

Critique of Quantitative Research Article Critique of Quantitative Research Article Introduction The Research problem for the study was an escalated hip fracture amongst the Japanese female osteoporosis patients having unilateral hip fracture. The research problem is precisely stated in the paper both in the abstract and the introduction sections making readers easily grasp the direction of the document (Osaki et al. 2011). The problem is significant to patients because hip fracture is the worst of all fractures attributable to osteoporosis. The hip fracture significantly influences the survival amongst the osteoporosis, life quality and enormous cost of treatment. Therefore, the nurse finds it rational and professional to designed intervention preventive measures rather waits for the fracture. In addition, the hip fracture incidence was anticipated to rise by 4.8 million by 2050 hence the studys massive and inevitable significance to nurses. The study is justified due to a significant threat to life of hip fracture amongst the osteoporosis. Indeed, prior fracture further puts the life quality and survival rates at a stake leave alone the enormous cost of hip fracture treatment (Osaki et al. 2011). The patients who have a history of prior hip fracture are therefore at a risk of unaffected side hip fracture. Therefore, it is justifiable to probe the preventive impact of risedronate on the subsequent hip fracture immediately after an initial hip fracture amongst Japanese osteoporosis female. Indeed, it is known that people with a history of fracture are at more risk but no particular study has been conducted to solve this problem. Therefore, the current study is valid and justified to present such information to help this population of patients. The results would help design another useful mechanism alongside risedronate to help revamp the problem. The hypothesis, questions and objectives are not stated however they are implied in the study and any reader would quickly follow. For example, it is hypothesized that female patients with a history of fracture are at risk of subsequent fractures. In addition, the objective of the study can be drawn from the stated purpose of the study (Osaki et al. 2011). For example, the goal was to establish the preventive effect of risedronate on the subsequent hip fracture amongst the osteoporosis females in Japan. The study conceptual as well as theoretical and conceptual mechanisms were not however stated but clearly implied in the study. The theoretical framework applied is that despite the effectiveness in risedronate, the female’s osteoporosis in Japan is at higher risk of the second hip fracture following immediate initial hip fracture. Such a theoretical framework is linked precisely to the stated purpose of the study that aimed at investigating the preventive effect of risedronate amongst the patients with a history of the hip fracture. It is, therefore, clear that risedronate may not be as preventive following the immediate second fracture after the first fracture. The current literature was published online on March 2011with the open access at Springerlink.com. With this in mind, I feel the current literature falls within a range of contemporary literature and the outcome can be effectively used. In addition, the literature reviewed is logically organized to help the readers effectively follow and determine whether the literature review supports the purpose of the study. In my view, therefore, clearly supports the need for the study. Methods The study applied the prospective cohort study exploratory quantitative research design to determine the preventive effects of risedronate on osteoporosis Japanese female with a history of hip fracture. It was exploratory quantitative research as the 36-month follow-up was only based on assessing the frequency of adverse events and incidence of unaffected side hip fracture, all numerical-based. The design fits the purpose of the study as the number of patients with a history of both control and treated cohorts would help depict the preventive effect of risedronate. Indeed, the quantitative exploratory research was further in line with the study purpose since the presence of significance difference in the two cohorts will help reduce the preventive effects of the risedronate. On the other hand, if the two groups showed no significance difference, then the notion of patients with a history of fracture being at risk of the second fracture will be trashed. Therefore, further revealing the preventive effects of risedronate in both cohorts. The design is linked to the sampling method that was based on a prospective matched cohort study incorporating both 184 treated patients and 445 controls (Osaki et al. 2011). The inclusion of both control and treated groups would help gauge the significance difference to make a conclusion on the preventive effect of the risedronate. In other words, it would be difficult to note the office if the within groups rather than between groups technique sampling technique were applied. With respect to statistical analysis, the design is connected to the analysis. The determination of the significance difference between the groups would aid in exploring in quantitative terms, the preventive effects of risedronate in curtailing hip fracture. Also, the calculation of the percentage of fracture incidence and the determination of the numbers of the adverse events indicated the quantitative analysis. The sample is adequate in the study with 184 treated patients, and 445 controls showed adequate sample size. The sampling procedure is precisely outlined with the enrolment running from July 2003 to 2009. The study also stated the enrolment element as sex, age, height, body mass index and body weight. The exclusion criteria are also stated benchmarked against bilateral hip fracture, prior history of hip culture, and those subjects who could not be followed-up. The authors give the prospective match as a justification for the sample size as well as the inclusion and exclusion criteria stated. The study protocol is clear and concise based precise treatment and procedure. The physician is attending to the subjects clearly outlined the purpose of the study and its procedures and further specified the Japanese diagnosis criteria for osteoporosis (Osaki et al. 2011). Patients treated with risedronate at the approved Japanese dose of 2.5 mg/day were included in the Administration cohort. Patient in the control group was never treated with bisphosphonate preparation and the needed information uploaded as the control group. Subjects in the treated group took a Benet 2.5 mg tablet orally with water during awakening. The study was discontinued if the administration of risedronate was stopped or shifted to another bisphosphonate. Kaplan-Meier method was applied to measure the incidence of unaffected side hip fracture. The log-rank test was also used to measure the significance difference in both cohorts. The univariate and multivariate analysis aided in determining the significant intergroup differences to estimate the hazard ratios. Intergroup adverse effects were measured by Fisher’s exact test, and the SAS software applied in performing all statistical analyses. The mentioned instruments measured the concept they were intended to measure and concept definition consistent with the operational definition. The authors, however, did not present information on reliability and validity of the instruments. The internal threats in the study design were dealt with through discontinuation of the subjects that did not meet the set criteria. The external threats were also curtailed by ensuring that the patients were treated with the approved risedronate and only included the patents that met the standard criterion already stated. In addition, the study being a post-marketing surveillance, it was executed in accordance with the Japanese GPMSP and GPSP) decree. The evidence provided in regarding human subjects is the prior explanation of the study purpose to the participants and the specification of Japanese diagnosis criteria for osteoporosis. In addition, risedronate was administration was in compliance with Japanese approved policies and also according to the judgment of the attending physician (Osaki et al. 2011). The ethical concern described is the study was a post-marketing surveillance and hence had to comply with GPMSP and GPSP guiding the sale of drugs in Japan. There is also a detailed description of replication. Results Out of the 2051 patients that faced hip fracture surgery and after the preamble enrolment, 184 patients took risedronate at the original outpatient visits following discharge. 445 patients got matched with the patients that took risedronate. Eleven patients from risedronate cohort and 89 patients from control got excluded due to the inability to follow-up following the initial visit. 529 patients remained of which 173 were in risedronate and 356 in the control cohort for subsequent efficacy examination. The hypothesis is answered as there was no significance difference in the two groups. However, the research question was answered it was concluded that risedronate have effective effects in hip fracture as it reduced significantly in risedronate cohort. The data collected was with respect incidence of unaffected side hip fracture and frequency of adverse events (Osaki et al. 2011). The age, BMI and the significance difference in administering vitamin D3, treatment and drug treatment for osteoporosis at discharge and the complication at discharge data were gathered. The data analysis procedure used was based on Cox regression analysis of unaffected hip side fracture also called efficacy analysis test. The regression tables are used to represent the data on unaffected hip side. In addition, graphs are also used to explain the probability of fracture and the Kaplan-Meier curves showed efficacy analysis set. The text supplements that data in the table for precise understanding. The findings with respect to unaffected side hip fracture revealed five patients from risedronate and 32 patients arising from the control group. In addition, adverse events happened in 38 patients from risedronate and 94 patients from the control. Discussion/Implications for practice The authors linked the findings of the study to the hypothesis, purpose and objectives. The findings of the study are in with other previous reports that have indicated that risedronate is effective in preventing hip fracture in such high-risk patients. Other recent reports indicate a significance reduction in the incidence of hip fracture in USA and Europe. However, arise is hip fracture is projected due to aging population (Osaki et al. 2011). The author discusses a conflicting finding in Japan that showed a rising incidence of hip fracture. Hence, incorporating the threats of aging population, Japan heath policy is greatly focused on preventive measures for hip fracture. The limitation of the study is that it was only a prospective cohort study and therefore lacked randomization as well as blinding. Therefore, incomplete comparability between the two cohorts leading to multivariate adjustment of demographic factor indicating significant intergroup difference. The new research arising from the study is the need precisely to define the characteristics of individual drug and large scale long term follow-up. Thus, collapsing into a prospective international cohort study, The Global Longitudinal Study of Osteoporosis in women instigated in 2006. GLSO is significant to nurses to characterize drugs for osteoporosis. Overall Presentation and final summary The title accurately describes the type of study, major variables and target population. In addition, the abstract provides information at a glance about the study including purpose and methods. The report is logically consistent driven by an outstanding clarity and concise writing style. Reference Osaki, M. et al. (2011). Benefit Effect of Risedronate for Preventing Recurrent Hip Fracture in the Elderly Japanese Women. Nagasaki. Japan. 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