NURS 701 – Assignment 1 – Research Article Reviews
Refer to the article “Short and Long-Term Outcomes from a Multisession Diabetes Education Program Targeting Low-Income Minority Patients: A Six-Month Follow Up”. Answer the following questions pertaining to this article.
a) What statistical methods did the researchers report using in analyzing the results of their research? (2 pts.)
b) What percentage of the patients completed the program? What do you think are the consequences of this percentage in terms of the effectiveness of this program? (2 pts.)
Examine the Flow of patient recruitment, engagement, and completion chart on page A46 of paper. Questions (c) – (e) refer to this chart.
c) What percentage of eligible subjects (522 patients) ultimately ended up completing the 4 classes of the education program?
d) In the Discussion section of the paper the authors state that the completion and attrition rates were 44.51% and 55.49% respectively. Are these figures supported by the Flow chart on page A46? Explain. (2 pts.)
e) In your opinion what does the attrition of patients, particularly amongst those that started the classes, say about the effectiveness of the program?
(1 pt.)
Refer to Table 1 on page A47 of the paper, answer questions (f) – (h)
f) What test was used to compare the percentages in reported in this table? Do you feel this test was appropriate for the comparison of these percentages for completers (n = 73) and noncompleters (n = 101)? Name at least one other test procedure they could have used instead. (3 pts.)
g) What test was used to compare means between completers and noncompleters of the education program? Do you feel this test would be appropriate for the comparison of the mean outcomes between these two group? (2 pts.)
h) On which outcome did the completers and noncompleters significantly differ? (1 pt.)
i) The authors conducted a total of 13 tests in Table I and found one significant difference, would this be expected on the basis of Type I Error? Did the authors mention any experiment-wise error rate control? (2 pts.)
Refer to Table II on page A48 of the paper, answer questions (j) – (l)
j) What test was used to compare means the Table II? Was this test appropriate for these comparisons? (2 pts.)
k) For what clinical/physical outcome was a significant difference from baseline found? (1 pt.)
l) For what patient-reported outcome was a significant difference from baseline found? (1 pt.)
Refer to Table III on page A49 of the paper, answer questions (m) – (o)
m) What test was apparently used to compare the baseline and follow up results on these outcomes classified as Within (not outside acceptable ranges) or Above (above acceptable levels)? To help answer the question I have included the JMP output from the analysis of glycosylated hemoglobin (HbA1c) that contains the author’s results in it. (3 pts.)
n) The authors write the following about this analysis in their paper
“There was a statistically significant change in the proportion of patients whose HbA1c level was 7.0% at baseline compared with follow up; 8 of 30 patients (26.67%) moved from the 7.0% to < 7% category (c2, 13.42; P < 0.001), and 2 patients moved from the < 7% to 7.0% category.”
Their conclusion is INCORRECT! It gets much worse when you consider other outcomes, particularly obesity and BMI where the others appear to have extremely strong evidence of improvement, when in fact they DO NOT even come close to having significant results!!! Why would I say this? (2 pts.)
o) BONUS 5 POINTS – conduct an appropriate analysis for this outcome and state the correct conclusion using a = .05 level of significance.
p) BONUS 5 POINTS – do the same for the obesity result (2nd to the last row of the table) and compare contrast your results with those of the authors’.
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