Tool for critiquing qualitative research is modified based on the Critical Review Form-Qualitative Studies ©Law, M., Stewart, D., Pollock, N., Letts, L. Bosch, J., & Westmorland, M.
Complete all of the questions in the template below in reference to the article that you have selected. Ensure that you have selected the correct template (quantitative or qualitative) to match the research method in the article that you have selected.
Where there is a Yes/No option in the question, delete the option that does not apply.
(a) Did the study have a clearly stated purpose/research question? Yes / No
Yes, the study has clearly stated the purpose/research question
(c) Explain your response below:
Through the study, the authors want to examine the effective usage of short message service (SMS) in reminding administration of influenza vaccine. The paper provides evidence-based research by demonstrating the quantitative approach to increasing the seasonal influenza vaccine overage among high-risk patients.
(a) Explain how this question was relevant to nursing/midwifery practice.
The question is necessary for nursing//midwifery practice as it helps in demonstrating the clinical practices of study design. The question is highly relevant for the student as it helps in knowing more about the seasonal influenza vaccination, which is one of the important aspects of health management in Australia
(a) What were the possible risks of participating in the study?
The risks associated with the study are the following:
The study relies on general practice records of patients having chances of developing seasonal influenza. The usage of this kind of approach will detect the most patient with chronic conditions, thus the vaccination accuracy is limited studied.
The study worked on those patients who have their mobile phones on medical file. Thus, the SMS reminder can be only sent to the people having mobile phones and thus those people who have limited or no telephone coverage is excluded in the study
The study included those patients who were recommended for one dose of influenza vaccine, it does not provide an insight on the patients with continue medicine intervention or patient who recommended to receive two doses of influenza were not incorporated.
(b) Were these risks clearly identified by the authors? Yes / No
Yes, all the risk is identified by the authors.
(c) If risks were identified by the authors, how did they propose to minimise risk?
The authors did not minimise the risk. However, they were keen to do further research on this topic in future
(d) Did the authors state that they had approval from an ethics committee to undertake the study?
Yes, the authors had approval from the ethic committee. The study was approved by the Department of Health Western Australia’s Human Research Ethics Committee.
(e) How did the authors obtain informed consent from participants?
The authors have included those patients who at the participating practices were eligible for the inclusion study if they belong to the high-risk group and has received a consent from the patient that they can be called upon by SMS.
(f) Did you identify any potential risks associated with the study that were not identified by the authors and if so, what were they?
Yes, as the authors provide that the study will only include those participants who are suffering from a chronic condition and whose name was mentioned in EHR. However, this will create a loophole on those patients who were at higher risk but never maintained on EHR record.
Secondly, the other small-risk associated patient were also be neglected in the study. However, if the patient pool does not receive SMS notification regarding drug administration can develop a severe health condition.
(a) Describe the chosen study design for this study.
Data for the high-risk located patient were taken from the Department of Health Western Australia to prevent the quality audits to improve the management and occurrence of chronic health ill condition. Five different high risk associated people were targeted for the study. These people include people of age more than 65 years, children within the age of six months and four years, people of the age six months and older who are suffering from other disease lie asthma, immune impairment, diabetes, and heart disease, and pregnant women. Moreover, only those patients were included in the study who were at high risk of developing the disease. The patient will be notified regarding the seasonal influenza vaccine through SMS. The eligible people were randomly assigned to receive the notification alert. The notification alert is different for different individual. The intervention group receive SMS, the control group does not, and the general practice staff was blinded to the patients’ group assignment. Through this, the data was collected and statistical analysis was made on this.
(b) Was this a suitable study design for the given research question?
Yes / No
Yes, the study design is suitable for the given research question
(c) Explain why the chosen study design was or wasn’t suitable.
The study was suitable because the author has divided the study into age-group, sex, race, medical history, and marital status. This creates a deep understanding and close look at every segment of the population. These criteria of inclusion will demonstrate an analysis on larger patient pool
(a) How many participants were included in the study?
12,354 eligible candidates were included in the study
(b) What were the inclusion and exclusion criteria?
Inclusion criteria of the study are as follow:
People of age more than 65 years,
Children within the age of six months and four years,
People of the age six months and older who are suffering from other diseases like asthma, immune impairment, diabetes, and heart disease, and pregnant women.
Aboriginal and Torres strait people
(c) Explain how the participants were recruited.
Participant list was generated with the help of EHR and general practice record. These participants have randomly received the SMS notification.
(d) Describe the setting in which the study took place (hospital, community, etc.).
The study took place online, no physical address mentioned in the paper.
(a) Describe the intervention (e.g. treatment, therapy etc.)
It was a randomised controlled trial of SMS reminder for a high-risk patient suffering from seasonal influenza.
(b) What was the comparator (e.g. alternative treatment or therapy; placebo etc.)
No use of SMS reminder
(c) Was this intervention adequately described so that it could be replicated in practice? Yes / No
Yes, the intervention adequately describes to replicate it in practice
(d) Explain your response to (c)
The study focused on providing the patient with an SMS reminder for seasonal influenza vaccination. The study shows a positive result that can be evidenced by statistical analysis as well. The study has used baseline characters of patients, that were compared with control groups through X2 statistics. Other than this, the log-binomial method and seasonal regression model were used to determine the relative risk of seasonal influenza vaccination between the groups. Through this, it was found that SMS reminders for influenza vaccination were significantly increased as compared to non-SMS reminder patient.
(e) Describe the method/s used to collect data (you do not need to include basic demographic/sociographic data)
To conduct the study, the data was collected from the Department of Health Western Australia, through which the author has received the telephone number of patients who were high-risk individuals and suffer from seasonal influenza symptoms.
(f) Describe the randomisation process used in the study
Baseline data was extracted from the participating practices and six weeks after the start f influenza vaccination period in Australia. Out of 12,354 inclusive patients, half of the patient randomly assigned to receive SMS notification. The one who receives a notification is the intervention group; the one who does not receive it is the control group.
(g) Were any groups blinded in the study? If so describe
Yes, the general practice staff were blinded towards the patient’s group assignment
(h) Explain how the points in (f) and (g) reduce bias and contribute to the validity of the study
(a) What were the main findings of this study? (provide a dot point summary)
From the study, we can summarise the following:
The author wants to relate the vaccine reminder notification with active vaccination process.
Through the study, it was found that the SMS notification showed a significantly increased in seasonal influenza vaccination in high-risk patients.
The study was successful among parents of children less than five years, in terms that they were keener to provide vaccination to their children if receive the notification on SMS
The study also shows that SMS notification is one of the modest way (3.5%) of reminding the high-risk group individuals through SMS alert
However, the study does not show a much increase in vaccination among pregnant women and Aboriginal and Torres strait indigenous population.
(a) What were the limitations of this study stated by the author/s?
Authors have included only high-risk group people whose data is available on EHR. However, the approach neglects the patient pool that was not falling under the high-risk group category. The people whose data was not maintained in the EHR portal were also not included in the study. These create a sense of negligence in the incorporation of patients’ pool in the study. Other than this, the study relies on general practice records to identify the high-risk group, but most of these patients suffer from other chronic conditions and not necessarily seasonal influenza. Moreover, the inclusive criteria include those patients whose number is mentioned on the EHR record; thus, this also reduces the number of patients in the study. Thus, these limit the study research and design.
(b) Explain why these are study limitations.
These were the study limitation because; they are hindering the actual result criteria and are interfering with the study result.
(c) Explain why bias may reduce the validity of the study.
The bias can be reduced if the proper inclusive criteria were followed for conducting the study design. A different approach must be used for increasing the number of patients so that each patient must receive the SMS alert. This will broaden the population of participation in the study.
(a) According to the Levels of Evidence pyramid, what level of evidence are the reported results from this paper?
From the paper, it can be coined that the higher level of evidence pyramid is used. The author has mentioned the background information, case-controlled studies, cohort study, randomised controlled trials, critically-appraisal individual article, critically appraised topics, and systematic review. The presence of these factors determines the quality of evidence and the type of paper written by the author.
(b) Overall, should the outcomes of this study be used to inform evidence-based practice?
Yes / No
Yes, the outcome of the study is used to inform the evidence-based practice.
(c) Explain your rationale for your responses to questions (a) and (b).
In the paper, authors have clearly defined his thoughts, objective, method, study design, and statistical analysis of his finding. He has provided a flowchart of the participation of SMS reminders for people suffering from influenza. This determines the effected effect of 12,345 participants in response to an SMS notification. The author has also provided a baseline characteristic of patients participating in the trial, he has used a wide variety of characteristics like sex, age group, race, pre-existing medical history, marital status. In the end, he has also provided statistical analysis in terms of X2, log-binomial regression model insight to determine the risk of seasonal influenza vaccination. Moreover, the author has also related its study with the studies conducted back years, which provide a comparative analysis of his study with others. All these findings suggest a good and effective approach to make the paper evidence-based.
Regan, A. K., Bloomfield, L., Peters, I., & Effier, P. V. (2017). Randomized controlled trial of text message reminders for increasing influenza vaccination. Annals of Family Medicine, 15(6), 507-514. https://doi.org/10.1370/afm.2120
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