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  • Subject Name : Clinical Nursing

Quality assessment of a clinical study

A 37-year-old woman wants to know if severe pain within the lumbar region of the spinal cord should be treated by surgical intervention or by conservative treatment.
You have found a retrospective study published by a surgeon of a local hospital 40 male patients were treated in this clinic. 22 were forwarded to the Surgery and 18 were treated conservatively. After 2 months the pain level was evaluated. All patients with surgical treatment and 10 of the conservatively treated persons stayed in the clinics. The rate of pain level reduction was slightly higher than in the group treated conservatively.
There are several concerns that should be mentioned with respect to the quality of this study. Which aspect is of specific interest in each of the following sentences

1.1 Due to the comparably small number of participants the study might provoke a wrong impression with respect to the effect of the surgical intervention.
A) Selection bias in this context can occur because the selection of the population was not done randomly.
B) Information bias
C) Confounding
D) Results can be obtained by chance
E) External validity (generalization to a broader population)

1.2 The results of this study cannot be applied to your patient as the study analyzed the outcome for male patients and your patient is female.
A) Selection bias
B) Information bias
C) Confounding
D) Results obtained by chance
E) External validity (generalization to a broader population) External validity because the study is not related to gender-specific complications.

1.3 The patients that were sent to the surgical intervention were younger than those with conservative treatment.
A) Selection bias because of nonhomogeneous baseline characters of selected population.
B) Information bias
C) Confounding
D) Results obtained by chance
E) External validity (generalization to a broader population)

1.4 Two months after the decision for surgical treatment or conservative treatment a smaller number of patients of the conservative treatment group stayed within the clinics.
A) Selection bias
B) Information bias
C) Confounding bias because there are external factors that are affecting the outcomes of the study.
D) Results obtained by chance
E) External validity (generalization to a broader population)

1.5 Compared to the surgically treated patients the conservatively treated patients might have a lower tendency to talk about their pain level and the respective physicians might have been not that much interested in noting the pain level into the case sheets.
A) Selection bias
B) Information bias
C) Confounding
D) Results obtained by chance These results may be obtained by chance because of the consent of the patient and doctors for not sharing the information or their experiences.
E) External validity (generalization to a broader population)

 

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