This written assessment is a critical appraisal of the selected article that described the applicability and reliability to answer the question. The question framed is based on the Taylor family which has a concern that autism is linked with vaccination and the sisters doubt that their brother has autism because he got vaccinated for immunization. This is a critical appraisal of two articles which are rebuttal to each other. The critical appraisal was performed for both the articles to prove their authenticity and to extract the evidence. The evidence collected from both of these articles was compared for their authenticity and the conclusion was drawn based on this comparison.
The comparison was made to compare the information and this was selected as the answer to the question. This evidence was then supported with literature and this was highly relevant. The findings of this study were drawn based on this comparison and the conclusion best answered the question of Alison and provided the best available evidence for helping her to persuade Emily to get her children vaccinated as there is no link between autism and vaccination.
The main focus of this essay is on the Taylor family as this family has three children out of which the son Edward has autism since the age of five. One of the sisters Emily believes that her brother is suffering from autism because he got vaccinated in childhood. The main question asked by Alison the second sister of Edward is, what evidences she should use to persuade her sister Emily to get her children vaccinated as she is against this vaccination. Emily does not get her children vaccinated and this concerns Alison who is in favour of vaccine and gets her children vaccinated.
This is a critical analysis of the chosen article that will help in analyzing the conclusion so that it can be used as a piece of evidence by Alison to persuade Emily to get her children vaccinated. The main aim of this article is to investigate a consecutive series of children who are suffering from chronic enterocolitis and regressive developmental disorder. The methodology adopted for the analysis was a primary data collection method which involved clinical investigations, laboratory investigations and histology assessment (Wakefield et al., 1999). All the details of selected children who initially showed normal development and after some time they lost the acquired skills. The strength of this article is that it collected the details of immunisations and their data of exposure to infectious diseases and the assessment of children.
The laboratory investigations involved the investigation of thyroid function, urinary creatinine and the children were also screened for anti endomysial antibodies. The weakness of this article is its adopted methodology and the results were obtained from the laboratory, endoscopic and histological findings only. There is no clear evidence of one type of data and multiple factors were analysed that has led to the conclusion that the onset of the behavioural symptoms was noticed with the vaccination of measles, mumps and rubella vaccination. This is a cohort study that is a primary observational study that is a low level of evidence (Burns et al., 2011). The weakness of this article is that it only tests the children for the risk of autism with vaccination with very few diseases like chronic enterocolitis disorder.
The article that has helped in gaining knowledge and that serve as evidence that there exists no association between autism and vaccination is a systematic review. This is the highest level of evidence and this makes it more efficient for its applicability (Tabacchi et al., 2016). The MMR measles, mumps and rubella immunization are very important for children all across the globe. The parents of these children have some misconceptions related to these vaccines that draw them back from using it for immunization. This is a systematic review and a meta-analysis that determines the parents' decision on the vaccination of their children. The conclusion of this article states that there are many misconceptions of the parents and there is no link between vaccine and autism.
This literature possesses a denial of this link and it states that the possible mechanism underlying the real upset of autism is very different (Tabacchi et al., 2016). This is a highly reliable source of information and is a high level of evidence. It also states that the parents of these children fear the development of some behavioural changes because they think that their children might get affected by the vaccines. This is secondary based evidence which forms the conclusion based on wide-ranging literature.
The literature in this article has high implacability and applicability and is better than primary evidence because the primary evidence is limited to an area but secondary evidence collects the articles from various sources like databases. The strength of this article is that it takes into account the perception of the parents that do not prefer their child getting a vaccination for immunization and address this issue by giving denial of a link between autism and vaccination.
This article also takes into account the evidence that is suggested by WHO and UNICEF which states that the parents should not take decisions about the whole vaccine schedule and they should only make evidence on the individual vaccine. They should be educated on the importance of immunization vaccines (Dudley et al., 2018). The strength of this article is its methodology because the different papers cover a larger aspect of demographics and consider the factors of their ethnicity and the child's age factors.
The findings of this study can also be supported with various sources as it is authentic and more reliable than the primary study findings. There exists no link between autism and vaccination and the children should be given the vaccination for immunization from measles, rubella and mumps (Wilder-Smithh & Qureshi, 2019).
Alison should give this evidence to Emily for making her children get vaccinated and to make her understand the importance of immunization vaccination as it has no link to the development of autism. The behavioural symptoms are not observed after the vaccination given to the children for immunization and there is no risk behavioural disorder like autism in children (Fombonne, 2020). The secondary data based article selected has a high level of evidence as has better methodology as compared with primary data article.
The family group of Taylor will be educated to use the secondary data-based evidence to educate Emily to get her children vaccinated. She thinks that her brother Edward has developed autism because he was vaccinated in his childhood and this fear of hers like many parents does not allow her to get her children vaccinated. The systematic review thus gives a high level of evidence showing that there exists no link between autism and vaccination and the parents need to be educated on this. This highly reliable and applicable evidence should be used by Alison and this will help Emily in believing the positive side of vaccination that provides immunization to the children and protects them from a various disease like mumps, measles and rubella.
Burns, P. B., Rohrich, R. J., & Chung, K. C. (2011). The levels of evidence and their role in evidence-based medicine. Plastic and Reconstructive Surgery, 128(1), 305.
Dudley, M. Z., Salmon, D. A., Halsey, N. A., Orenstein, W. A., Limaye, R. J., O’Leary, S. T., & Omer, S. B. (2018). Do vaccines cause autism?. In The Clinician’s Vaccine Safety Resource Guide (pp. 197-204). United States: Springer, Cham.
Fombonne, E. (2020). Epidemiological controversies in autism. Swiss Archives of Neurology, Psychiatry and Psychotherapy, 171(01).
Tabacchi, G., Costantino, C., Napoli, G., Marchese, V., Cracchiolo, M., Casuccio, A., ... &Esculapio Working Group. (2016). Determinants of European parents' decision on the vaccination of their children against measles, mumps and rubella: A systematic review and meta-analysis. HumanVaccines&Immunotherapeutics, 12(7), 1909-1923.
Wakefield, A.J., Murch, S.H., Anthony, A., Linnell, J., Casson, D.M., Malik, M., Berelowitz, M., Dhillon, A.P., Thomson, M.A. . (1999). Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. The Lancet, 351.
Wilder-Smith, A. B., & Qureshi, K. (2019). Resurgence of Measles in Europe: A Systematic Review on Parental Attitudes and Beliefs of Measles Vaccine. Journal of Epidemiology and Global Health.
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