Submited on: 28 Sep 2010 10:44:34 AM GMT
Published on: 28 Sep 2010 07:12:17 PM GMT
 
Critical appraisal
Posted by Dr. William Kent on 19 Jun 2011 06:06:25 PM GMT

1 Is the subject of the article within the scope of the subject category? Partly
2 Are the interpretations / conclusions sound and justified by the data? No
3 Is this a new and original contribution? Yes
4 Does this paper exemplify an awareness of other research on the topic? No
5 Are structure and length satisfactory? No
6 Can you suggest brief additions or amendments or an introductory statement that will increase the value of this paper for an international audience? Yes
7 Can you suggest any reductions in the paper, or deletions of parts? No
8 Is the quality of the diction satisfactory? No
9 Are the illustrations and tables necessary and acceptable? No
10 Are the references adequate and are they all necessary? No
11 Are the keywords and abstract or summary informative? Yes
  • Other Comments:

    Critical appraisal1 

     

    Criteria

    Comment

    Evaluation*

    Research Question

    Study design:

    Prospective cohort study

    CRD evidence level = 3a

    Population:

    68 of 89 patients with SCI at 1 centre in Nigeria.

     

    Y

     

    Intervention/

    Exposure:

    1. 18 of 22 with catheter encrustation had Bladder stones on USS scan

     

    2. 37 UTI of which 27 had bladder stones

    Y

     

     

    Comparison/

    Control:

    1. 7 of 46 without catheter encrustation had bladder stones

     

    2. 0 OF 31 WITHOUT UTI had bladder stones

     

    Y

    Outcome:

     

    CGO

    EGO

    1

    15.2%

    81.8%

    2

    0%

    72.9%

    3

     

     

     

    Y

     Follow-up duration:

     

    3 months

    Y

    Minimizing bias, confounding & chance

    Recruitment

    Randomization

    N

    Inclusion criteria

    N

    Exclusion criteria

    N

     

    N

    Allocation

     

     

    N/A

    Maintenance

     

     

    N/A

    Measurement

    blinding

    N

    objectivity

    N

     

     

     

    N

    Statistical analysis

    Sample size calc.

    N

    ES

    Y

    p & precision (95%CI)

    N

    Intention to Rx

    N

     

    N

    Outcomes

    Relative risk (RR) = EGO/CGO

    OUTCOME 1 RR = (18/22)/(7/46) = 5.38 Outcome 2.  RR n/a

     

     

     

    Risk (Absolute) difference (RD) = CGO – EGO

    Outcome 1. RD = 0.66

     

     

     

     

    NNT = 1/RD

    =1.5

     

     

    Adequacy of reporting

    Suggested checklist for writing cohort studies (STROBE checklist)2

    Only 6/22 items on checklist adequately described

    * Y = adequate; N = inadequate; ? = unsure/not reported; n/a = not applicable

                       

    Evaluation, limitations & suggestions for improvements

    An interesting topic of research with an appropriate study design for generating incidence data and demonstrating associations. However, the reporting of the trial is inadequate and much of the required information is missing to fully assess the quality of the trial (only 6 / 22 STROBE criteria are met).  The validity of the conclusion is therefore hard to ascertain.  Re-writing the paper according to the STROBE recommendations would improve this paper and correct some of the omissions  (e.g. the study design should be stated in the title, the scientific rationale and hypotheses need to justified in the introduction, eligibility criteria and reasons for exclusion of participants, sample size justification, how statistical studies are applied- they are described but not presented etc). Further methods for reducing confounding and bias should also be discussed (see Kent, W. Why not just flip a coin? Randomisation and blinding in clinical trials:Educational article [Internet]. Version 8. Open Journal of Medicine. 2011 Jun 13. Available from: http://knol.google.com/k/w-kent/why-not-just-flip-a-coin-randomisation/1blm6ty1i8a7z/4) as well as the advantages and limitations of different trial designs (see Kent, W. The advantages and disadvantages of observational and randomised controlled trials in evaluating new interventions in medicine:Educational article [Internet]. Version 6. Open Journal of Medicine. 2011 Jun 9. Available from: http://knol.google.com/k/w-kent/the-advantages-and-disadvantages-of/1blm6ty1i8a7z/8).

  • Competing interests:
    No competing interests.
  • Invited by the author to review this article? :
    No
  • Have you previously published on this or a similar topic?:
    No
  • References:
    None
  • Experience and credentials in the specific area of science:

    Foundation trainee in orthopaedics and sports scientist

  • How to cite:  Kent W .Critical appraisal[Review of the article 'Bladder Stones in Catheterized Spinal Cord Injured Patients in Nigeria ' by Olawepo A].WebmedCentral 2011;2(6):WMCRW00829
1 2 3 4 5 6 7 8 9
Report abuse