• Introductory paragraph – provide an introductory paragraph that gives the reader
background information on the article you are evaluating.
• Internal Validity – discuss and evaluate the factors that impact internal validity (internal study
methods). State if the article is internally valid.
• This can include participant selection (random/non-random), researcher involvement, sample size calculation, search process, search criteria, participant selection, reducing bias, reducing confounding factors, etc.
• Provide recommendations to improve the internal validity of the study (must be ethical). If there are no recommendations, support why.
• External Validity – discuss and evaluate the factors that impact external validity (application to a population outside the study).
• This can include sample size, study population, statistical significance, ability to achieve outcomes or apply results outside the study, etc.
• Provide recommendations to improve the external validity of the study (must be ethical). If there are no recommendations, support why.
• Summary – provide a concluding paragraph about your evaluation of the article, bringing the most important key points and recommendations forward.
Sheehy et al. (2017) studied the effectiveness of Subanesthetic doses of ketamine in the treatment of pain children, adolescents, and young adults, as well as its efficacy the reduction of opioid intake. The study involved children with acute and chronic pain syndromes receiving treatment in a tertiary pediatric hospital’s inpatient setting. The longitudinal cohort study of 230 different patients revealed that ketamine infusions led to significant reductions in mean pain scores. As a result, the study showed the efficacy of ketamine infusions in treating pain unresponsive to routine pharmacologic interventions as well as a reduction in opioid intake. The assignment evaluates the article’s internal and external validity, factors that impact each, and recommendations on how to improve each. Although the two measures of validity were met, the researchers could improve by conducting an experimental study in multiple settings and using a larger sample.
The focus in this area is the factors that affect the internal validity of a study, such as the size of the population, participant selection and sample size, researcher involvement, sample size calculation, reducing bias, reducing confounding factors, time taken to collect data, and maturation. The study used a purposive sampling method in a cohort study, using patients who had received subanesthetic doses of ketamine. As a result, they did not use any sample calculation method. They used 230 different patients in the study who met the inclusion criteria. Researcher involvement in the study was minimal because Sheehy et al. (2017) used data available at the hospital for patients admitted between January 2006 and April 2014. As a result, the study did not suffer the effect of researcher bias. They used medical charts to retrieve information regarding the efficacy of the target treatment and used recorded pain scores throughout admission days. The period for the data collection (between January 2006 and April 2014) was adequate and would provide valid findings. However, changes could have occurred during the period, such as the nature of pain, which were unaccounted.
The recommendation to improve the internal validity of the study would be to use an experimental study, with the treatment and control groups. The approach would address various factors that affected internal validity, such as the lack of randomization, selection bias, controlling for confounding variables, such as potential of a different treatment used in the course of the disease, changes over time, and researcher control over the sampling method and sample size. Nevertheless, the study met the criteria for an internally valid study.
The section focuses on factors that affect external validity (the way the parameters apply to populations outside of the study), such as population characteristics independent variable description, interaction of subject selection and research, researcher or experimenter effects, data collection methodology, the effect of the research environment, and the effect of time. The study was conducted in a single setting, regular patient care units in a tertiary pediatric hospital. However, the researcher addressed the limitation by collecting data from a large sample and over a long period (between January 2006 and April 2014). The characteristics of the participants are clearly defined, including “sex, age, race, ketamine infusion duration, pain duration (acute vs chronic), pain diagnoses, primary clinical diagnosis, functional gastrointestinal disorder, inflammatory disease, and primary pain location” (788). Considering that the data was skewed of the data, Sheehy et al. (2017) used the Wilcoxon signed-rank test to test for statistical significance. They found 95% confidence interval [CI]) and p-values <0.05 found to be statistically significant. Other factors, such as the sample size and study population, revealed external validity and potential of applicability of the findings to other settings.
However, the researcher would have achieved greater external validity in the study by using more than a single setting to collect the data. The use of more settings would improve the applicability of the findings outside the study setting. The present study is limited in this areabecause the Sheehy et al. (2017) focused on a single setting. Furthermore, the researchers would increase external validity by increasing the sample size from multiple settings. The study would provide results with a higher statistical significance and increase generalizability.
Research findings are useful in practice if they can be applied in real-life settings to improve practice. The reviewed article contains findings of research to establish the effectiveness of Subanesthetic doses of ketamine in the treatment of pain children, adolescents, and young adults, as well as its efficacy the reduction of opioid intake. The evaluation focused on the internal and external validity of the study. The research revealed a high level of internal and external validity because of the various factors that affect each was met. However, the researchers would have improved the measures of internal and external validity by conducting an experimental study using patients drawn from multiple settings, as well as using a bigger sample to improve generalizability. Future efforts could use the findings as to the foundation for study on the efficacy of ketamine in the treatment of pain children, adolescents, and young adults.
Sheehy, K. A., Lippold, C., Rice, A. L., Nobrega, R., Finkel, J. C., & Quezado, Z. M. (2017). Subanesthetic ketamine for pain management in hospitalized children, adolescents, and young adults: a single-center cohort study. Journal of pain research, 10, 787-795. doi:10.2147/JPR.S131156
Summary – provide a concluding paragraph about your evaluation of the article, bringing the most important key points and recommendations forward.