Randomized control trial design might be beneficial for the studies that explore the public health issue, and their results are frequently interpreted for a lay audience and published in popular sources. For instance, Newswise has recently posted an article, “Group-randomized Trial Showed Significant Improvement in Asthma Control Among Urban Black Adults,” and explained how chronic disease control is crucial for treatment (Columbia University School of Nursing, 2020). This paper aims to analyze the selected research, its ethical issues, and the impact randomized trial design selection had on its results.
Asthma remains a public health challenge because it is chronic and requires costly treatment. Furthermore, Columbia University School of Nursing (2020) states that “compared to whites and Hispanics, Blacks have a higher prevalence of asthma and are about three times as likely to die of the disease.” As an entire ethnical group is at a high risk of having severe asthmatic conditions, a randomized study was conducted to address the public health issue (George et al., 2020). The further publication in Newswise helped a broader audience access the results and made evidence-based decisions for addressing asthma-related problems.
The study’s purpose was to prove that the approach of dose-matched attention control of asthmatic conditions is outdated. The scientists developed the “BRief intervention to Evaluate Asthma THErapy” (BREATHE) strategy for evaluating the need for disease regulation (Columbia University School of Nursing, 2020). The population included 80 adults with an average age of 45 years, and 83% of them were female with uncontrolled persistent asthma, and ten clinicians trained for the program’s conditions. Half of the participants and healthcare providers were involved in the BREATHE routine, and another half exercised the common dose-matched attention control intervention (George et al., 2020). The research included data collection methods such as interviews, surveys, trials, lung tests, and post-intervention follow-ups and lasted from December 2017 to May 2019 (George et al., 2020). As a result, the BREATHE group showed more significant improvement in their conditions and decision-making than the dose-matched attention control one (George et al., 2020). The scientists concluded that the novel approach would improve asthma outcomes in a health disparity population, and the Newswise interpretation emphasized the impact of addressing a serious challenge of treating asthma.
The benefit of conducting a randomized study for testing the disease control approach is that such groups make the conditions average. The results become easier to measure because certain individual circumstances have less impact on overall outcomes (Hemming & Taljaard, 2020). This study had a relatively narrow group which is frequently considered a health disparity; therefore, randomizing was beneficial for reducing the biases influence and avoiding judgments after publishing. If other designs were selected for this research, the impact of BREATHE program on asthmatic conditions control would not be demonstrated objectively. Consequently, the results would not be applicable for a wide range of patients, and the impact of the study would be decreased.
Randomized studies which explore a particular group and conduct disease control intervention must consider ethical issues and limitations. The researchers worked with 80 black or multiracial adults, most of whom were female; however, they have not included the description of their common disease control approaches. Treatment opportunities display the participants’ socioeconomic status and might incorrectly reflect the real conditions of their ethnicity. Moreover, the ethical limitation in the given study is related to that half of participants were restricted from receiving a better disease control option crucial for their health (Hemming & Taljaard, 2020). These ethical issues frequently prevent randomized studies from implementing methodologies that would improve the outcomes.
Randomized control trial design can help healthcare providers and scientists test novel treatment strategies and optimize the disease control for chronic conditions. Asthma is one of the severest healthcare challenges, and specific populations suffer from it harder than others; therefore, separated research is necessary. Publishing the related articles in the widely available sources helps increase awareness of disease control and prevention strategies. The randomized design has ethical limitations, yet it allows the results to be published without privacy issues.
Columbia University School of Nursing (2020). Group-randomized trial showed significant improvement in asthma control among urban black adults. Newswise.
Friis, R. H., & Sellers, T. A. (2021). Epidemiology for public health practice (6th ed.). Jones & Bartlett.
George, M., Bruzzese, J. M., S. Sommers, M., Pantalon, M. V., Jia, H., Rhodes, J., Norful, A. A., Chung, A., Chittams, J., Coleman D., & Glanz, K. (2020). Group‐randomized trial of tailored brief shared decision‐making to improve asthma control in urban black adults. Journal of Advanced Nursing, 77(3), 1501-1517.
Hemming, K., & Taljaard, M. (2020). Reflection on modern methods: when is a stepped-wedge cluster randomized trial a good study design choice?. International Journal of Epidemiology, 49(3), 1043-1052.