Type 2 diabetes mellitus (T2DM) remains a severe healthcare issue for patients both worldwide and in the US alone. Despite the variety of approaches to the treatment of T2DM, there is no explicit clinical evidence on the superiority of any of them. The motivation behind the scholarly inquiries presented by Courcoulas et al. (2020), Shauer et al. (2017), and Aminian et al. (2020) was the limited amount of data presented on the efficacy and long-term patient outcomes of bariatric surgery as an instrument for T2DM treatment. Since nurses are responsible for introducing the most relevant and efficient patient practices in order to improve the intervention outcomes, it is imperative to look into the present scholarly evidence on the matter of surgical treatment of T2DM due to the issue’s seriousness and prevalence in the current health care context (Stucky et al., 2020).
When defining the source’s credibility, four major criteria are to be addressed, including:
- the relevance of source (it shall be published within last five years);
- authorship, which should contain academically recognized professionals;
- the source of information, which should be either a government-related source or scholarly database such as PubMed;
- objectivity, which means that the source should be by no means funded or written by biased authors and organizations.
One of the most widespread instruments designed to appraise the credibility of the evidence is the (Non)Research Evidence Appraising Tool. Fundamentally, the tools categorize the evidence into three major groups: “A,” “B,” and “C” levels, with “A” being the highest (Wood, 2019). For instance, when applying these crriteria to the research conducted by Courcoulas et al. (2020), the AORN tool identifies the article as the one with high evidence rating of IB, and the article is published in a peer-reviewed scholarly source The Journal of Clinical Endocrinology & Metabolism in 2020, and the authors declare no conflict of interest and external funding except for the funding allocated by a governmental grant support. Hence, the source may be considered as a credible backing for EBP in the context of treating T2DM.
When considering the credibility and relevance of the three aforementioned articles, it should be noted that all of them are relevant due to the publication date varying within the past five years and the absence of explicit conflicts of interest or ethical issues. The studies conducted by Courcoulas et al. (2020) and Schauer et al. (2017) are RCTs and qualify for the strongest evidence type. The research by Aminian et al. (2020), for its part, is a retrospective cohort study most likely categorized as quasi-experimental research with a II score. However, as far as the quality is concerned, the “A” quality level may be given to Aminian et al.’s (2020) study due to sufficient sample size and comprehensive and coherent outcomes.
The information used in all the sources is supported by external scholarly evidence, and all the publications may be found on PubMed with the help of the digital object identifier (DOI) and in the peer-reviewed scholarly medical journals. While all the sources are applicable for EBP, the study conducted by Aminian et al. (2020) is the most relevant due to the scope of conducted research in terms of sample size and literature review prior to the intervention.
The EBM model chosen for the present issue is an IOWA model, as it is an application-oriented practice model. In terms of this model, all scholarly evidence should be scientifically reasonable and relevant to the PICOT question outlined (Cabarrus College of Health Sciences Library, 2021). In the case of T2DM treatment, the implementation of credible evidence is explicitly related to saving lives of people with a severe chronic condition. For example, the study presented by Courcoulas et al. (2020), although credible in terms of theoretical background and objectivity, cannot be used in isolation from other sources, as the sample of 61 participants shall not be extrapolated to the general population. However, once reviewing this evidence within the paradigm of other scholarly evidence on the matter, nurses may have a chance provide the best possible care at a given time.
Aminian, A., Vidal, J., Salminen, P., Still, C. D., Hanipah, Z. N., Sharma, G., Tu, C., Wood, G. C., Ibarzabal, A., Jimenez, A., Brethauer, S. A., Schauer, P. R., & Mahawar, K. (2020). Late relapse of diabetes after bariatric surgery: Not rare, but not a failure. Diabetes Care, 43(3), 534-540. Web.
Cabarrus College of Health Sciences Library. (2021). IOWA model of evidence-based practice. Web.
Courcoulas, A. P., Gallagher, J. W., Neiberg, R. H., Eagleton, E. B., DeLany, J. P., Lang, W., Punchai, S., Gourash, W., & Jakicic, J. M. (2020). Bariatric surgery vs. lifestyle intervention for diabetes treatment: 5-year outcomes from a randomized trial. The Journal of Clinical Endocrinology & Metabolism, 105(3), 866-876. Web.
Schauer, P. R., Bhatt, D. L., Kirwan, J. P., Wolski, K., Aminian, A., Brethauer, S. A., Navaneethan, S. D., Singh, R. P., Pothier, C. E., Nissen, S. E., & Kashyap, S. R. (2017). Bariatric surgery versus intensive medical therapy for diabetes – 5-year outcomes. The New England Journal of Medicine, 376, 641-651. Web.
Stucky, C. H., De Jong, M. J., & Rodriguez, J. A. (2020). A five‐step evidence‐based practice primer for perioperative RNs. AORN Journal, 112(5), 506-515. Web.
Wood, A. (2019). Updates to the AORN evidence rating model. AORN Journal, 110(1), 5-8. Web.