The title of the article is good as it suggests the key variables (primary care diabetes, primary care physicians, and nurse practitioners) and the study population (Medicare patients) (Lutfiyya et al., 2016). Similarly, the abstract is clear and it concisely summarizes the main features of the report including aims, background, design, methods, results, and conclusions.
In the introduction section, the statement of the problem is stated unambiguously, it is easy to identify, and it builds a cogent and persuasive argument for the new study by highlighting why the research is needed and its relevance to nursing. In addition, there is a good match between the research problem and the paradigm and methods used and the quantitative approach is appropriate for this study. The authors have clearly stated the aims of the study.
The study’s research questions are explicitly expressed with appropriate wording and clear specification of key variables and the study population and they are consistent with the literature review and the conceptual framework. However, hypotheses are lacking in the study but their absence is justified by the inclusion of clear research questions. Additionally, the literature review is current with most of the sources (which are mainly primary studies) published within 10 years. The review provides a state-of-the-art synthesis of evidence on the research problem and a solid base for the new study. Similarly, key concepts are adequately defined conceptually using a theoretical framework.
The study used de-identified secondary data and thus human subjects were not involved. Consequently, the study did not require external review or oversight from the Institutional Review Board (IRB). The most rigorous possible design was used given the purpose of the research and appropriate comparisons were made to enhance the interpretability of the findings. The instrument used (five percent SAF) was appropriate valid, and reliable.
However, given the nature of the study, there was no need to design it in a way that minimizes biases and threats to the internal and external validity of the study. One data collection point, the 2012 Medicare National Claims History file, was used and it was appropriate. People who had made claims could be taken as the population sample, which is described sufficiently in the article. The random sampling design was used, biases were minimized, and the sample size was adequate even though power sample was not used given the nature of the study.
The operational and conceptual definitions are congruent and key variables were operationalized through observation with adequate justification, but the specific instruments were not described nor do they have documented reliability and validity given the nature of the study. However, the report provides evidence that data collection methods yielded reliable and valid data. There was no intervention given that the study did not use human subjects, but the data was collected in a way that reduces bias, hence the study is easy to replicate.
Analyses were taken to address the research question using appropriate statistical methods, the most powerful analytic method was used, and the issue of Type I and Type II errors is not addressed. The findings are adequately summarized, tables and figures have not been used, the results are valid and reliable, and they are presented in a manner that facilitates a meta-analysis with enough information needed for evidence-based practice.
All major findings are interpreted and discussed within the context of prior research and interpretations are consistent with the results and the study’s limitations. However, the report does not address the issue of the generalizability of the findings. The researchers have discussed the implications of the study for clinical practice and further research and the implications are reasonable and complete.
The report is well written, organized, and sufficiently detailed for critical analysis in a manner that makes the findings accessible to practicing nurses. Additionally, the researchers’ qualifications and experience enhance confidence in the findings and their interpretations. Finally, the study findings appear to be valid and it contributes to meaningful evidence that can be used in nursing practice.
Lutfiyya, M. N., Tomai, L., Frogner, B., Cerra, F., Zismer, D., & Parente, S. (2016). Does primary care diabetes management provided to Medicare patients differ between primary care physicians and nurse practitioners? Journal of Advanced Nursing, 73(1), 240-252. Web.