Healthcare Workers and Trial Article Critique

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Therapist differences in a randomised trial of the outcome of cognitive behaviour therapy for health anxiety in medical patients." It was authored by Tyrer et al. and appeared in the International Journal of Nursing Studies in 2015.

Did the trial address a clearly focused issue?

After thoroughly anatomizing this article it is clear that the trial described within it certainly did address a clearly focused issue. Specifically, the authors were looking to determine which group of healthcare practitioners was best suited to assist patients with health anxiety through the usage of cognitive behavior therapy. In particular, the authors were looking to discern whether or not nurses nurses could demonstrate a greater efficacy for this task than other groups of medical practitioners. Therefore, the authors utilized original research in the form of a randomized clinical trial to see if nurses could prove they had such effectiveness with this particular issue: that of successfully implementing cognitive behavior therapy for patients who were afflicted with some form of health anxiety.

2. Was the assignment to patients to treatments randomized?

Absolutely, the assignment of patients to treatments was entirely randomized. The researchers were able to produce this effect firstly by pooling all of the patients from a homogeneous source. They were taken from various medical centers throughout England and were seen for a variety of different events. Moreover, the researchers deployed to the two branches of the study via block randomization generated from a computer sequence in which "The allocation sequence was not available to any member of the research team until databases had been completed and locked" (Tyrer et al., 2015, p. 688). Thus, it is clear that the randomization of patients was entirely impartial and quite effective in this regard.

3. Were all of the patients who entered the trial properly accounted for at its conclusion?

There were a fair amount of patients who entered the trial who were not properly accounted for at the conclusion of he aforementioned research paper.

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The vast majority of the patients who were not accounted for were not mentioned. There was little more than a cursory explanation for these patients. According to the researchers (2015) 445 patients were randomized to the trial and 376 (76%) completed the follow-up after two years" (p. 689). The reader is largely left to the infer that the majority of the 24% which did not complete the trial simply declined to participate once the trial began. The best attempt made to explain this fact is that of the patients randomized to the therapist group, "15 therapists did not respond for treatment after randomisation and 6 more did not attend initially but did have some form of contact later" (Tyrer et al., 2015, p. 689).

4. Were patients, health workers and study personnel 'blind' to treatment?

The patients were certainly blind to the treatment or the control group. The healthcare workers were equally blind to this fact. They received training on how to implement cognitive behavioral therapy, but were not appraised of the overall study design and the control involved. However, the study personnel were not blind to the treatment, since they were the ones how devised the study and required cognizance of it to assess their hypotheses.

5. Were the groups similar at the start of the trial?

The groups were identical in every way possible at the start of the trial. In fact, the researchers took several measures to include the fact that there was no differences between the two groups. The entire population for this study was pooled from those attending out-patient clinics for a variety of areas of assistance, including cardiology neurology, and others. Moreover, they were pooled from six different hospitals in different parts of England (Tyrer et al., 2015, p. 687). Still, the crux of the absolute parity found between the two groups lies in the way in which they were randomized, which further corroborates the equality between.....

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