Overview of the Study
The research conducted by El-Jawahri and colleagues (2015) looks into the issue of advance care planning with a critical focus on cardiopulmonary resuscitation (CPR) and intubation for the severely ill hospitalized patients. The authors seek to identify the impact of a video decision tool on the patient choices, knowledge, medical orders, and interaction with providers. The randomized controlled trial presented a three-minute video describing CPR and intubation along with verbal communication to a sample population of 150 patients of a mean age of 76 years old and a prognosis of 1 year or less. The results of the study showed that following the presentation of the video, majority of the patients were more informed about their options for treatment and discuss their preferences with medical providers. However, they were less likely choose the treatment and more likely to set orders to forgo it altogether.
Potential Weaknesses of the Study
The use of RCTs has become a common approach for conducting clinical research in numerous health concerns. Although these experiments have brought about significant benefits in the field of medicine and healthcare practice, it presents multiple weaknesses as depicted in the study in question. One of the major concerns of incorporating this practice is the ethical implications of the study as it will usually result in the denial of treatment of one group as has been seen in the above case. Secondly, the experiment may not realize results that can mimic real life application. In this case, it is essential that the RCTs are conducted on a large sample population whereas the particular concern for the study may be too specific leading to decreased variance and lacking applicability. The aforementioned weakness arises from incidence of recruitment bias that may be too difficult to overcome as is evident in the above case where participants of the study had to be seriously ill, hospitalized, above the age of 60, and had a prognosis of 1 year or less. With only two hospitals as the source of the participants and over two years of conducting the study, only 150 patients were found. In this regard, the fourth weakness is evident where the experiment requires a huge amount of financial resources to conduct a study that can be implemented over a large population.
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References
El-Jawahri, A., Mitchell, S. L., Paasche-Orlow, M. K., Temel, J. S., Jackson, V. A., Rutledge, R. R., ... & Lopez, L. (2015). A randomized controlled trial of a CPR and intubation video decision support tool for hospitalized patients. Journal of General Internal Medicine, 30 (8), 1071-1080.
