Critique Paper Quantitative

Critiquing Evaluation Criteria for Quantitative Research Article

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Ana G. Méndez University

NURS-502

Instructor: XXXXXXXXXXXXXX

2019

Critiquing Evaluation Criteria for Quantitative Research Article

The title of the article selected is Association between sarcopenia and mortality in healthy older people, the authors are Daniel Bunout, Maria P de la Maza, Gladys Barrera, Laura Leiva, and Sandra Hirsch; and fortunately in references, found some articles written by some of them, and it has authors credentials to let us know more about them, and give us more credibility on the literature review.

The title is clear including group of studies (older people) but not area where the research would be done. The purpose of this study is presented and discussed the importance of the problem; it is stated at the beginning of the report “to evaluate the association between loss of fat-free mass and mortality among older people.” Also shows the key points that sarcopenia is associated with functional decline in older people, and appendicular fat-free mass is a significant predictor of mortality in them. Researchers also provide an idea of ​​what they are doing and why it can offer useful importance to evaluate the association between fat-free mass and mortality among older people. They stated that “the available prospective studies show an association between functional measures or frailty and mortality rather than muscle mass per se” and they wanted to evaluate the association between muscle mass (and fat-mass) with mortality in a cohort of healthy older people.

The problem statement is clear because many factors have been evidenced to associate loss of muscle mass with loss of muscle strength and function, but not as a potential predictor of mortality, and it’s the aim to be evaluated on this work.

During the study, the authors identify key research points and variables to be examined. The length of survival was tatted as dependent variable, and age, appendicular fat-free mass/height, and appendicular fat mass /height as independent variables, stratifying by sex; also were added life table analyses considering survival as a dichotomous variable, using the time of death or end of follow-up as the censoring variable, and sex-specific quartiles of appendicular fat-free mass.

Sarcopenia, as stated by the researchers, “is defined as the inexorable loss of muscle mass that occurs with aging”. Available prospective studies only show the association between the functional measures or frailty and mortality rather than muscle mass per se, and the purpose of this study was to evaluate the association between muscle and fat mass, measured by DEXA and death in a cohort of healthy older people. The study has the potential to help solve this problem that is currently faced in clinical practice.

The literature review follows a logical sequence that leads to a critical analysis of previous work support and conflict, since it refers to earlier studies of the case, making comparisons and drawing the same results valid for issuing proposals for improvement of the situation. But there is not a full literature review, because, after a little introduction where references are made, the authors begin immediately with the method of study. Then they added more literature review in the Discussion section, but not too much. The need for the present study, to the authors, is to complement and further deepen existing studies.

The authors did not emphasize a rationale for the conceptual framework, which supports the basis of the study. At the Discussion section they stated “these results show that the loss of appendicular fat-free mass was significantly associated with mortality among people aged over 74 years of age”, so it liked to be their hypothesis, if so, then we could say that the hypothesis was posed precisely and in a form that permits it to be rested.

Regarding the methodology used, the variables are relevant, and the concepts are clearly defined as the purpose of the study. Despite not having a clear question in the study proposal, and not being sure if what stated in my paragraph before was the hypothesis on it, I think that the design used is appropriate to find answers for this theme.

The methods of data collection are sufficiently described; it was the information of healthy older people between 1995 and 2005, with body composition measured by DEXA. They had to leave independently in the community and be free of disabilities diseases (cancer, cardiac or renal failure). Life table analyses were performed considering survival. One thousand four hundred thirteen participants (1001 women and 412 men) were included in the report, but there was no information about how they were recruited.

The study does not refer to identified or potential threats to internal or external validity, but they reported at the end of it that they did not measure functional parameters that were associated with mortality and that there was no record regarding chronic conditions that could modify the mortality results. The methods data collection is not sufficiently described (as explained before). It did not specify if all the researchers were data collectors or one of them only was. It’s no clear for me.

Both sampling methods and subjects were described in the Methods section. They explained that it was a large population of participants (1413).All participants signed informed consent at the time of examination, authorizing the authors to use the data obtained for research purposes. The Institute of Nutrition and Food Technology Ethics Committee approved the studies.

The instruments for data collection used are appropriate for this study. They used body composition obtained by DEXA, body mass index, and performed a Cox proportional hazards model with the variables listed above. Also, I think the reliability and validity of the measuring instruments of the study are adequate because were performed all statistical analysis using Intercooled Stat 9.1 for Windows, numerical values with a normal distribution were expressed as mean +/- standard deviation, and with non-normal distribution were expressed as median and range. Also survival differences between participants allocated in different quartiles of body composition were compared by X 2 analysis.

The results for each were clearly and objectively presented in the study. They offer the characteristics of the study population on the results, and also tables that illuminate the presentation of results, with characteristics demographics, anthropometrics and the body compositions of participants by sex, and also they presented figures showing the twelve-year survival of older people between 74 and 78 years of age, and according to sex-specific fat-free mass/height.. This makes the presentation of the subject much easier to understand, besides supporting the theoretical framework raised and affirms the bibliography even more.

The conclusion on this study are based on the results and related to the hypotheses that “the loss of appendicular fat-free mass was significantly associated with mortality among people aged aver 74 years of age, but fat mass was not predictive of mortality”. The researcher stated that in previous report they showed that there was a median loss of fat-free mass among women and men, but weight remained stable as there was a simultaneous increase in fat mass, and it would be associated with a significant reduction in walking capacity, disabilities, and even death, if there’s not preventive intervention on it. Figures illuminate the presentation for results, table show demographic, anthropometric and body composition parameters of the participants.

They concluded that their study “showed having a low amount of appendicular fat-free mass is a significant predictor of mortality in older people and that efforts should be made to prevent age-associated Sarcopenia”, so it’s related to the hypothesis related above. They stated that the study has two weaknesses, one of them is that there was no record of chronic conditions which could modify the mortality results, and the other one is that they did not measure functional parameters that are associated with mortality in other studies. They added that training is the only way to revert the functional effects of sarcopenia. This would help us to be more cautious when assessing these patients, since early detection of frailty or sarcopenia, would be the key to preventing aging disabilities, even death.

Thus further prospective studies are needed to confirm the results obtained in other populations because there is no information about chronic conditions together with sarcopenia and its influences on mortality results. In conclusion they added that “having a low amount of appendicular fat-free mass is a significant predictor of mortality in older people, and efforts should be made to prevent age-associated sarcopenia.

No doubt, after the above, we can say that the study is relevant to the practice in the health field, either to prevent the development of disease or to mitigate its consequences.

Despite having addressed to a conclusion that has implications on health practice and to recommend further studies on other populations, this study is not of sufficient quality to meet the criterion of scientific merit. There is not hypothesis or questions stated clearly, no theoretical or conceptual framework explained, the literature review was not enough, especially considering it is matter of concern to health workers, and the researchers belong to Institute of Nutrition and Food Technology (University of Chile).This study did not show risk to the participants.

References

Bunout, D., De la Maza, M. P., Barrera, G., Leiva, L., & Hirsch, S. (2011). Association between Sarcopenia and Mortality in Healthy Older People. Australasian Journal of Ageing, 30 (2), 89-92.

  

 

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