Survey (including pre-test probabilities)

Elander J et al
Pain management and symptoms of substance dependence among patients with sickle cell disease
Social science and medicine
2003;1683-166

Submitted by:sheena mccullough - medical student
Institution:Manchester Royal Infirmary
Date submitted:8th July 2006

Before CA, i rated this paper: 5/10

1 Objectives and hypotheses

1.1 Are the objectives of the study clearly stated?

YES. The list of objectives was stated

2 Design

2.1 Is the study design suitable for the objectives

yes, they conducted in dept, semi-structured intervieweds with sickle cell patients

2.2 Who / what was studied?

Sickle cell patients

2.3 Was this the right sample to answer the objectives?

The sample size was small

2.4 Did the subject represent the full spectrum of the population of interest?

yes

2.5 Is the study large enough to achieve its objectives? Have sample size estimates been performed?

no the study size was small and no sample size estimates were done

2.6 Were all subjects accounted for?

yes

2.7 Were all appropriate outcomes considered?

yes

2.8 Has ethical approval been obtained if appropriate?

no mention of any ethical approval

2.9 What measures were made to contact non-responders?

all participants responded

2.10 What was the response rate?

100%

3 Measurement and observation

3.1 Is it clear what was measured, how it was measured and what the outcomes were?

yes

3.2 Are the measurements valid?

I am not a statistical expert but they seemed valid

3.3 Are the measurements reliable?

yes

3.4 Are the measurements reproducible?

yes

4 Presentation of results

4.1 Are the basic data adequately described?

yes

4.2 Are the results presented clearly, objectively and in sufficient detail to enable readers to make their own judgement?

yes tables of data were clearly set out

4.3 Are the results internally consistent, i.e. do the numbers add up properly?

yes

5 Analysis

5.1 Are the data suitable for analysis?

yes

5.2 Are the methods appropriate to the data?

yes

5.3 Are any statistics correctly performed and interpreted?

yes

6 Discussion

6.1 Are the results discussed in relation to existing knowledge on the subject and study objectives?

yes

6.2 Is the discussion biased?

I would say it is slightly biased

6.3 Can the results be generalised?

7 Interpretation

7.1 Are the authors' conclusions justified by the data?

yes

7.2 What level of evidence has this paper presented? (using CEBM levels)

7.3 Does this paper help me answer my problem?

It is helpful but it does not answer my problem completely

After CA, i rated this paper: 5/10

8 Implementation

8.1 Can any necessary change be implemented in practice?

yes, patients with sickle cell crisis should not be undertreated or suspected of having a drug addiction

8.2 What aids to implementation exist?

8.3 What barriers to implementation exist?