The current report aims to present a systematic analysis of the article Remote Care Costs for Congestive Heart Failure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials in the United States Comparing Remote Versus More Intensive Care Settings by Jeffrey Voigt and Michael Mosier. Various aspects of the article including the significance of the chosen problem, methods, and approaches, the reliability of results and the articles structure will be discussed and evaluated.
The article aims to clarify the situation around reducing costs for congestive heart failure care settings. It tends to present a detailed analysis in favor to remote care, as a practice that saves more costs for the health care system. This is an actual and acute problem considering that heart failure affects about 5.7 million people in the United States (Roger et al., 2012, p. 125), and the annual cost spent for the specific treatment is $35.1 billion (Lloyd-Jones et al., 2010, p. 121). The problem is clearly stated as significant to nursing and healthcare as it deals with person’s physical state and the medical technics applied to maintain the organism’s stable condition and providing in-time treatment. The purpose of the article to define the reliable, safe and relatively low-cost ways to take care of the people exposed to heart failure is clearly stated. Overall, the article is written in a simple and understandable language, including four classical parts of a scholarly paper that are Introduction, Methods, Results, Discussion, and Reference sections. The background information in Introduction and Discussion sections reflects the vast range of reliable scholarly sources.
The analysis provided in the article is based on statistical data from “Medline, technology assessment Websites, and relevant cardiovascular and heart failure journals” (Voigt & Mosier, 2013, p. 192). According to the data provided in the article, the research question was broadly presented in the analyzed literature that gave the basis for an extensive mixed study research, including both qualitative and quantitative analysis (s2, 2012, p. 58) together with detailed meta-analysis. The analyzed qualitative data was mostly obtained through specific case studies carried on similar or comparable conditions. The sources were carefully selected to provide the firm basis for quantitative meta-analysis. Authors carefully describe the setting, as well as the applied methodology, and it seems to fit the study perfectly.
As the purpose of the research is the broad analysis tending to reflect the most objective and full picture, the approach selected by authors is correct, stated as a literature review of research results on the selected topic that is comparing costs and intensive care settings through meta-analysis.
As the analyzed information published by authors is taken from the open library sources and public databases, it has already been conformed to the people who were the subjects of study and the source of original data. So going through the double filter of processing and publishing does not leave any chance of violating human rights of the subjects on whom the initial research was conducted. The authors do not provide any specific information of a personal character. Besides all the research is about data gained through the method of anonymous clinical observation.
The method and results sections provide a clear description of the basic criteria and methodology of the analyzed sources selection, as well as an understandable graphic description of all selection stages and the summary of the risk of bias assessment. All the provided graphs and information seem to be reliable and acceptable, as they reflect the appropriate situation.
According to authors’ statements, the data was collected and analyzed by both authors separately, but later all the disagreements and questionable issues were thoughtfully discussed and adjusted according to the criteria and the approach initially applied. The risk of deviations was also evaluated through specifically related methodology (Cochrane Community, 2013, para.1). As the method of obtaining the resulting information is considered to be mixed, it combines both qualitative and quantitative parts. The appropriate approaches are applied for both parts, as the methodology of selecting the papers of interest is described in detail, as well as all the inequalities and questionable issues are claimed to be taken into account and either excluded, or included into sample through getting additional information from the authors of original papers, if possible. The quantitative meta-analysis was carried basing on the accurate fitting of the conditions and the parameters, so the analyzed data would be uniformed. The carefulness and exactingness of the selection criteria are demonstrated by the fact that only ten sources were chosen from the initial number of records that is eighty-three (forty-one after all the duplicates were removed). All the processed data was grouped into three tables representing the specific healthcare sphere of cost spending. The tables and data are clear and understandable.
The description of methods, as well as the approach to data collection, analysis of the results, theoretical basis and presentation clearly testify the scientific rigor of the paper. The conclusions presented in the discussion section are clearly stated and highlighted. Thus, the results do not confirm the initial expectations, as remote monitoring does not save costs comparing to usual care in the hospitals or hospital-like facilities. The authors also compared to the results of previous key studies. The contradictions with those sources and their reasons as well as the conditions that might lead to these contradictions are discussed and partially explained. The discussion section provides limitations for the current research, also explaining the bias significance as it can affect the accuracy of the obtained results. According to the explanation, the bias seems to be not that significant for the research result, but there might be certain doubts if the costs in the official sources correspond to the actual costs spent.
The suggestions for future research are not included in the article directly, but due to contradictions with other key sources, the current article refers to, the independent global study involving high volumes of uniformed data collected on similar conditions would clarify the total situation on the issues of interest.
In general, the analyzed article is considered to be dedicated to the actual and important subject. It is scientifically valid, refers to many reliable sources providing it with the rigid background. It is presented well containing all the parts required for the scholarly paper. All the sections of the article contain corresponding information. The methodology and approaches are clearly explained and motivated. All the serious contradictions are taken into account, or, at least mentioned, the bias is calculated and presented in a separate table. The results presentation is clear and understandable. The discussion section provides direct explanations, comparisons, assumptions, and limitations, also leaving the opportunities for further research. The article is written in a comprehensible language, easy to read and assimilate.
References
Cochrane Community: Cochrane Methodology Register (CMR). (2013). Web.
Lloyd-Jones, D., Adams, R. J., Brown, T. M., Carnethon, M., Dai, S., De Simone, G., & Wylie-Rosett, J. (2010). Heart disease and stroke statistics—2010 update A report from the American Heart Association. Circulation, 121(7), 46-215.
Polit, Denise. (2012). Nursing Research: Generating and Assessing Evidence for Nursing Practice. New York, NY: Wolters Kluwer Health Inc.
Roger, V. L., Go, A. S., Lloyd-Jones, D. M., Benjamin, E. J., Berry, J. D., Borden, W. B., & Turner, M. B. (2012). Heart disease and stroke statistics—2012 update a report from the American heart association. Circulation, 125(1), 2-220.
Voigt, J., & Mosier, M. (2013). Remote Care Costs for Congestive Heart Failure: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials in the United States Comparing Remote Versus More Intensive Care Settings. Congestive Heart Failure, 19(4), 192-199.