The purpose of this essay is to conduct a comprehensive critical appraisal of a research paper titled ‘Chloramphenicol treatment for acute infective conjunctivitis in children in primary care’ that was carried out by Rose et al. (2005) in the United Kingdom (UK). The aim of evaluation is to critically concentrate on the strength and limitation of the study. Firstly, a clear definition of critical appraisal and its importance will be highlighted, going on further will be the critical, analysis, discussion and evaluation of the peer reviewed paper contents so as to ascertain the validity and reliability of the study. Therefore, a conclusion will be drawn to learning its significance in public health. BACKGROUND Critical Appraisal The term critical appraisal involves a structured and meticulous scrutiny on research to evaluate its reliability and relevance to the context being considered (Burls, 2009). According to University College London (UCL) (2011), critical evaluation helps to filter necessary information, identify studies that are applicable clinically and also for continuous professional development (CPD). However, evaluation of an article, is assessed using pre-designed instrument that encourages a more thorough and systematic method; it is designed for different study design and ask specific questions as pertain validity of the study such as: if the study has given an answer to the research question and has met its set aims and objectives, the methodology, analysis and interpretation of findings (Harder, 2014; Burls, 2009; Whiffin and Hasselder, 2013). It could be said that a good critical assessment plays a vital in evidence-based practice. Therefore, a critical appraisal skills programme (CASP, 2009) checklist will be used to evaluate the selected paper for this essay. Critical appraisal of the paper Evidence based journals must be critiqued in terms of the structure so as to determine generalisation, reliability and validity. This would help inform decision making clinically. Nevertheless, the journals or article must have a realistic research question (s) and objectives that would determine the appropriate research design. The study is a randomised control trial (RCT) quantitative study conducted by Rose et al. (2005) with the sole aim of determining the effectiveness of topical chloramphenicol for children presenting with acute infective conjunctivitis in a primary care sector, United Kingdom (UK). Bowling (2009) defines RCT as an experimental method for the evaluation of the effectiveness of health services and interventions in relation to specific conditions. RCT involves the random allocation of participants between experimental groups, whose members receive the treatment or other intervention, and control group whose members receive a standard or placebo treatment. Also, it is a gold standard in testing the efficacy of an intervention (UCL, 2011). To commence the article assessment is the view of the abstract. The heading and abstract of the study was well outlined, concise and focused on the sample population, methodology, data analysis as well as the result of the study. Burns and Grove (2009) state that abstract is a clear, succinct outline of a study, usually between a hundred to two hundred and fifty words count. Also, abstracts are short outline generally found toward the start of an article (Parahoo, 2014). Also, the study had a clear objective that gave a solution to the hypothesis. Stanley (2007) opines that for easy identification of a well-designed and conducted clinical trial is the obvious precision of the research aims and objective. One might propose that although, abstracts are clear and straightforward information that are limited in words, it still prepares the reader’s mind to the rest of the paper. The study sample population consists of three hundred and twenty six participants who were children between six months and twelve years from twelve different general practices in Oxfordshire, England, also it highlighted that with clinical treatment on the seventh day through information recorded by parents from diaries as the primary effect of interest which was accurately measured. According to Bowling (2009), measurement of primary outcome of interest is obtained from different types of data such as diaries, questionnaires, telephone or interview so as to determine subject’s health status. A hundred and sixty three subjects were randomly selected and allocated to experimental or control group respectively. Parahoo (2014) proposed that, subjects are randomly allocated to treatment and control group so as to determine the efficacy of an intervention or treatment. Nevertheless, the authors noted that a total of nine participants both from the experimental and intervention group opted out of the study. In addition, randomisation will help to eliminate selection bias in a study (Polit and Beck, 2014; Stanley, 2007). Also, stratified randomisation was carried out in the study in order to avoid confounding issues. This justifies the study to be valid. Therefore, the study demonstrates positive null hypothesis as there was no distinction in discrepancy observed between those treated with the medication and placebo (Bowling, 2009). Furthermore, to determine the generalisation of the study, the authors highlighted, the inclusion criteria for the study which are as follows: Subjects must be within the age range of six months to twelve years old, must be clinically proven to have acute infection of the conjunctiva. Nevertheless, it excluded subjects that were on antibiotic treatment during the commencement of the study or forty eight hours before they were recruited. Eligibility criteria are vital benchmarks that influence generalisabilty of result outcome in a study (Ellis, 2010). Following the selection of participants was an ethical approval that was obtained from the board for clinical research in Oxfordshire, UK. Likewise, informed consent was obtained from parents of potential subjects who decided to participate in the research after reading through the guidance form and explanation of what the study entails. It could be said that due ethical procedure was adhered to in the research. However, it was not documented by the researchers if sufficient time was given to subjects to decide if they would take part in the study or not. Wood and Haber (2006) indicates that, subjects should have a clear explanation of the study by the researchers and also should be given time to make informed decision towards participation. The major results of the study showed that the subjects are similar in terms of their age and clinical diagnosis, CONCLUSION In summary, it was observed that appropriate mechanisms of an RCT study was applied in the research conducted by Rose et al. (2005). These procedures include; appropriate abstracts, objectives as well as methodology, there was double-blinding in the study among the participants and the researchers, researchers accounted for all the participants that took part in the study and intention to treat for analysis of result was also done. Also, the researchers noted the eligibility criteria for the study. However, there is a need to increase the sample population in future study so as to achieve the mean number for power analysis as shown from evidence that it should be two hundred and eighteen as against the targeted participants in the study. Nevertheless, the study identified that a child with sudden onset of acute infective conjunctiva could be treated without antibiotics; although chloramphenicol eye treatment still display effectiveness in the study. Therefore, it could be said that the study has a huge impact in public health practice.
