Re:Discussion

·         Review this week’s Learning Resources, focusing on how researchers find meaning in their data and generate sound conclusions. Pay particular attention to Table 2 in the article, “Study Design in Medical Research.”

·         Revisit the 5 articles that you identified in Part 2 of the Course Project. Select one to consider for the purpose of this Discussion.

·         Read sections of the chosen article where the data is presented, analyzed, and interpreted for meaning. What reasoning process did the researchers use to formulate their conclusions? What explanation did they give to support their conclusions? Were there any weaknesses in their analysis or conclusions?

·         Consider possible alternate conclusions that the researchers could have drawn based on their data.

·         Examine the findings that the article presents and consider how well they addressed the researcher’s initial question(s). What additional research could be done to build on these findings and gain a fuller understanding of the question?

By Day 3

Post an APA citation and brief summary of the research article that you selected. Describe the data and the results of any statistical tests or analyses presented in the article. Explain how the researchers formulated their conclusion, any weaknesses in their analysis or conclusions, and offer at least one alternate interpretation of their data. Propose at least one additional research study that could be done to further investigate this research topic.

Expert Solution Preview

Introduction:
The chosen article for this discussion is “Association of Fluid Balance with Clinical Outcomes in Critically Ill Patients With Respiratory Failure: A Prospective Observational Study” by Lee et al. (2020).

APA citation: Lee, J., Kim, H. J., Kang, M. G., Kim, J., Hong, S. B., Lim, C. M., & Koh, Y. (2020). Association of fluid balance with clinical outcomes in critically ill patients with respiratory failure: A prospective observational study. Annals of intensive care, 10(1), 1-9.

Summary of the article: The study aimed to investigate the association of fluid balance with clinical outcomes in critically ill patients with respiratory failure. It was a prospective observational study conducted in a medical intensive care unit of a tertiary care hospital. The study enrolled 148 patients, and data regarding daily fluid balance, clinical variables, and outcomes were collected for seven days. The researchers used regression analysis to determine the association between fluid balance and clinical outcomes.

Data and results of statistical tests: The researchers presented the data on daily fluid balance, clinical variables such as Sequential Organ Failure Assessment (SOFA) score, and outcomes such as ventilator-free days and mortality. They found a significant association between positive fluid balance on day 1 and increased SOFA score, prolonged ventilator use, and increased mortality. The statistical tests used were regression analysis and Cox proportional hazard model.

Formulation of conclusion: The researchers concluded that positive fluid balance on the first day of admission was associated with adverse clinical outcomes in critically ill patients with respiratory failure. They explained that a positive fluid balance might contribute to lung injury, multiorgan dysfunction, and mortality.

Weaknesses in analysis or conclusions: One weakness in the analysis could be the limited sample size of 148 patients. Moreover, the study did not account for the differences in the underlying disease, severity of respiratory failure, and individual treatment variation. The researchers could also have considered other factors that contribute to fluid balance, such as medications and nutritional support.

Alternate interpretation of data: An alternate interpretation of the data could be that patients who had worse clinical outcomes had higher fluid intake, which resulted in a positive fluid balance. The researchers did not differentiate whether the fluid intake was due to oral or intravenous fluids.

Additional research study: A potential additional research study could be a randomized controlled trial to evaluate the effectiveness of a fluid management protocol. This would involve allocating patients to either a restrictive or liberal fluid management protocol and evaluating clinical outcomes such as ventilator-free days, length of ICU stay, and mortality. The study could also account for factors such as underlying disease severity, individual treatment variation, and fluid intake from multiple sources.

#ReDiscussion

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