Maarie template for evaluating evidence based health research

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MAARIE Template for Evaluating Evidence Based Health Research (please use attached template)

  

Method- The   purpose and population for the investigation
1. Study hypothesis
What is the study question being investigated?

2. Study   population
What   population is being investigated and what are the inclusion and exclusion   criteria for the participants of the investigation?

 

 3. Sample size and statistical power
How many individuals are included in the study and in   the control groups? Are the numbers adequate to demonstrate statistical   significance if the study hypothesis is true (what is the statistical power)?

  

Assignment-   Selection of participants for the study and control groups
1. Process
  What method is used to identify and assign individuals or populations to study   and control groups?

 2. Confounding variables
  Are there differences between study and control groups, other than the factor   being investigated, that may affect the outcome of the investigation?

3. Masking or blinding
  Are the participants and/or the investigators aware of the participants’   assignment to a particular study or control group?

  

Assessment- Measurement of   outcomes or endpoints in the study and control groups
1. Appropriate
Does the measurement of   outcomes address the study’s question?

2. Accurate and   precise
Is the measurement of   outcomes an accurate and precise measure of the phenomenon that the   investigators seek to assess?

 3. Complete and unaffected by observation
Is the outcome measurement   nearly 100% complete and is it affected by the participants’ or the   investigators’ knowledge of the study group or control group assignment?

 

Results-   Comparison of outcomes in the study and control groups
1. Estimation
What is the magnitude or   strength of the relationship observed in the investigation?

2. Inference
What statistical   technique(s) are used to perform statistical significance testing?

3. Adjustment
What statistical technique(s) are used to take into   account or control for differences between the study group and the control   group that may affect the results?

 

Interpretation-   Meaning of the results for those included in the investigation
1. Contributory cause   or efficacy
Does the factor being investigated alter the   probability that the disease will occur (contributory cause) or work to   reduce the probability of undesirable outcomes (efficacy)?

 

2. Harms
Are adverse events that affect the meaning of the   results identified?

 3. Subgroups and interactions
Do the outcomes in subgroups differ and are there   interactions between factors that affect outcomes?

 

Extrapolation- Meaning for those not specifically included   in the investigation
1. To similar individuals, groups, or populations
Do the   investigators extrapolate or extend the conclusions to individuals, groups,   or populations that are similar to those who participated in the   investigation?

 
2. Beyond the data
Do the investigators extrapolate by extending the   conclusions beyond the dose, duration, or other characteristics of the   investigation?

 
3. To other populations
Do the investigators extrapolate to populations or   settings that are quite different from those in the investigation?

Rev. 2021

Riegelman, R.K. & Nelson, B.A. (2021). Studying a study & testing a test. Wolters Kluwer.

Bovbjerg, M. L., Cheyney, M., & Everson, C. (January 01, 2016). Maternal and Newborn Outcomes Following Waterbirth: The Midwives Alliance of North America Statistics Project, 2004 to 2009 Cohort. Journal of Midwifery & Women’s Health, 61, 1, 11-20.

Links to an external site.

Bovbjerg_et_al-2016-Journal_of_Midwifery_%26_Women-s_Health.pdf (attached)

MAARIE Template for Evaluating Evidence Based Health Research

Method- The purpose and population for the investigation

1. Study hypothesis
What is the study question being investigated?

2. Study population

What population is being investigated and what are the inclusion and exclusion criteria for the participants of the investigation?


3. Sample size and statistical power
How many individuals are included in the study and in the control groups? Are the numbers adequate to demonstrate statistical significance if the study hypothesis is true (what is the statistical power)?

Assignment- Selection of participants for the study and control groups

1. Process
What method is used to identify and assign individuals or populations to study and control groups?

2. Confounding variables
Are there differences between study and control groups, other than the factor being investigated, that may affect the outcome of the investigation?

3. Masking or blinding
Are the participants and/or the investigators aware of the participants’ assignment to a particular study or control group?

Assessment- Measurement of outcomes or endpoints in the study and control groups
1. Appropriate
Does the measurement of outcomes address the study’s question?

2. Accurate and precise
Is the measurement of outcomes an accurate and precise measure of the phenomenon that the investigators seek to assess?

3. Complete and unaffected by observation
Is the outcome measurement nearly 100% complete and is it affected by the participants’ or the investigators’ knowledge of the study group or control group assignment?

Results- Comparison of outcomes in the study and control groups
1. Estimation
What is the magnitude or strength of the relationship observed in the investigation?

2. Inference
What statistical technique(s) are used to perform statistical significance testing?

3. Adjustment
What statistical technique(s) are used to take into account or control for differences between the study group and the control group that may affect the results?

Journal of Midwifery &Women’s Health www.jmwh.org
Original Research

Maternal and Newborn Outcomes Following Waterbirth:
The Midwives Alliance of North America Statistics Project,
2004 to 2009 Cohort
Marit L. Bovbjerg, PhD, MS, Melissa Cheyney, PhD, CPM, LDM, Courtney Everson, MA, PhD

Introduction: Data on the safety of waterbirth in the United States are lacking.

Methods: We used data from the Midwives Alliance of North America Statistics Project, birth years 2004 to 2009. We compared outcomes of
neonates born underwater waterbirth (n = 6534), neonates not born underwater nonwaterbirth (n = 10,290), and neonates whose mothers
intended a waterbirth but did not have one intended waterbirth (n = 1573). Neonatal outcomes included a 5-minute Apgar score of less than 7,
neonatal hospital transfer, and hospitalization or neonatal intensive care unit (NICU) admission in the first 6 weeks. Maternal outcomes included
genital tract trauma, postpartum hospital transfer, and hospitalization or infection (uterine, endometrial, perineal) in the first 6 weeks. We used
logistic regression for all analyses, controlling for primiparity.

Results:Waterbirth neonates experienced fewer negative outcomes than nonwaterbirth neonates: the adjusted odds ratio (aOR) for hospital trans-
fer was 0.46 (95% confidence interval [CI], 0.32-0.68; P � .001); the aOR for infant hospitalization in the first 6 weeks was 0.75 (95%CI, 0.63-0.88;
P � .001); and the aOR for NICU admission was 0.59 (95% CI, 0.46-0.76; P � .001). By comparison, neonates in the intended waterbirth group
experienced more negative outcomes than the nonwaterbirth group, although only 5-minute Apgar score was significant (aOR, 2.02; 95% CI,
1.40-2.93; P � 0001). For women, waterbirth (compared to nonwaterbirth) was associated with fewer postpartum transfers (aOR, 0.65; 95% CI,
0.50-0.84; P = .001) and hospitalizations in the first 6 weeks (aOR, 0.72; 95% CI, 0.59-0.87; P � 0.001) but with an increased odds of genital tract
trauma (aOR, 1.11; 95%CI, 1.04-1.18; P = .002).Waterbirth was not associated withmaternal infection.Women in the intended waterbirth group
had increased odds for all maternal outcomes compared to women in the nonwaterbirth group, although only genital tract trauma was significant
(aOR, 1.67; 95% CI, 1.49-1.87; P � .001).

Discussion:Waterbirth confers no additional risk to neonates; however, waterbirth may be associated with increased risk of genital tract trauma
for women.
J Midwifery Womens Health 2016;61:11–20 c© 2016 by the American College of Nurse-Midwives.

Keywords: childbirth, complications, perineal trauma, safety, waterbirth

INTRODUCTION

Waterbirth is highly controversial in the United States,1–8
despite being an accepted practice in other high-resource
nations.9–12 Proponents of waterbirth cite anthropological ev-
idence from Odent and Tjarkovsky regarding childbearing
tradi

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