Adapted from: Qualitative checklist 14/10/10 ©CASP This work is licensed under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-sa/3.0/ These questions consider the following: Are the results of the review valid? What are the results? Will the results help locally? A number of italicised prompts are given after each question. These are designed to remind you why the question is important. There will not be time in the small groups to answer them all in detail! How surgeons design treatment recommendations in orthopaedic surgery Pamela L. Hudak, Shannon J. Clark, Geoffrey Raymond Social Science & Medicine 73, 1028-1036 http://dx.doi.org/10.1016/j.socscimed.2011.06.061 This model CASP has been prepared by Israel Berger for QUAL5005 at the University of Sydney. [email protected] Screening Questions 1. Was there a clear statement of the aims of the research? Consider: The authors explore the interactional reasons for surgeons approaching recommendations for surgery directly and briefly yet recommendations for other treatments (i.e. not for surgery) in a mitigated fashion. It is important to know how treatment recommendations are made to improve practice. This paper explores the influence that different parties have on treatment. 2. 2. Is a qualitative methodology appropriate? Consider: If the research seeks to interpret or illuminate the actions and/or subjective experiences of research participants The research illuminates the ways in which patients' tacit and explicit expectations affect how surgeons approach recommendations for or against surgery. Detailed questions 3. Was the research design appropriate to address the aims of the research? Consider: If the researcher has justified the research design (e.g. have they discussed how they decided which method to use)? Conversation analysis looks at the details of interaction and how participants orient to interactional particulars. It is well-suited to the complex and potentially sensitive nature of the consultations being studied. The authors do not specifically justify their use of the method, but rather it is implicit in their approach to the phenomenon. 4. Was the recruitment strategy appropriate to the aims of the research? Consider: If the researcher has explained how the participants were selected If they explained why the participants they selected were the most appropriate to provide access to the type of knowledge sought by the study If there are any discussions around recruitment (e.g. why some people chose not to take part) The recruitment strategy was not reported but is probably a convenience sample. The dataset was fairly large for the method and consisted of audiotapes of office visits between 121 patients and 14 orthopaedic surgeons at 2 academic hospitals in a major Canadian city. Te patients were diverse, but the surgeons were all men and of either Caucasian or Asian background. However, this probably is representative of Orthopaedic surgeons in Toronto. 5. Were the data collected in a way that addressed the research issue? Consider: If the setting for data collection was justified If it is clear how data were collected (e.g. focus group, semi-structured interview etc.) If the researcher has justified the methods chosen If the researcher has made the methods explicit (e.g. for interview method, is there an indication of how interviews were conducted, or did they use a topic guide)? If methods were modified during the study. If so, has the researcher explained how and why? If the form of data is clear (e.g. tape recordings, video material, notes etc.) If the researcher has discussed saturation of data It is clear what the data were: audiotaped consultations with orthopaedic surgeons, and the data is appropriate for the method and research question. Saturation is not a consideration in this method, because it describes how practices can be used or why they might be used in a particular sequential context. The urrent research explores an observation made during initial data analysis. 6. Has the relationship between researcher and participants been adequately considered? Consider: If the researcher critically examined their own role, potential bias and influence during: o Formulation of the research questions o Data collection, including sample recruitment and choice of location How the researcher responded to events during the study and whether they considered the implications of any changes in the research design One author acknoledges grant funding for the project. No discussion is provided regarding relationships with participants. 7. Have ethical issues been taken into consideration? Consider: If there are sufficient details of how the research was explained to participants for the reader to assess whether ethical standards were maintained If the researcher has discussed issues raised by the study (e.g. issues around informed consent or confidentiality or how they have handled the effects of the study on the participants during and after the study) If approval has been sought from the ethics committee Research Ethics Board approval was obtained from all participating institutions and patients and surgeons gave informed consent prior to their involvement. All names and identifying references have been changed to protect participants’ identities. The authors do not discuss how the informed onsent process occurred. 8. Was the data analysis sufficiently rigorous? Consider: If there is an in-depth description of the analysis process If thematic analysis is used. If so, is it clear how the categories/themes were derived from the data? Whether the researcher explains how the data presented were selected from the original sample to demonstrate the analysis process If sufficient data are presented to support the findings To what extent contradictory data are taken into account Whether the researcher critically examined their own role, potential bias and influence during analysis and selection of data for presentation The authors provide an in depth analysis with extracts and sequentialmanalysis according to conversation analytic method. The researchers do not appear to have been present, so they would not have likely affected the interactions. Analysis is based on actual interactions and the actions of participants rather than interpretation of meanings. The authors maintain a focus on participant orientations. 9. Is there a clear statement of findings? Consider: If there is adequate discussion of the evidence both for and against the researcher’s arguments If the researcher has discussed the credibility of their findings (e.g. triangulation, respondent validation, more than one analyst) If the findings are discussed in relation to the original research question The findings are presented clearly in some parts of the paper but muddied in later discussion. However, the abstract provides a clear conclusion. The paper has three authors, thereby providing multiple perspectives. Findings are directly related to the research question. 10. How valuable is the research? Consider: If the researcher discusses the contribution the study makes to existing knowledge or understanding e.g. do they consider the findings in relation to current practice or policy, or relevant research-based literature? If they identify new areas where research is necessary If the researchers have discussed whether or how the findings can be transferred to other populations or considered other ways the research may be used This paper provides a clear statement of implications for avoding problems in making treatment recommendations as well as to our theoretical understanding of treatment recommendations more generally.