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The number of individuals prone to disease of diabetes has reached an alarming stage in the year 2015. This trend can be witnessed from the fact that around 415 million people in the world are suffering from diabetes (Diabetes, 2016). In pursuance to these statistics, the authors have made a systematic analysis of the effectiveness of the self-management programmes developed for enhancing quality of life in countries with low and middle level of income. The author of the study seeks to conduct a critical review of the theoretical framework, Research , method, data collection methods, data analysis and findings of the said article.
The theoretical framework of the article has successfully established the background of the article by reflecting the prevalence of disease of diabetes across various nations through the use of various statistics. Further, a clear distinction has been established in prevalence and the impact of diabetes in nations with low-income level and middle income level. However, unlike the typical pattern to be followed under this head, the article fails to make an in-depth study of the subject matter. This can be inferred from the fact that the number of article reviews or the authors quoted does not suffice the extent of research required for the given topic. It essentially reviews self-management programmes in a systematic manner, for people prone to diabetes, primarily in nations with low and middle level of incomes. In their study, the authors should have reviewed number of relevant articles to produce an elaborative theoretical framework on the subject matter, and in addition, should have presented a detailed text on the findings of more number of scholars as well as their studies. Though, this section provides for various definitions of relevant terms and concepts, there is still a large scope for the authors to undertake an extensive review of the existing literature on the subject and related topics. This would have enabled the readers to establish a better understanding of the subject as well as would have satisfied the requirement of the systematic review and meta-analysis which the authors seek to undertake through the article.
Followed by the literature review or the theoretical framework, the article provides the objectives of research, as against the requirement of stating the research topic (Wodak and Meyer, 2009). In fact, the head of Objectives has been stated after the background of the study which clearly establishes a broad objective which the authors seek to achieve by undertaking the present study. However, there is no mention of the aim with which this research is being carried out and also the objectives stated does not provide for specific requirement which is intended to be realized by the authors by carrying out the instant research. In fact, the author should have presented a clear statement of the aim to be realized by undertaking the study which should have been bifurcated or broken in parts to develop the specific objectives to be achieved. Also, the article should have explained the rationale behind choosing the topic of research and the phenomenon of interest which cannot be traced anywhere in the whole article. To make the readers understand the relevance of the topic in the present world, a mention of the rationale relying on which the subject area was chosen by the authors should have been made in the text of the article (Whiting and et. al., 2011). This would have given the authors a grip of the subject matter and in addition would have enhanced the level of understanding of each of the concepts presented.
The article has failed to formulate elaborative research questions which could have enabled them to undertake a more structured and elaborative exploration of the subject. It is important to highlight that the article does provide for an objective and two research questions, which reflect a vague understanding of the approach of the research undertaken by the authors and the results expected to be realized. Furthermore, the authors have not even made use of the PICO framework in formulation of the research questions so stated in the article. This framework essentially requires the presence of the following elements – Patient's problem or population (P), Intervention (I), Comparison (C) and Outcome (O) (Shaw, Sicree and Zimmet, 2010). The authors on the contrary have stated only 2 questions which in essence only cover the effectiveness and the impact which can be realized by the application of the said measure. Moreover, the article does not establish any hypothesis on the basis of which the study was undertaken by the authors. In result of this, the article fails to provide a clear picture of the point of commencement of the research as well as the suppositions considered by the authors while undertaking the research.
The research method used to carry out the present study is very effective and has enabled the authors to realize results in spite of the loopholes present under other heads of the article. First of all, the author has made use of the systematic review study protocol which has also been published in PROSPERO International Prospective Register. This has enabled the authors to undertake a systematic review of the self-management programmes which can prove to be effective in enhancing the quality of life in nations with low and middle level income. The author through this approach has successfully appraised the subject in a critical manner as well as has studied the replications. In order to determine the studies which shall be reviewed, various effective measures have been utilized to realize the effective outcomes. Some of the tools which have been used are randomized controlled trials (RCTs), non-randomized controlled risks, quasi-randomized controlled trials. In addition, the observational studies have been made with a design which includes both comparison group as well as uncontrolled observational designs. This shall enable the authors to realize data which has been taken from scattered sources and is completely diversified in nature (Ramachandran and et. al., 2012). Furthermore, the types of interventions considered for collecting relevant data and undertake a holistic research is completely comprehensive in nature and has enabled the authors to realize data which reflects the true picture of the real scenario. Lastly the data has been collected from various reliable sources which includes Cochrane Library, PubMed, PsycINFO Database, CINAHL and MEDLINE. Further, a search strategy is suggested to be developed to undertake a search which is completely web-based in order to obtain relevant data from unpublished sources and language has not been considered as a restriction while undertaking the research (Facts and Figures, 2016).
However, the article does not show usage of literature search strategy, which formulates to be one of the essential techniques of undertaking the research. Under the head of literature search strategy the tool of search terms has not been used. This would have enabled the authors to undertake the research in a particular direction which eliminates the possibilities of irrelevant distractions from the subject matter. Fundamentally, the search terms are the variables which enable the research to be concentrated between the boundaries of the specified terms and thus, find relevant results (Scully, 2012). Such key words are determined at the preliminary stage before search in journal and articles to carry out an effective literature review. For instance, in the present article the subject matter could have been broken into key terms such as peer-led self-management programmes for diabetes, improvement of clinical outcomes and quality of life of adults & low and middle – income countries. Furthermore, a trace of usage of inclusion and exclusion criteria for ascertainment of relevant and irrelevant literature, in context of the present subject matter, has been witnessed. This tool limits the research within precise boundaries and restricts realization of irrelevant data, which in turn saves the most imperative resource of time (Gaziano and et. al., 2010). These criterion in essence acts as a screen for elimination of unrequited data and inclusion of the all the relevant data only.
A very systematic approach has been adopted by the authors for collection of relevant data which can be further synthesized for achievement of the fundamental aims and objectives of carrying out the research. The method deployed herein under can be characterized as highly component as they are empowered to make a close inspection of the data to check the relevance with the subject matter as well as the degree of usage. Every part of data collected is analyzed on the basis of the relevance and involves efforts from the end of two reviewers. It is important to note that the process used for reviewing the data has been designed in such a manner that there is no scope of irrelevance left in the whole process of data collection. Three heads have been developed to categorize the data so collected i.e. Excluded, Included and Pending. Information categorized under each of the head is preserved in a systematic manner and views from all the reviewers shall be compared and contrasted to realize the final judgement on relevance. It is important to highlight that the shall produce a flow chart for to show and facilitate transparency in the whole process of data collection. Furthermore, the three reviewers have been assigned the task of extracting information from various sources which shall be based on Cochrane Consumers and Communication Review Group' s Data Extraction Template. A systematic system of extraction has also been developed which shall be undertaken by the reviewers for achievement of an optimum level of results. Moreover, the element of discussion and consultation has also been involved to reach a level of consensus where necessary and produce accurate results. However, this data extraction from various articles should have been represented in a tabular format for clear and categorized reflection of the data so collected (Hu, 2011). This amounts to be one of the major loopholes which is reflected under the head of data collection and analysis.
Another important requirement of risk of bias has also been efficiently analyzed by the author by deployment of a systematic and efficient quality elements of randomization sequence generation, treatment allocation concealment, blinding and so on. This has enabled the authors to assess the internal validity of the results so obtained which in essence is produced through description in a systematic narrative formation. Followed by this assessment of presence of bias factor, the article synthesizes the data in various elaborative steps to present the outcomes in the form of risk ratios or relative risk. Further a synthesis table shall be formulated on the basis of designs used in carrying out the study. The factor of heterogeneity shall be assessed to study the specific variations in the study. Finally, a sensitivity analyses shall be undertaken to evaluate the effectiveness of various factors present in the study. With the assistance of these steps of data synthesis an efficient analysis of the data so collected has been conducted by the authors to produce relevant results. Finally, PRISMA-P reporting style has been utilized for systematically showcasing the findings of the systematic review and meta-analysis of the subject. In view of the subject matter and the quality of data so collected to realize the specific findings this is one of the most appropriate format of recording the findings of the study.
On undertaking a critical review of the article which is primarily a study based on effectiveness of peer-led diabetes self-management programmes for improvement of the quality of life of people suffering from this ailment. The author in this article seeks to conduct a systematic review and meta-analysis of the mentioned subject matter. Overall the author has undertaken an efficient study and has produced desirable outcomes by deployment of relevant tools and techniques. However, one of the loopholes identified in the present study is that the theoretical framework could have been more extensive with inclusion of more articles. In addition, research methods such as search terms could have been deployed for undertaking a more focused research.
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