Nursing 5024 Research Article Review Matrix Essay Assignment

Nursing 5024 Research Article Review Matrix Essay Assignment

NURSING 5024 RESEARCH ARTICLE REVIEW MATRIX										Identify what system used.
Authors	Pub Yr	Sample	IV-quantitative or Phenomenon of interest-qualitative	DV-quantitative	Research Design	How data collected	Summary of findings Including significant stats & tests used	Identified strengths	Identified weaknesses	Level of study (hierarchy )
Gaziano, et al	2018	55 years old men and 60 years old women with a moderate risk of CVD. 12,456 patients were enrolled and randomly assigned to receive aspirin (n=6270) or placebo (n=6276) at 501 study sites. ORDER HERE A PLAGIARISM FREE PAPER HERE	To determine the efficiency of using aspirin instead of treatments without active elements on patients with low CVD risk. A computer generated randomization code to receive enteric-coated aspirin tablets (100 mg) Placebo tablets Nursing 5024 Research Article Review Matrix Essay Assignment.	Time of occurrence of first cardiovascular death, myocardial infarction, unstable angina, stroke, or transient ischemic attack. Safety endpoints were hemorrhagic events and incidence of other adverse events.	Randomized, double-blind, placebo-controlled, multicenter study.	Patients were assigned to receive enteric-coated aspirin tablets (100 mg) or placebo tablets once daily. Follow-up was done by primary care physicians at face-to-face visits, through phone calls, and by obtaining medical records which were submitted for adjudication. Key variables were collected every 6 months during yearly visits and during yearly phone contact. Participants were followed up until their last contact; outcome ascertainment was attempted for 30 days after discontinuation	In the intention-to-treat analysis, the primary endpoint occurred in 269 (4·29%) patients in the aspirin group versus 281 (4·48%) patients in the placebo group (hazard ratio [HR] 0·96; 95% CI 0·81–1·13; p=0·6038). Gastrointestinal bleeding events (mostly mild) occurred in 61 (0·97%) patients in the aspirin group versus 29 (0·46%) in the placebo group (HR 2·11; 95% CI 1·36–3·28; p=0·0007). The overall incidence rate of serious adverse events was similar in both treatment groups (n=1266 [20·19%] in the aspirin group vs n=1311 [20·89%] in the placebo group. The overall incidence of adverse events was similar in both treatment groups (n=5142 [82·01%] vs n=5129 [81·72%] in the placebo group). The overall incidence of treatment-related adverse events was low (n=1050 [16·75%] vs n=850 [13·54%] in the placebo group (p<0·0001).	The research evidenced the advantage of contemporary risk management strategies. RCT Large sample size Double-blind study	The low cardiovascular events led to inconclusive results.	Level II Good quality
Jones, et al	2021	15,076 patients suffering from CVD in 40 chosen centers. The patients are either on an 81mg or 325mg dose.	To determine if the collect aspirin dosing can lower the risk of CVD in patients by studying the difference in CVD attacks between patients of different dosage.	Death, hospitalization for myocardial infarction, or hospitalization for stroke, and hospitalization for major bleeding.	Systematic review of randomized controlled trials.	15.076 patients were observed for 26.2 months. The existing medical records were taken before randomization. CVD attacks were recorded for the two different groups of 81mg dose and 325mg dose. Bleeding cases that led to hospitalization were also recorded. Instances of dose change were earmarked.	96% of the patients had an aspirin intake history. 85.3% were on an 81mg dose. In the 81mg dose 590 patients (7.28% of the group) had CVD attacks while 53 patients (0.63% of the group) had severe bleeding. 569 patients (7.51% of the group) in the 325mg dose had the attacks while 44 patients (0.60% of the group) had major bleeding. The 325mg group switched the dose more than the 81mg group by 41.6% to 7.1%.	The sample size and statistical analysis offered encouraging findings. Substantial dose switching to 81mg proved the hypothesis of the research.	The research offered more assumptions than results. The dose switching was due to patients’ preference.	Level I Good quality
Miller, et al	2019	83,749 0f 60 years old or younger women with a stroke risk as determined by California hospital records from 1995 to 31^st December 2015.	To determine whether aspirin lessens the risk of stroke in women with preceding pregnancy hypertensive disorders by calculating adjusted and unadjusted hazard ratios and confidence intervals.	Adjusted and unadjusted hazard ratios and confidence intervals for the primary outcomes of all stroke and stroke before the age of 60years.	Analysis of prior and present HDP.	83,749 were analyzed. After aspirin use the adjusted HR and CI was calculated. The results were compared for patients before and after the age of 60 years, and for non-users and users of aspirin for comparison.	4.9% of the 83,749 sample group had HDP. Those with HDP had a 95% risk of stroke which had a HR 1.3 and CI 1.2-1.4. HDP history and aspirin use were found to have an interaction (p=0.18). After comparing the HR and CI for users and non-users, it was evident that aspirin lessen the risk. Aspirin non-users had a 95% risk with HR1.5 and CI 1.0-2.1 while users had 95% risk with HR 0.8 and CI 0.4-1.7.	Women with prior HDP could use aspirin to reduce stroke risk.	The results need randomized trials to ascertain the long-term applicability of using aspirin for stroke risk reduction.	Level V Good quality
Ridker, et al	2019	39,876 healthy women with 45 years or more receiving a 100mg aspirin dose or a placebo for 10years.	To study whether low-dose aspirin can primarily prevent cardiovascular disease in women by studying their reaction to low-dose aspirin trials.	First main cardiovascular incident, individual end points, gastrointestinal bleeding, ischemic stroke, and myocardial infraction.	Randomly controlled trials on the 39,876 women for 10 years.	39,876 women were observed for 10 years. They received 100mg dose of aspirin on alternated days or a placebo. A first major cardiovascular event was noted and recorded. The risk reduction was calculated with the confidence interval. The results were compared for those using and using aspirin.	The aspirin set recorded 477 cardiovascular events while the placebo group recording 522 events. The reduction of risk was 9% which was insignificant. However, individual end points showed a 17% risk reduction. Ischemic stroke reduced by 24%. The placebo had no effect on the risk reduction of myocardial infraction. Gastrointestinal bleeding was an issue in the aspirin group.	Use of aspirin for primary prevention of cardiovascular events is conclusive with regard to individual end points.	The results are contradicting when using the tally of cardiovascular events between the aspirin and placebo group.	Level II Good quality
Sugawara, et al	2019	Patients with less than 70years or patients with more than 70 years but with hypertension, dyslipidemia, or diabetes.	To determine whether low-dose aspirin can be used for primary prevention of cardiovascular events in older patients by administering 100mg dose of aspirin to the patients between 2005 and 2007 Nursing 5024 Research Article Review Matrix Essay Assignment.	Primary events of nonfatal stroke and nonfatal myocardial infarction. Secondary outcome of cardiovascular events requiring surgical intervention.	Randomized controlled trials of patients receiving and not receiving aspirin.	Patients received 100mg dose of aspirin daily or no aspirin. Cardiovascular events such as stroke, myocardial infraction, ischemic attacks, arteriosclerotic disease, and angina pectoris were recorded for users and non-users of aspirin. The hazard ratio and confidence interval for primary and secondary outcomes was used to calculate the risk reduction.	With primary (hazard ratio [HR] 0.92 [95% confidence interval {CI} 0.74–1.16]; P = 0.50) and secondary (0.85 [0.70–1.04]; P = 0.11) the aspirin did not reduce the risk. Gastrointestinal hemorrhage occurred more in the aspirin group than the non–aspirin- group (63 [1.58%] vs 18 [0.45%]; relative risk [RR] 3.5 [2.08–5.90]; P < 0.0001). Cerebral hemorrhage occurred more in old patients than in young-old patients (33 [0.41%] vs 10 [0.15%]; HR 2.7 [1.34–5.53]; P = 0.0055). Gastrointestinal hemorrhage was slightly higher in old patients compared with young-old patients (81 [1.02%] vs 53 [0.82%]; RR 1.2 [0.88–1.76]; P = 0.21). Aspirin did not reduce the risk of the primary or secondary outcomes in old patients.	The research proved the null hypothesis. The results were encouraging for young-old patients.	The research caused intracranial hemorrhages on the older patients. The interest of the research was a failure.	Level II Good quality

PICO Question

For women under age 60 (P), does the daily use of 81mg low does Aspirin(I) reduce the future risk of stroke (O) compared with no usage of low dose Aspirin(C)?

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References

Gaziano, J. M., Brotons, C., Coppolecchia, R., Cricelli, C., Darius, H., Gorelick, P. B., … & ARRIVE Executive Committee. (2018). Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): A randomized, double-blind, placebo-controlled trial. The Lancet, 392(10152), 1036-1046. Doi: 10.1016/S0140-6736(18)31924-X. Epub 2018 Aug 26. https://www.sciencedirect.com/science/article/abs/pii/S014067361831924X

Jones, W. S., Mulder, H., Wruck, L. M., Pencina, M. J., Kripalani, S., Muñoz, D., … & Hernandez, A. F. (2021). Comparative effectiveness of aspirin dosing in cardiovascular disease. New England Journal of Medicine, 384(21), 1981-1990. DOI: 10.1056/NEJMoa2102137. https://www.nejm.org/doi/full/10.1056/NEJMoa2102137

Miller, E. C., Boehme, A. K., Chung, N. T., Wang, S. S., Lacey, J. V., Lakshminarayan, K., … & Willey, J. Z. (2019). Aspirin reduces long-term stroke risk in women with prior hypertensive disorders of pregnancy. Neurology, 92(4), e305-e316. DOI:10.1212/WNL.0000000000006815. https://n.neurology.org/content/92/4/e305.abstract

Ridker, P. M., Cook, N. R., Lee, I. M., Gordon, D., Gaziano, J. M., Manson, J. E., … & Buring, J. E. (2019). A randomized trial of low-dose aspirin in the primary prevention of cardiovascular disease in women. New England Journal of Medicine, 352(13), 1293-1304. https://www.nejm.org/doi/full/10.1056/NEJMoa050613

Sugawara, M., Goto, Y., Yamazaki, T., Teramoto, T., Oikawa, S., Shimada, K., … & Ikeda, Y. (2019). Low-dose aspirin for primary prevention of cardiovascular events in elderly Japanese patients with atherosclerotic risk factors: subanalysis of a randomized clinical trial (JPPP-70). American Journal of Cardiovascular Drugs, 19(3), 299-311. DOI: 10.1007/s40256-018-0313-0. https://link.springer.com/article/10.1007/s40256-018-0313-0

PICO QUESTION: For women under age 60 (P), does the daily use of 81mg low does Aspirin(I) reduce the future risk of stroke (O) compared with no usage of low dose Aspirin(C)?

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References

Gaziano, J. M., Brotons, C., Coppolecchia, R., Cricelli, C., Darius, H., Gorelick, P. B., … ARRIVE Executive Committee. (2018). Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): A randomized, double-blind, placebo-controlled trial. The Lancet, 392(10152), 1036-1046. https://doi.org/10.1016/S0140-6736(18)31924-X. Epub 2018 Aug 26.

Sugawara, M., Goto, Y., Yamazaki, T., Teramoto, T., Oikawa, S., Shimada, K., … & Ikeda, Y. (2019). Low-dose aspirin for primary prevention of cardiovascular events in elderly Japanese patients with atherosclerotic risk factors: s Subanalysis of a randomized clinical trial (JPPP-70). American Journal of Cardiovascular Drugs, 19(3), 299-311. DOI: 10.1007/s40256-018-0313-0 Nursing 5024 Research Article Review Matrix Essay Assignment.

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