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NB3083 Biostatistik Gunaan Kritikan Artikel Jurnal. Tajuk Jurnal : Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet. Kumpulan: Diet 1. Title.
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NB3083 BiostatistikGunaanKritikanArtikelJurnal TajukJurnal: Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet. Kumpulan: Diet 1
Title • The title is appropriate and clearly indicated the focus of the study, but the independent and dependent variables and population of study were not stated. It is better for the strength of the study to include these variables in the title which makes it clearer .
Abstract (Strength) • The data gathering method are clearly explained and agree with the title. • The population of sample used was adequate and situation was explained. • The conclusion were based on the findings and logically stated.
Abstract (Weakness) • The background was short and not clearly explain. • The purpose was not clearly stated and was limited to researcher capabilities and resources. • The objective was not reported.
Hypotheses • Hypothesis of the research was not clearly stated, but implicitly researchers stated that the low carbohydrate diet may be effective alternative to low-fat diet.
Introduction • Similar studies were cited and pertinent to the research problem. • The review concludes brief summary of relevant literature and its implications for the research problemunder study. • The review did not relate directly to research problem. It summarizes the previous work and the results.
Method • This journal state clearly the place this research conducted that is in Dimona, Israel in a workshop at a research center medical clinic. • The date was stated clearly between July 2005 to June 2007 with a period of 2 years . • This research was define clearly the type of subject to be investigated with a clear and organized procedure to carry out this research.
Population • This research with 322 moderately obese person was randomly assigned with several criteria which eligible to take part in this research was clearly define .
Method • This research data was evaluated by validated food frequency questionnaire . • The research also involve validated questionnaire to assess physical activity . • Participant completing questionnaire were assisted by the study nurse and dietitian. • The data collection also refer to Israel food database
This research also included the used of generalized estimating equations for panel data analysis, also known as cross-sectional time-series. • Besides, it also usedStata software XTGEE command for non-independence of repeated measurement.
Result (Strength) • The result is related well to the title of study that is to compare the three different methods(low-carbohydrate diet,low-fat diet and Mediterranean-diet)in weight loss. • The figures and tables have clear title and well designed. The results in table and figure are arranged properly in a way that different groups(low-carbohydrate, low-fat and Mediterranean-diet group)can be compared.
This study shows a clear explanation in results or findings that gained.The details are stated completely for each group including the exact number, standard deviation and percentage of weight decrease,the p value for each test to determine whether it is significant and confidence interval. • The result was recorded accurately from time to time within 24 months after different methods of weight loss being introduced to follow up the progress of subjects.
Percentage of compliance of subjects have been identified as there are persons that withdrew from the study from time to time. • The enrolment of the participants and the completion of the study are explained in a very clear flow chart starting from December 2004 until June 2007. This makes the reader very clear about the overall process and the end results of this study.
-Figure 2 shows easy understanding on the mean weight change(kg)due to different diet group in 24 months.Low-carbohydrate has the most loss of weight while low fat diet has the least loss of weight. The colour used is sharp and clearly differentiate the three diet groups.X-axis and y-axis also stated clearly.
Result (Weakness) • The level of compliance of subjects in this study is low. There is only 84.6% of compliance at the end of study as many subjects withdrew from time to time. • The level of adherence for the three diet groups are not the same as the number of person who complete the intervention for 24 months for low-fat and Mediterranean diet are about the same (94 &93 respectively)while for low-carbohydrate diet is only 85 person.
The authors mentioned that during the study,there was little change in usage of medications and there were no significant differences among groups in the amount of change.The authors should not come with this opinion or conclusion without any evidence. • The tables that show result are a bit small and there are too many information in a table but do not show clearly the main aspects and difference between three diet groups that the author want to study in this research.
In Figure 2,the weight changes for three diet groups is shown.The type of diet should be stated near each line of plottings for clearer understanding at first sight.Inaddition,this figure does not indicate much about the pattern of weight changes within 2 years as all diet groups decrease in weight for first 5 months then regain weight for the following months until 17th or 18th month then weight is maintained until the end of study.
Discussion (Strength) • Author does not overemphasize on one idea. • Example: In addition to producing weight loss in this moderately obese group of participants, the low-carbohydrate and Mediterranean diets had some beneficial metabolic effects, a result suggesting that these dietary strategies might be considered in clinical practice and that diets might be individualized according to personal preferences and metabolic needs. • The author does not overemphasize on weight loss for both low-carbohydrate and Mediterranean diets, but also taking into consideration of metabolic effects.
Changes in biomarkers according to all three diet groups was provided in graph form and explained with a short narrative. • The findings were well organized, sectioned and reported objectively. The graphs were well organized but, due to the difficulty of the statistical tests employed, would not stand alone to the average reader. • Author’s statements have theoretical implication • Example: Consumption of monounsaturated fat is thought to improve insulin sensitivity, an effect that may explain that favorable effect of the Mediterranean diet on glucose and insulin level.
Author’s statements were clear regarding limitations and strength of the study. • LIMITATION • Example: We enrolled few women; however, we observed a significant interaction between the effects of diet group and sex on weight loss (women tended to lose more weight on the Mediterranean diet), and this difference between men and women also reflected in the changes in leptin levels. • Author suggested that this possible sex-specific difference should be explored in further study.
STRENGTH • Example: This study included the one phase design, in which all participants started simultaneously; the relatively long duration of the study; the large study group size; and the high rate of adherence. • Author stated that monthly measurements of weight permitted a better understanding of the weight loss trajectory than was the case in previous study.
Discussion (Weakness) • Author’s statements were not comparing with the previous work • Author does not comparing his work with the previous research • The author didn’t give the suggestions for further studies to expand this research such as the suitable area at the end of sentences. They are simply proposing a model to improve health that can be widely used in the workplace only. • Example : this trial also suggests a model that might be applied more broadly in the workplace. As Okie recently suggested, using the employer as a health coach could be a cost-effective way to improve health.
Summary • There isno summary included in this study. • The summary is important to give an overview to the readers about the study in form of shorter sentences.
List of References • The format used in listing references was consistent and all references given were cited in the article. • The references were from a variety of sources including journals, books, and theses. • The references are not arranged alphabetically.
Overall Critique of the Study • Every report study has strengths and weaknesses. Qualitative research usually offers a base of knowledge and stimulates further studies. Quantitative research presented by numeric and tables strengthen the report of qualitative research. This study is both qualitative and quantitative, that’s why researcher presents the data and findings by tables and graph to make it easy to understand. • For the most part, it was well written and well organized. There was a definite need for a short review of literature to develop the situation. The article did get a little complicated in the reporting of data due to the complicated statistical procedures used. Overall, it was a very interesting, significant contribution to the field of research.
According to the journal • The criteria for eligibility were an age of 40 to 65 years and a body-mass index (BMI, the weight in kilograms divided by the square of the height in meters) of at least 27, or the presence of type 2 diabetes (according to the American Diabetes Associationcriteria18) or coronary heart disease, regardless of age and BMI.
In Malaysia • The nationwide Third National Health and Morbidity Survey (NHMS III) conducted in 2006 showed that 29.1% of the adult population studied was found to be overweight (BMI 25.0 to 29.9). The prevalence of obesity (BMI >30) was reported to be 14.0%. The proportion of the adult population that are overweight and obese is therefore 43.1% Source: Tee, E.S. 2010. Oversize me. http://thestar.com.my/health/story.asp?file=/2010/7/18/health/6665358&sec=health. [08 May 2012]
As if we are going to carry out the research entitled “ Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet in Malaysia ”. It is known that 43.1% of Malaysian are overweight and obese. Assume that confidence level needed is 95% and accuracy estimated to be within 5%.
Sample size for nominal data estimating for single proportion for large population nₒ = (Z α/2 )2 p(1-p) Δ2 P = 0.431, Z α/2 = 1.96, Δ2 = 0.05 nₒ = (1.96)2 0.431 (1-0.431) (0.05)2 nₒ ≈ 377 Thus, our sample size needed for this research are 377 subjects with BMI >25.0
