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Naturalistic Design Clinical Research

The topic I chose for naturalistic design clinical research concerns physician advice on

the topic of smoking cessation. The hypothesis was that advice from a medical practitioner is

deemed more effective than not receiving any advice and the advice is always more beneficial if

it includes follow ups. The hypothesis also states that it would be important to supplement the

advice with guides such as self help manuals and visual aids. It is pertinent to motivate the

patient in order to ensure the advice is being implemented, and not simply received.

The aim of the article is to assess the effectiveness of advice from physicians in

promoting smoking cessation, in comparison to the otherwise minimal interventions received by.

It compares several types of advice, from effectiveness of various aids to brief advice given by

passersby to computer-generated tailored letters, as well as pamphlet handouts. It even includes

additional aids such as demonstration of expired carbon dioxide levels or pulmonary function

tests. It even collected data on the specific effects that anti-smoking has on overall mortality of

patients.

The data was collected from several different countries, over the span of several years

(specifically between the years 1972 and 2013). This ensures that there is not only plenty of data

to base the study on, but also that the data represents a general demographic, and can determine

the effect of smoking on the state of current humanity. The main outcome measured was the

amount of people who abstained from smoking for at least six months, and were followed up on.

These were randomized trials so as to not fall under selection bias.

The study is very well conducted and the conceptual framework for the project is very

clear about the method of data collection, as are the selected boundaries of the study. Validity
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and reliability of the research were very clear in the article, as there is research and data to back

up the truthfulness of the facts, and multiple repetition of the evidence to prove the accuracy of

the information. The study even specified that certain patients had specific diseases that could be

related to smoking and could have confounding consequences, so as to take into consideration

the effects of this on the study.

The study shows a clear application of a naturalistic hypothesis that a patient can quit the

smoking on physician advice. The purpose of the study is to test which is more beneficial for the

general population to improve their health by stopping smoking. As smoking is a social issue, it

does not take as alarm of harmfulness. In many cultures it is the norm, and completely socially

acceptable to smoke. The rate of smoking prevalence has increased in the female population over

the past few years, as changes in society and culture have come about.

There were certain boundaries set for the study. Participants could be smokers of either

gender, but pregnant women were not to be included, as there is much controversy and ethical

issue surrounding that issue because smoking can have dire effects on the fetus. The article

clearly describes the types of studies selected, as well as the process by which they were quasi

randomised controlled trials.

The search method based information on Cochrane Tobacco Addiction Trials from

electronic searching of Medline, Embase and Psycinfo, and the Latin American database which

covered six databases through the virtual library of health in 2013. The article gave the full

search strategy used to identify reports of trials which ensure the validity and reliability .The data

has been reviewed for each trial, the documented following aspects such as country of origin,

study population, eligibility criteria, nature of the intervention, details of study design, and

validation of smoking status.

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From the article it is clear that the research was assessed thoroughly. The methodological

quality and the Data analysis shows 95% confidence interval for the estimate. The only dilemma

depicted was that many randomised participants had been lost over time, or were out of reach

and therefore were unable to come for a follow up.

All the conclusions supported the study and the result indicates the potential benefits that

are derived from even brief advice given by physician to their patients. This is useful as it means

that doctors can make a difference with even simple talks with patients who have begun smoking

and even work on prevention with patients who have not yet started smoking. Providing follow

ups is likely to produce additional benefit. This way patients have an outlet to discuss and

understand the risks of their behavior with a well informed professional, in a safe setting.

Primary care seemed to be the main source of delivery for the advice. Primary care has long been

considered the branch that focuses on prevention, as that should be a priority for all doctors,

especially concerning health risks that can be avoided.

Smoking is so prevalent, millions of Americans are currently dealing with their habits,

and there is a growing mortality rate of lung cancer every year. It is important to keep updated

with studies that are especially relevant to the demographic so that we can be aware of the issues

that patients are currently facing and be able to help overcome these issues using methods that

have been tested and backed by ample research. I like this reviewed article as it covered pretty

much everything I read in the clinical research book as well as learned in class. It followed all

the criteria for the critical evaluation of the literature, such as the purpose of the study and how it

influences the design.

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Works Cited

Physician Advice for Smoking Cessation. Wiley, John Wiley & Sons, Ltd, 31 May 2013,

onlinelibrary.wiley.com/doi/10.1002/14651858.CD000165.pub4/full.ll.