Analyzing 5 health Articles using a Matrix Document

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MATRIX

Matrix Document

Matrix

APA Citation:

Lassen, M. R., Gallus, A., Raskob, G. E., Pineo, G., Chen, D., & Ramirez, L. M. (2010). Apixaban versus Enoxaparin for Thromboprophylaxis after Hip Replacement. New England Journal of Medicine, 363(26), 2487–2498. https://doi.org/10.1056/NEJMoa1006885

Variable and key concepts

The study sought to compare the effectiveness of apixaban and enoxaparian as treatments for thromboprophylaxis following hip replacement. The hypothesis was not clearly stated, but from the background information provided, it is implicit that the researchers hypothesized that apixaban is more effective for treating venous thromboembolism (VTE) after hip replacement surgery.

Sampling

5,407 patients scheduled for hip replacement were recruited from 160 healthcare facilities in 21 countries to participate in the study. This is without a doubt a sufficient sample size. Potential subjects were singled out during a screening exercise conducted 14 days prior to scheduled surgery. Out of the 5,407 patients initially recruited, only 72% were included in the final analysis.

Design and Method

The research was designed as a double-blind randomized controlled study. An experimental design was appropriate given that the study aimed to compare the effectiveness of apixaban and enoxaparian in treating VTE after hip replacement.

Instruments/Data Collection

Data was collected following the administration of the interventions. Following surgery, subjects were assessed for symptoms of VTE, pulmonary embolism, deep vein thrombosis, bleeding, wound infections, and VTE-related death. The data was collected using a survey, which was appropriate given the objective of the study.

Results

As expected, apixaban was found to be more effective in treating VTE after hip replacement compared to enoxaparin. Also, apixaban was associated with reduced bleeding.

Strengths & Limitations

Strengths:

· A sufficiently large sample was used

· A low dropout rate (28%)

· There were significant statistical differences between the two groups

Limitations:

· No notable limitations

Critique

Overall, the study is a valuable contribution to the literature on effective regimens for thromboprophylaxis following hip replacement surgery. The researchers have clearly explained the research, making it easy for the reader to understand. The study would be a useful addition to the literature review.

APA Citation:

Lassen, M. R., Raskob, G. E., Gallus, A., Pineo, G., Chen, D., & Hornick, P. (2010). Apixaban versus enoxaparin for thromboprophylaxis after knee replacement (ADVANCE-2): a randomized, double-blind trial. The Lancet, 375(9717), 807–815. https://doi.org/10.1016/S0140-6736(09)62125-5

Variable and key concepts

This study also sought to investigate the efficacy and safety of apixaban versus enoxaparin, albeit for knee replacement surgery as opposed to hip replacement surgery. The hypothesis is not clearly stated, but it is implicit that the researchers hypothesized that apixaban is more effective and safer for thromboprophylaxis following knee replacement surgery.

Sampling

3,057 patients scheduled for knee replacement surgery were recruited from multiple healthcare centers to take part in the study: 1,528 patients in the apixaban group and 1,529 in the enoxaparin group. This is a fairly representative sample. Potential subjects were singled out during a screening exercise conducted 14 days prior to the scheduled surgery. Out of the 3,057 patients initially recruited, 1,973 were suitable for efficacy analysis, translating to a 35.5% dropout rate.

Design and Method

The study was a double-blind, randomized controlled trial (RCT). Given that the research aimed to compare the efficacy of apixaban and enoxaparin, an RCT design was appropriate.

Instruments/Data Collection

The primary outcomes were symptoms of deep vein thrombosis, pulmonary embolism, and mortality in the course of treatment. These outcomes were sufficient as they are the major events likely to occur after knee replacement surgery. A survey was used to collect data relating to these outcomes.

Results

15% of patients in the apixaban group depicted the primary outcomes compared to 24% in the enoxaparin group. Also, non-major bleeding was reported in 4% of the patients in the apixaban group and 5% in the enoxaparin group. Hence, as expected, apixaban turned out to be more effective and safer for thromboprophylaxis following knee replacement surgery compared to enoxaparin.

Strengths & Limitations

Strengths:

· A fairly large sample was used

· There were significant statistical differences between the two groups

Limitations:

· No notable limitations

Critique

Overall, the study would be a valuable item in the literature review. It provides useful information on the effectiveness and safety of apixaban and enoxaparin as thromboprophylaxis regimens after knee replacement surgery. The study is well organized and explained, making it easy for the reader to understand.

APA Citation:

Nieto, J. A., Espada, N. G., Merino, R. G., & González, T. C. (2012). Dabigatran, Rivaroxaban and Apixaban versus Enoxaparin for thromboprophylaxis after total knee or hip arthroplasty: Pool-analysis of phase III randomized clinical trials. Thrombosis Research, 130(2), 183–191. https://doi.org/10.1016/j.thromres.2012.02.011

Variable and key concepts

This study aimed to compare the effectiveness of oral anticoagulants (dabigatran, rivaroxaban and apixaban) versus enoxaparia in treating VTE following total knee or hip replacement. The hypothesis is implied, but the objective of the study was clearly stated.

Sampling

The study included a total of 32,144 patients scheduled for either in knee or hip replacement surgery. This is certainly a large sample. The subjects were drawn from numerous centers in different countries.

Design and Method

The research was designed as a pool analysis of 10 randomized controlled experiments. This design was appropriate given the objective of the study.

Instruments/Data Collection

The primary efficacy outcomes included VTE, deep vein thrombosis, and VTE-related death. The primary safety outcome included major bleeding. The data was collected using a survey, which was appropriate for the study.

Results

As expected, oral anticoagulants were found to be more effective for treating VTE after hip or knee arthroplasty compared to enoxaparin. Nonetheless, similar safety scores were reported for both interventions.

Strengths & Limitations

Strengths:

· The study brought together 10 RCTs. The studies collectively had a sample of 32,144 subjects, which is a sufficiently representative sample for purposes of generalization.

Limitations:

· There were no significant statistical differences between the two groups.

Critique

The study would be a valuable item for the literature review as it reports the results of 10 RCTs measuring the effectiveness and safety of oral anticoagulants versus enoxaparin as thromboprophylaxis regimens for hip and knee replacement. The research is well explained and easily understandable.

APA Citation:

Raskob, G. E., Gallus, A. S., Pineo, G. F., Chen, D., Ramirez, L.-M., Wright, R. T., & Lassen, M. R. (2012). Apixaban versus enoxaparin for thromboprophylaxis after hip or knee replacement. J Bone Joint Surg Br, 94–B(2), 257–264. https://doi.org/10.1302/0301-620X.94B2.27850

Variable and key concepts

The authors of this research aimed to compare the efficacy of oral apixaban and enoxaparin for thromboprophylaxis following knee or hip replacement surgery. The objective of the study was clearly mentioned, though the hypothesis was implied.

Sampling

The participants of the study were 8,464 patients scheduled to undergo either knee or hip replacement surgery. This sample size can be described as sufficient. The participants were recruited during screening for knee or hip replacement surgery. Of the 8,464 patients initially recruited, 6,788 were eligible for efficacy analysis.

Design and Method

The research was a pooled analysis of two double-blinded RCTs. This was an appropriate design for the study given its objectives.

Instruments/Data Collection

The outcomes measured included VTE and major bleeding following knee or hip replacement surgery. Arguably, this data was not sufficient as other crucial outcomes such as VTE-related death and deep vein thrombosis were not considered. The data was collected using a survey.

Results

The results of the pool analysis indicated that VTE occurred in 0.7% of the patients in the apixaban group and 1.5% of the patients in the enopaxarin group. Furthermore, major bleeding occurred in 0.7% of the patients in the apixaban group and 0.8% of the patients in the enopaxarin group. Overall, apixaban was found to be more effective and safer as a regimen for VTE following knee or hip replacement surgery. These results were expected given most studies support the efficacy of apixaban over enopaxarin.

Strengths & Limitations

Strengths:

· A large sample was used

· The study showed significant statistical differences

Limitations:

· Variables such as VTE-related mortality were not measured.

· Only two RCTs were included

Critique

Overall, the study would be a useful item for the literature review. The research is well organized and easily understandable.

APA Citation:

Yan, X., Gu, X., Zhou, L., Lin, H., & Wu, B. (2016). Cost Effectiveness of Apixaban and Enoxaparin for the Prevention of Venous Thromboembolism After Total Knee Replacement in China. Clinical Drug Investigation, 36(12), 1001–1010. https://doi.org/10.1007/s40261-016-0444-5

Variable and key concepts

Dissimilar to other studies in this matrix, this study sought to establish not only the benefits, but also the cost effectiveness of apixaban and enopaxarin as thrombophylaxis regimens for knee replacement. The objective of the study was clearly stated, but the hypothesis was implied.

Sampling

The study was conducted within the context of China. The researchers focused on Chinese patients who had undergone total knee replacement surgery.