Making Sense of a New Technology in Clinical Practice

What is the purpose of this research?

The purpose of the study by Pals et al. (2015) was to check whether patients and doctors would perceive a device (“Vagus”) as useful for detecting CAN (cardiovascular autonomic neuropathy).

What is the research question (or questions)? This may be implicit or explicit

The research questions were: Are physicians able to communicate the purpose and the meaning of the CAN test to patients? Do patients understand the purpose and meaning of the CAN test and its behavioral implications?

Give a complete description of the research design of this study

The study is qualitative, employing semi-structured interviews with further content-analysis of the gathered data.

What is the population (sample) for this study?

The population includes patients suffering from diabetes, and doctors attending to such patients. The sample was recruited in a diabetes clinic and included 19 patients who underwent the CAN test and 9 doctors that reported the results of this test.

Was the sampling approach adequate for the research design that was selected and explain why?

The sampling approach was adequate for the research because it was needed to study how patients/physicians perceived the test. The study was qualitative, with interviews, in which cases random sampling techniques are not commonly used. In this case, purposeful sampling was employed, which permitted to interview of participants with the desired characteristics.

Describe the data collection procedure

The data was collected from patients who underwent the CAN test, and from physicians, most of whom were purposefully selected. (It should be noted that the response rate was low; e.g., most physicians were purposefully asked to be interviewed after they refused initially; many patients did not recall using the CAN test at all.) The data was collected via semi-structured interviews; it is stated that “the duration of each interview was about 30 min (mean: 22 min),” whatever that means (Pals et al., 2015, p. 5).

How were the data analyzed?

The data were analyzed qualitatively, with content analysis techniques, to identify the statements about the knowledge about and views on the CAN test concerning what it means for clinical practice and the patient’s condition. Main themes in the responses were identified to pinpoint the technological frames that doctors and patients were using

Discuss the limitations found in the study?

Many patients did not recall utilizing the test, and thus, could not explain their opinions about it. Also, only very few of the doctors who participated in tests agreed to be interviewed. It is also stated that the three central concepts identified (views on the clinical relevance of the CAN test; communication of the results of the test, which are difficult to comprehend; motivation for changes in behaviors) are intertwined, and are hard to distinguish from reach other. Finally, the test was not compared with any other similar tests and technologies.

Discuss the authors’ conclusions. Do you feel these conclusions are based on the data that they collected?

It is concluded that doctors found it difficult to communicate the purpose of the test to patients, and patients were unsure about what the test meant. The conclusions are based on the collected data.

How does this advance knowledge in the field?

These results show that doctors should employ other techniques than those which were employed for explaining the purpose of identifying CAN, as well as for elaborating how patients should change their behavior if they have CAN.

References:

Pals, R. S., Hansen, U. M., Johansen, C. B., Hansen, C. S., Jørgensen, M. E., Fleischer, J., & Willaing, I. (2015). Making sense of new technology in clinical practice: A qualitative study of patient and physician perspectives. BMC Health Services Research, 15(1), 1-10. Web.

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