Effectiveness of enhanced communication therapy in the first four months after stroke for aphasia and dysarthria: a ramdomized controlled trial by Bowen et al.

Effectiveness of enhanced communication therapy in the first four months after stroke for Aphasia and Dysarthria: a randomized controlled trial by Bowen et al.
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Effectiveness of enhanced communication therapy in the first four months after stroke for Aphasia and Dysarthria: a randomized controlled trial by Bowen et al.
Comment on threats to validity and how evidence from this study is strengthened by protections from threats or weakened by unprotected threats
The study by Bowen is crucial and need to initiate debate on the way therapy is given in the early stages of patients after stroke. Currently, the evidence provided is not sufficient to ensure large scale changes in the provision of services for individuals suffering from such disorders based on the findings of the study. There is bias as past studies including that of Bowen make an exclusion of individuals with such disorders of communication. The recruitment of the ACT was seen as being selective and slow as only 21% of the participants were recruited and from this only 44% were later recruited to provide consent and this is due to an inclusion criterion that was seldom used. Patients with communication disorders should have been invited by the researcher to participate as 699 members were excluded.
Assess baseline homogeneity of groups or the adequacy of follow-up
The outcome measurement was indicated as being reliable there is no seen sensitivity when it comes to the use of different methods shown in the study.

Those concerned need to agree on outcome measures that have strong psychometric indicators which can be put in place while giving clinical changes to measure the rate of recovery. Preferably, the use of a universal measure of outcome should be employed, one that should be used with intervention research which are specific to dysarthria and aphasia rehabilitation. The use of quality guidelines to comply with different scientific requirements is ignored by the study.
Comment on Effect size (statistically significant), Confidence Interval (widths of the confidence intervals), issues related to negative trials. Will the results help me in caring for my patients?
The research sample size is not significant and the confidence level not reliable. The level of confidence that is related to the interval often shows the probability that the range of the confidence gets the real and true population when a distribution sample is provided. The results from the research will not be of great help when the need to care for patients arises. Through the use of the 95% CI with the (5) calculator interval, it is clear that the research had no statistical power to agree with the authors conclusion.
The group difference for the period stated was not significant as it indicates 0.25 (95% CI –0.19 to 0.69) points when considerations of therapy are made. The idea of sensitivity analyses, which became apparent after the adjustment for chance baseline imbalance made the difference low. Additions to improved therapy were also void on the part of secondary outcomes like aphasia or bad effects though it was not common after involvement, the ratio of odds was at (0.42 (95% CI0.16 to 1.1)).