Physical Activity In Addition Sleep Quality

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Physical Activity In Addition Sleep Quality

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Discuss About The Physical Activity In Addition Sleep Quality.

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Introduction

The assignment is the critique of the randomised control trial by Lean et al. (2018) using the CASP checklist. As per the CASP observation the author had clearly focused issue. The issue is type 2 diabetes in population aged 20–65 years and the intervention targeted is the weight management. The control group is not subjected to this intervention. The outcomes of the intervention include remission of type 2 diabetes. This ensures the validity of the trial as per the CASP framework.
On further critiquing the validity, it was found that the patients were randomised to avoid contamination between treatment groups. The validity seems to have been hampered as the allocation was not concealed as recommended by the CASP framework. However, it was justified as the intervention was lifestyle management. To maintain the balance for practice list size, the randomisation was stratified. All the patients were analysed in the group to which they were randomised and the trial was not stopped before 12 months for any adverse events. Based on this data the validity seems to be ensured and the paper was worth continuing (Casp-uk.net 2018).

The groups were similar at the start of the intervention; however, they were aware of the planned allocation. The health workers and the patients were not blind to treatment as the intervention was in primary care setting. There are other factors that may affect the results which are racial and ethnic characteristics. It is the limitation of the study. Also there was no detailed body composition assessed. There was no bias related to gender and age. The group was also treated equally in all aspects as recommended by the CASP framework (Casp-uk.net 2018).
On critiquing the result it was found that the outcomes measured were reduction of weight 15 kg or more, diabetes remission, HbA less than 48 mmol/mol after ant diabetic medication given for 2 months and outcomes were measured from baseline to 12 months. Thus the primary outcomes and secondary outcomes are specified. The later includes quality of life, serum lipids; and physical activity in addition to sleep quality, blood pressure and programme acceptability. The results of each outcome include loss of desired weight only in intervention group and not in control group. There was diabetes remission in 64% of participants and only 4% in control group. The intervention group also showed improvement in the quality of life (Lean et al. 2018). The results were significant at 95% confidence interval. The results seem to be reliable and valid as the findings are generalisable with sample characteristics being similar to the general population with diabetes. Overall it can be interpreted that there are more benefits than harms and costs. Therefore, remission of type 2 diabetes can be called a practical target for the primary care.

References
Casp-uk.net. 2018. [online] Available at: https://casp-uk.net/wp-content/uploads/2018/01/CASP-Randomised-Controlled-Trial-Checklist.pdf [Accessed 8 Jul. 2018].
Lean, M.E., Leslie, W.S., Barnes, A.C., Brosnahan, N., Thom, G., McCombie, L., Peters, C., Zhyzhneuskaya, S., Al-Mrabeh, A., Hollingsworth, K.G. and Rodrigues, A.M., 2018. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. The Lancet, 391(10120), pp.541-551.

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