The
reviewer, XXX , chose an article entitled “Randomized Controlled Trial of Yoga
among a Multiethnic Sample of Breast Cancer Patients: Effects on Quality of
Life” which was published in the Journal of Clinical Oncology. The reviewer
thoroughly explained how the introduction section of the paper built logical
case to provide context for the problem statement. The problem statement was
that it is not known whether yoga could improve the quality of life (QoL) of
minority population (i.e. African American, Hispanic) who survived from cancer
although yoga has been examined to enrich QoL in other individuals (i.e. groups
of varying educational and ethnic backgrounds) both with and without cancer. It
was pointed out by the reviewer that the reviewer failed to provide an explicit
conceptual framework and a hypothesis statement. Elements in group 1 of the
checklist of review criteria was well investigated; however, it might have been
better if the reviewer included the statement why this article has been selected.
As mentioned by the reviewer, the literature
review was related to the construct of interest and up-to-date; however, it was
not comprehensive as the author failed to include the background information
regarding minority population. The argument, the need of the study, could have
been more persuasive if the author included why more attention is needed to
this population and what makes it difficult for them to participate in
interventions.
The aim of the reviewed article was
to examine the impact of yoga on quality of life of minority population which
is clearly relevant to the aims and scope of the journal, Journal of Clinical
Oncology, which focus on breast
cancer, molecular oncology, supportive care and quality of life issues. The
reviewer mentioned about the generalizability and replicability of the study
based on the selection of participants, setting, and measures (QoL). The fact
that other minority populations (i.e. Asian American, Pacific Islander, Native
American, etc.) were not included was pointed out by the reviewer. This is
important because not including other minority groups could lead to a selection
bias which means that the recruited participants are not representative of the
population of the interest. Moreover, the reviewer stated that the
authors failed to provide sufficient detail in participant recruitment process
which reduce the replicability. The randomization process was also not included
by the author which makes it difficult to know whether confounding variables
were balanced at the baseline. Although this could increase the chance to
introduce bias, the reviewer missed to point this out.
The major
weakness of the design pointed out by the reviewer was the variability of the
amount of practice in yoga. She stated that the variability in the dosage of
yoga practice could have affected internal validity creating challenge in the
process of interpreting the results. Moreover, the reviewer mentioned that
information regarding the yoga intervention such as description for both
at-home and in-person class yoga prescription was not sufficient enough to be
replicated. However, the author clearly stated that audiotape/compact disks
were provided to guide at-home daily yoga practice even though the contents in
those materials were not provided. Overall, the research design (i.e. yoga
intervention, internal and external validity) of the study was thoroughly
analyzed.
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