Answer

• Activity A1.7: Article Evaluation Based on Drummond’s Criteria

  Introduction

  This activity uses two of the ten criteria developed by Drummond to analyze how Freeman et al. (2011) conducted their study with particular focus on research questions and methods used to establish the effectiveness of Warfarin and Dabigatran in preventing stroke in arterial fibrillation (AF) patients. The two criteria used are 1) “was a well-defined question posed in answerable form?”; and 3) “was the effectiveness of the programme or services established?” (US National Institutes of Health, 2007).

  Although Fieldman et al. (2011) did not clearly state their research question, they framed their study’s objective in an answerable form. First, the researchers assessed both the costs and effectiveness of dabigatran in reducing the risks of ischemic stroke in AF patients and then compared it with warfarin to establish which of the two medications was more effective. This meets the first criterion highlighted on Drummond’s checklist, which requires a study to examine both the costs and effects of a given intervention or program and compare it with at least one alternative for it to be considered relevant and appropriate. Second, the authors clarified that they approached their analysis from a societal perspective, leading them to conclude that dabigatran is a cost-effective alternative to AF patients aged 65 years or older at an increased risk of stroke. This again aligns with one of Drummond’s requirements that a researcher must clearly state the viewpoints for their analysis. While the authors failed to clarify the decision-making context of their study, it can be inferred from the study objective and conclusion that it is a clinical setting.

  The authors established the treatment- and cost-effectiveness of dabigatran as compared to warfarin using a single randomized clinical trial. This happens to be the study’s major limitation because according to Drummond’s criteria, the effectiveness of a given intervention or programme must be established through randomized controlled clinical trials.   

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