• Category:
  • Document type:
  • Level:
  • Page:
  • Words:

A critique of a quantitative paper2


A critique of a quantitative paper

The article titled Postoperative Gum Chewing after gynaecologic Laparoscopic surgery is published in the Green Journal. The journal is peer-reviewed since it meets the standards outlined by the Eighth International Congress on Peer Review and Biomedical Publication. All medical journals must adhere to the stated standards and are varied from the 10th September 2012 to the year 2017.

The article titled Postoperative Gum Chewing after gynaecologic Laparoscopic surgery was authored by Heinrich Husslein, MD (Husslein et al., 2013). He was in collaboration with other medicinal doctors including Maxmilian Franz, Martina Gutschi, Stephan Polterauer and Heinz Leipold. He is an expert in the fields of gynaecology and obstetrics that are addressed in the journal. Other skills and expertise possessed relevant to the field of study are laparoscopic surgery and vaginal surgery. The fellow authors of the journal are also experts in the field enabling them to conduct the study. Maxmilian Franz and Heinz Lipold have expertise in gynaecology and obstetrics. They are linked by the Medical University of Vienna in Vienna, Austria where many work in the department of obstetrics and gynaecology. Due to the balanced skills of the author caused by the diverse knowledge, the likelihood of discrimination in the study is minimized.

The choice of the title is appropriate to the study as it outlines all the aspects that are considered in the study. The study involves analysing the effect that chewing gum has in postoperative. It also maintains clarity indicating that the effect of gum chewing is only after surgery (Husslein et al., 2013). The type of surgery to be carried is also indicated and the area it addresses is also well represented in the title. The title, however, does not explain how the act of gum chewing is expected to have an impact.

The research question is addressed well in the objective of the study. It goes deeper in explaining how chewing of gum is expected to impact laparoscopic surgery. It is specific that the effect is tested on the bowel motility that impact defecation (Husslein et al., 2013). The abstract of the journal clearly outlines the reason for carrying out the study. Methods used to collect and analyse data, the results obtained and the conclusion of the research are clearly described in the abstract.

The literature review is used by the authors to explain the need for carrying out the analysis by borrowing from the existing literature. It is widely known that chewing gum imitate food intake and is believed by several scientists to have an impact on the intestinal activities. Several reports indicated in the literature review have mentioned the role of sham feeding, achieved by chewing gum, plays the intestinal motility through movements in the duodenum and stomach (Husslein et al., 2013). The journal also outlines other related content to the study such as the increase in the secretion of saliva and pancreatic juice and the release of other gastrointestinal hormones used in digestive system due to chewing (Husslein et al., 2013).

The paper identifies the gap in existing literature where after surgery is done, the bowel mobility is adversely affected depending on the length and depth of the incision. Research has only been done on the impact of chewing gum after surgery has only involved bowel surgery (Husslein et al., 2013). It has left a gap in knowledge on the impact expected on bowel motility without the involvement of bowel. The paper aims to fill the identified gap in knowledge using a controlled trial.

The methodology adopted in the study used random sample selection where the study group included volunteer from previous research who had undergone caesarean delivery. The study group was appropriate to help assess the impact comparing it with the previous study. The total sample population was 189 who participated in previous research where a sample size of 85 participants was selected. A significance level of 0.05 is calculated and power of 90 percent (Husslein et al., 2013). The generally accepted standards in calculation of a sample size in clinical research are 90 percent power and a significance level of 0.05. The sample size hereby adheres to the standards and the results of the study can be used to generalize.

A total of nine patients were excluded from the clinical trials where the exclusion was based on age and medical history. By age, patients younger than eighteen years and older than eighty years were excluded. Volunteers with the loose tooth, chronic obstipation and those that had experienced celiotomy were excluded from the research (Husslein et al., 2013). The exclusion was justifiable to prevent complication during surgery. The physicians were blinded on the patients using gums to avoid intentional manipulation of data. The patients also received the same medication and the tests were done at the same time to achieve equality between the test subjects. There was an assumption that the common standard deviation took twelve hours to enable determination of sample size. A mean time of passage of flatus of 24 hours and a mean difference of 6 hours was also assumed to help in the research (Husslein et al., 2013).

Ethics were observed during the research where the participants were informed of the procedure to be followed, and written consent was obtained from each patient. The use of sugarless gums was also ethical to avoid negatively impacting the patient. The researchers got the approval for the clinical trials from a local review board, Ethikkommission des Landes Kärnten (Husslein et al., 2013). They were then registered with the clinical trials registry as required by the law.

Data was analysed using the SPSS 16.0 software essential for assessing qualitative and quantitative data. The exclusion of data collected from a patient who declined from chewing the gum provided more than once shows the authenticity of the data (Husslein et al., 2013). The results were well presented in tables clearly indicating the different groups within which the data was collected and the results from the different time zones. Additional factors that can influence the results such as age, body mass, the length of hospitalization, duration of surgery and even smoking history were well presented in a table.

The author’s conclusion of the research matches with the results that were analysed. The conclusion that postoperative gum chewing improves the bowel movement also clearly stated (Husslein et al., 2013). The results obtained from the study can be used by gynaecologists in improving bowel motility after carrying out surgery. Other practitioners can equally use the results that indicated fast recovery the normal bowel movements than estimated in previous studies.

Limitations to the study and thus the data collected were clearly indicated. The study borrowed a sample size calculation from previous research. Another possible challenge to the results is the adherence of the procedures to the institution’s protocol where patients are mobilized after surgery, possibly affecting the return of regular bowel mobility (Husslein et al., 2013). Placebo effect could also have occurred due to the nature of the test. The nature of the test did not permit blinding of the participants.

The journal, however, fails to give the recommendations to future researchers in the same field. The sample population should also include patients who are yet to undergo a caesarean delivery to gain deeper insight.


Husslein, H., Franz, M., Gutschi, M., Worda, C., Polterauer, S. and Leipold, H. (2013). Postoperative Gum Chewing After Gynecologic Laparoscopic Surgery. Obstetrics & Gynecology, 122(1), pp.85-90.