Dear Editor:
RE: Reference to the article – full citation
My name is “name” and I am a Nursing student from the University of fill-in-the-blank. Recently I came across the article “A primary care cardiovascular risk reduction clinic in Canada was more effective and no more expensive than usual on-demand primary care – a randomized controlled trial” from the journal “Health & Social Care In The Community” and wanted to take this opportunity to share with you some comments and other feedback that I was with regard to some of its content. In my opinion, this article does a great service to the field of preventative medicine. The approach to this study was both thorough and well thought out. In my opinion, the practice of preventative medicine has been greatly undervalued in recent years and deserves this kind of attention and empirical evidence that is produces by this kind of peer reviewed research study. I was pleased to see that the demographics of the population that was not included in the final results were well accounted for.
In spit of the well-handled nature of the demographics in the included, I have some concerns about generalizability of the data to the overall population. My concerns are related directly to the information that is presented after the results. There seems to be a great amount of uncertainty in the overall validity of the results because of the demographic that was used; specifically the middle class individuals with high risk. Additionally the high risks of contamination of different variables, making referrals during the initial stages of the process, potentially introduced confounding variables into the study. Given that the reported assumption is that the benefits of the CaRR and the gap between its improvements and that of other groups; could it be possible that the benefits are overstated and nurse call lines, for example, are far more beneficial than this study gives credit? Does the study rule this out in any way?
Thank you for the opportunity to offer these questions and comments. I appreciate the work this journal brings to the field and look forward to your response.
Article; Mills, M., Loney, P., Jamieson, E., Gafni, A., & Browne, G. (2010). A primary care cardiovascular risk reduction clinic in Canada was more effective and no more expensive than usual on-demand primary care – a randomized controlled trial. Health & Social Care In The Community, 18(1), 30-40. doi:10.1111/j.1365-2524.2009.00872.x
