The
correct answer is (c).
Dismissing
the available chart review data is not the optimal stance
in this situation. The chart review has clear advantages
and disadvantages. On the plus side, it offers a method
for acquiring some information about fatigue and other
factors that may be important (any information available
from the medical record, including demographics, disease-related
data, and information about some potentially important
comorbidities) in a way that is feasible when resources
are limited. The sample size acquired through a chart
review can be large, offering the opportunity for interesting
statistical analyses. On the minus side, the approach
has all the limitations of retrospective studies: the
investigators would have no control over the method
of data collection and there would be numerous sources
of bias (missing questions, missing charts, and many
others) that would not exist in a monitored prospective
approach. In this case, the items for data collection
about fatigue are also unvalidated and rely on patient
recall from a period prior to hospitalization---another
potential source of bias. A chart review provides a
limited snapshot of information that must be interpreted
cautiously. The large amount of information available
should not be dismissed, but considered within the context
of the research agenda. In this case, perhaps it is
the pilot data that would open the opportunity for a
grant.