| 1. |
- Missiou, Aristea, et al.
(författare)
-
Health outcomes in primary care: a 20-year evidence map of randomized controlled trials
- 2023
-
Ingår i: Family Practice. - : OXFORD UNIV PRESS. - 0263-2136 .- 1460-2229. ; 40:1, s. 128-137
-
Forskningsöversikt (refereegranskat)abstract
- Objective To quantify the different types of health outcomes assessed as primary outcomes in randomized controlled trials (RCTs) in the primary care (PC) setting during the last 20 years and identify whether potential gaps exist in specific types of health care and types of intervention. Methods We systematically searched PubMed, Scopus, and Cochrane Central Register of Controlled Trials, from January 2000 to September 2020 for published RCTs in PC. We recorded characteristics of eligible studies and mapped evidence by health outcome category (patient health outcomes, health services outcomes); and for each outcome category, by types of health care (preventive, acute, chronic, palliative), and by types of intervention (drug, behavioural, on structure, and on process). For RCTs assessing patient health outcomes as primary outcomes, we further mapped using the quality-of-care dimensions, that is, effectiveness, safety, and patient-centredness. Results Of the 518 eligible RCTs in PC, 357 (68.9%) evaluated a patient health outcome as the primary outcome, and 161 (31.1%) evaluated only health services outcomes as primary outcomes. Many focused on population with chronic illness (224 trials; 43.2%) and evaluated interventions on processes of health care (239 trials; 46.1%). Research gaps identified include preventive and palliative care, behavioural interventions, and safety and patient-centredness outcomes as primary outcomes. Conclusion Our evidence map showed research gaps in certain types of health care and interventions. It also showed research gaps in assessing safety and measures to place patient at the centre of health care delivery as primary outcomes.
|
|
| 2. |
- Missiou, Aristea, et al.
(författare)
-
Underreporting contextual factors preclude the applicability appraisal in primary care randomized controlled trials
- 2023
-
Ingår i: Journal of Clinical Epidemiology. - : ELSEVIER SCIENCE INC. - 0895-4356 .- 1878-5921. ; 160, s. 24-32
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: To assess applicability reporting in randomized controlled trials (RCTs) conducted in primary care (PC).Study Design and Setting: We used a random sample of PC RCTs published between 2000 and 2020 to assess applicability. We ex-tracted data related to setting, population, intervention (including implementation), comparator, outcomes, and context. Based on data avail-ability, we assessed whether the five predefined applicability questions were adequately addressed by each PC RCT.Results: Adequately described elements that were reported frequently (O50%) included the responsible organization for intervention provision (97, 93.3%), study population characteristics (94, 90.4%), intervention implementation including monitoring and evaluation (92, 88.5%), intervention components (89, 85.6%), time frame (82, 78.8%), baseline prevalence (58, 55.8%), and the type of setting and location (53, 51%). Elements that were often underreported included contextual factors, that is, evidence of differential effects across sociodemo-graphic or other groupings (2, 1.9%), intervention components tailored for specific settings (7, 6.7%), health system structure (32, 30.8%), factors affecting implementation (40, 38.5%) and organization structure (50, 48.1%). The proportion of trials that adequately addressed each applicability question ranged between 1% and 20.2%, while none RCT could address all of them.Conclusion: Underreporting contextual factors jeopardize the appraisal of applicability in PC RCTs. & COPY; 2023 Elsevier Inc. All rights reserved.
|
|
