From: Systematic meta-review of supported self-management for asthma: a healthcare perspective
 | PRISMS systematic meta-review | RECURSIVE systematic review |
---|---|---|
Title and abstract screening | Initial training. One reviewer selected studies for full-text screening. Quality check: Random sample of 10% checked independently by second reviewer. Agreement: 97% for the initial search and 99% for the update. Uncertainties resolved by discussion. | Initial training. One reviewer selected studies for full-text screening. Quality check: Random sample of 40% checked independently by second reviewer. Agreement: 87% for the initial search and 88% for the update. Uncertainties resolved by discussion. |
Full-text screening | Following training, one reviewer selected possibly relevant studies for inclusion. Quality check: Random sample of 10% checked independently by second reviewer. Agreement: 83%. Uncertainties resolved by discussion. | Following training, one reviewer selected possibly relevant studies for inclusion. Quality check: Random sample of 30% checked independently by second reviewer. Agreement: 85%. Uncertainties resolved by discussion. |
Quality assessment | Duplicate quality assessment using: R-AMSTAR [17] for systematic reviews (‘high-quality’ defined as ≥31), combined with size of the review (‘large’ defined as ≥1000 participants) to give star rating (1* to 3*). Cochrane Risk of Bias tool for RCTs [15]. Disagreements resolved by discussion. | Duplicate quality assessment using: Drummond for economic evaluations [18, 19]. Allocation concealment for RCTs. Disagreements resolved by discussion. |
Data extraction | Data extraction by one reviewer. Quality check: 100% checked for accuracy by a second reviewer. Disagreements resolved by discussion. | Data extraction by one reviewer. Quality check: Random sample of 40% extracted independently by second reviewer. Disagreements resolved by discussion. |
Analysis | Reviews/RCTs categorised according to the question(s) that they answered: • Does supported self-management reduce healthcare utilisation and improve control? • For which target groups does it work? • Which components contribute to effectiveness? • In what healthcare contexts does supported self-management work? Meta-Forest plots for pooled statistics of the primary outcome (healthcare utilisation). Narrative synthesis within categories. | Meta-analysis: Standardised mean differences (random effects model) to examine the effects of self-management support interventions on hospitalisation rates, A&E attendances, quality of life and total costs. Permutation plots of the data from trials reporting both utilisation (hospitalisation rates, A&E attendances or total costs) and health outcomes (quality of life). |
Interpretation | Monthly teleconferences to enable synergies between PRISMS and RECURSIVE. End-of-project stakeholder conference to discuss findings and implications for commissioning and providing services for people with LTCs. |