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Table 2 PRISMS and RECURSIVE processes for selection of studies, quality assessment, data extraction, analysis and interpretation

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.

  1. A&E accident and emergency, LTC long-term condition, R-AMSTAR Revised Assessment of Multiple Systematic Reviews, RCT randomised controlled trial