Although QA Form Says RCT, on Second Glance I Don T Believe This Study Is an RCT

Although QA Form Says RCT, on Second Glance I Don T Believe This Study Is an RCT

<p>Although QA form says RCT, on second glance I don’t believe this study is an RCT</p><p>V1.0, July 23 A systematic review of depression management in patients with diabetes: Quality Assessment Sheet</p><p>EPOC Quality Assessment Criteria See Cochrane EPOC Group “Data Collection Checklist” (2002) for details. Code 1 for done, 2 for not done, and 3 for unclear. RCTs and CCTs Done? Description Allocation concealment [1 if central randomization OR clustered randomization, 0 if no mention of central/clustered] - Blinded assessment of primary outcomes [blind if explicitly stated, database, or mail survey] + - Immunization rates from Family Practice Center Baseline measurement [score 1 if some sort of confounders tables is included] - Reliable primary outcome measures [chart reviews – 1 if validated; surveys – 1 if validated; database – 1 always] + - Follow-up of professionals + Follow-up of patients + Protection against contamination [1 if unlikely control received intervention] + CBAs (include geographic control studies) Done? Description Blinded assessment of primary outcomes [blind if explicitly stated, database, or mail survey] Baseline measurement [score 1 if some sort of confounders tables is included]</p><p>Reliable primary outcome measures [chart reviews – 1 if validated; surveys – 1 if validated; database – 1 always] Follow-up of professionals</p><p>Follow-up of patients</p><p>Protection against contamination [1 if unlikely control received intervention] Similar characteristics of study and control providers (Second site studies only)</p><p>Downs and Black (1998) Quality Assessment Criteria See Downs and Black (1998) for details. Code 1 for yes, 0 for no, and 0 for unable to determine except in questions 5 and 27. Reporting Score 1. Is the hypothesis/aim/objective of the study clearly defined? 1 2. Are the main outcomes to be measured clearly described in the introduction or methods section? 1 3. Are the characteristics of the patients included in the study clearly described? [1 if inclusion/exclusion criteria are provided – rely on JH for this] 1 4. Are the interventions of interest clearly described? 1 5. Are the distributions of principal confounders in each group of subjects to be compared clearly described? [1 if they have age/sex, 2 if previous vaccination experience or 2 or more of other confounders] 0 6. Are the main findings of the study clearly described? 1 7. Does the study provide estimates of the random variability in the data for the main outcomes? [1 if any p-value or CI provided – rely on DL for this] 1 0 8. Have all important adverse events that may be a consequence of the intervention been reported? [always 0] 0 9. Have the characteristics of patients lost to follow-up been described? [1 so long as LTFU < 20%] 1 10. Have actual probability values been reported for the main outcomes, except where p<0.001? 1 0 External validity Score 11. Were the subjects asked to participate in the study representative of the entire population from which they were recruited? [always 1] 1 12. Were those subjects who were prepared to participate representative of the entire population from which they were recruited? [1 if any p-value or CI provided – rely on DL for this] 0 13. Were the staff, places, and facilities where the patients were treated, representative of the treatment the majority of patients receive? [almost always 1] 1 Internal validity – bias Score 14. Was an attempt made to blind study subjects to the intervention they have received? [likely a 0 unless there is no ‘patient’ element to the QI] 0 15. Was an attempt made to blind those measuring the main outcomes of the intervention? [blind if explicitly stated, database, or mail survey] 1 0 16. If any of the results of the study were based on "data dredging", was this made clear? 1 17. In trials and cohort studies, do the analyses adjust for different lengths of follow-up of patients, or in case control studies, is the time period between the intervention and outcome the same for cases and controls? [1 if follow-up same for all study participants] 1 18. Were the statistical tests used to assess the main outcomes appropriate? [0 if there is a unit of analysis error] 1 0 19. Was compliance with the intervention/s reliable? 1 20. Were the main outcome measures used accurate (valid and reliable)? 1 0 [chart reviews – 1 if validated; surveys – 1 if validated; database – 1 always] Internal validity – confounding Score 21. Were the patients in different intervention groups or were the cases and controls recruited from the same population? 1 22. Were study subjects in different intervention groups or were the cases and controls recruited over the same period of time? 1 23. Were study subjects randomized to intervention groups? [answer this as 0 if study is not an RCT i.e. a geographic control study] 1 24. allocation concealment  Was the randomized intervention assignment concealed from both patients and health care staff until recruitment was complete and irrevocable? [1 if central randomization OR clustered randomization] 0 25. Was there adequate adjustment for confounding in the analyses from which the main findings were drawn? [1 if there is randomization and covariates shown to be balanced or appropriate adjustment for confounding factors] 0 26. Were losses of patients to follow-up taken into account? [1 so long as LTFU < 20%] 1 Power Score 27. Did the study have sufficient power to detect a clinically important effect where the probability value for a difference being due to chance is less than 5%? 0</p><p>Unit of analysis Did the statistical analysis adjust appropriately for intra-cluster correlations? (Circle one) No clusters present. Clusters, unaccounted for. Clusters, appropriately adjusted for.</p><p>Comments:</p>

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