Quantity, topics, methods and findings of randomised controlled trials published by German university departments of general practice – systematic reviewReportar como inadecuado




Quantity, topics, methods and findings of randomised controlled trials published by German university departments of general practice – systematic review - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Trials

, 17:211

First Online: 23 April 2016Received: 05 November 2015Accepted: 05 April 2016DOI: 10.1186-s13063-016-1328-y

Cite this article as: Heinmüller, S., Schneider, A., Linde, K. et al. Trials 2016 17: 211. doi:10.1186-s13063-016-1328-y

Abstract

BackgroundAcademic infrastructures and networks for clinical research in primary care receive little funding in Germany. We aimed to provide an overview of the quantity, topics, methods and findings of randomised controlled trials published by German university departments of general practice.

MethodsWe searched Scopus last search done in April 2015, publication lists of institutes and references of included articles. We included randomised trials published between January 2000 and December 2014 with a first or last author affiliated with a German university department of general practice or family medicine. Risk of bias was assessed with the Cochrane tool, and study findings were quantified using standardised mean differences SMDs.

ResultsThirty-three trials met the inclusion criteria. Seventeen were cluster-randomised trials, with a majority investigating interventions aimed at improving processes compared with usual care. Sample sizes varied between 6 and 606 clusters and 168 and 7807 participants. The most frequent methodological problem was risk of selection bias due to recruitment of individuals after randomisation of clusters. Effects of interventions over usual care were mostly small SMD <0.3. Sixteen trials randomising individual participants addressed a variety of treatment and educational interventions. Sample sizes varied between 20 and 1620 participants. The methodological quality of the trials was highly variable. Again, effects of experimental interventions over controls were mostly small.

ConclusionsDespite limited funding, German university institutes of general practice or family medicine are increasingly performing randomised trials. Cluster-randomised trials on practice improvement are a focus, but problems with allocation concealment are frequent.

KeywordsGermany Primary care General practice Randomised controlled trials Academic performance AbbreviationsBMIbody mass index

CMEcontinuing medical education

COPDchronic obstructive pulmonary disease

EBMevidence-based medicine

GPgeneral practitioner

HbA1chaemoglobin A1c

LLlower limit of the 95 % confidence interval

RCTrandomised controlled trial

SF-3636-item Short Form Health Survey

SMDstandardised mean difference

ULupper limit of the 95 % confidence interval

Electronic supplementary materialThe online version of this article doi:10.1186-s13063-016-1328-y contains supplementary material, which is available to authorized users.

Download fulltext PDF



Autor: Stefan Heinmüller - Antonius Schneider - Klaus Linde - for the DFG Network Clinical Trials in General Practice

Fuente: https://link.springer.com/







Documentos relacionados