A meta-review of evidence on heart failure disease management programs: The challenges of describing and synthesizing evidence on complex interventions

Savard, Lori A., Thompson, David R. and Clark, Alexander M. (2011) A meta-review of evidence on heart failure disease management programs: The challenges of describing and synthesizing evidence on complex interventions. Trials, 12 : 194.1-194.10.

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Author Savard, Lori A.
Thompson, David R.
Clark, Alexander M.
Title A meta-review of evidence on heart failure disease management programs: The challenges of describing and synthesizing evidence on complex interventions
Journal name Trials   Check publisher's open access policy
ISSN 1745-6215
Publication date 2011-08-16
Sub-type Article (original research)
DOI 10.1186/1745-6215-12-194
Volume 12
Start page 194.1
End page 194.10
Total pages 10
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2012
Language eng
Formatted abstract Background: Despite favourable results from past meta-analyses, some recent large trials have not found Heart Failure (HF) disease management programs to be beneficial. To explore reasons for this and examine the quality of current evidence, we evaluated evidence from existing meta-analyses.

Methods:
Systematic review incorporating meta-review was used. We selected metaanalyses of randomized controlled trials published after 1995 in English that examined the effects of HF disease management programs on key outcomes. Databases searched: MEDLINE, EMBASE, Cochrane Database of Systematic Reviews (CDSR), DARE, NHS EED, NHS HTA, Ageline, AMED, Scopus, Web of Science and CINAHL; cited references, experts and existing reviews were also searched.

Results:
15 meta-analyses were identified containing a mean of 18.5 randomized trials of HF interventions +/- 10.1 (range: 6 to 36). Overall quality of the meta-analyses was very mixed (Mean AMSTAR Score=6 SD: 2.2; range 1-9). Reporting inadequacies were widespread around populations, intervention components, settings and characteristics, comparison, and comparator groups. Heterogeneity (statistical, clinical, and methodological) was not taken into account sufficiently when drawing conclusions from pooled analyses.

Conclusions:
Meta-analyses of heart failure disease management programs have promising findings but often fail to report key characteristics of populations, interventions, and comparisons. Existing reviews are of mixed quality and do not adequately take account of program complexity and heterogeneity.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Nursing and Midwifery Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 18 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 23 Aug 2011, 15:16:37 EST by Vicki Percival on behalf of School of Nursing and Midwifery