Appendix A

Technology Assessment: Non-Pharmacological Interventions for Post-Disc

Technology assessment on the effectiveness of non-pharmacological interventions for post-discharge care in heart failure patients.

Table of Contents

Appendix A

Search strategy

#Search HistoryResults
1 discharge planning.mp. or exp Patient Discharge/32632
2 case management.mp. or exp Patient Care Planning/ or exp Case
Management/
92238
3 patient readmission.mp.9266
4 Aftercare/12568
5 Continuity of Patient Care/20217
6 Patient Transfer/8094
7 Post discharg$.tw.2180
8 Postdischarg$.tw.2738
9 Post hospital$.tw.1061
10 Posthospital$.tw.1047
11Predischarg$.tw.1810
12 Pre discharg$.tw.496
13 Patient$ discharg$.tw.7039
14Discharg$.ti.24270
15 ((readmission$ or early or premature or care or medication or
destination or decision or decid$ or support$ or prepar$ or process$
or plan$ or system$) adj6 discharg$).tw.
25564
16 or/1-15194133
17 exp Heart Failure, Congestive/ or exp Cardiac Output, Low/ or
Heart failure.mp.
167913
18 16 and 173660
19 limit 18 to english language3394
20 limit 19 to “all adult (19 plus years)”2544
21 randomized controlled trial.pt.688706
22 controlled clinical trial.pt.221479
23 Randomized controlled trials/125964
24 random allocation/112192
25 double-blind method/252902
26 single-blind method/27409
27 clinical trial.pt.157319
28 (random$ or rct).tw.900347
29 controlled clinical trials/39157
30 (clin$ adj trial$).tw.222839
31 ((singl$ or doubl$ or trebl$ or Tripl$) adj (blind$ or
mask$)).tw.
275580
32 exp PLACEBOS/70143
33 placebo$.tw.288743
34 cross-over studies/53318
35 evaluation studies/214252
36 or/21-352048057
37 20 and 36684
38 animal/ not (animal/ and human/)3078777
39 37 not 38684
40 limit 39 to comment and (letter or editorial).pt.1
41 limit 39 to (addresses or bibliography or biography or case
reports or congresses or consensus development conference or
consensus development conference, nih or dictionary or directory or
editorial or festschrift or government publications or interview or
lectures or legal cases or legislation or news or newspaper article
or patient education handout or periodical index)
9
42 39 not (40 or 41)674
43 limit 42 to (guideline or meta analysis or practice guideline or
“review”)
30
44 42 not43644
45 limit 44 to yr=1990-2007615
46 remove duplicates from 45273

 

Discharge Plan data extraction/summary tables

Study Year  
UI number  
Methods
      Study design description
  
      Randomization method  
      Allocation concealment  
      Blinding  
      Number of centers  
      Recruitment years  
      Duration of followup  
Participants
      Country
  
      Study inclusion criteria  
      Study exclusion criteria  
 OverallInterventionControls
      N randomized   
      Mean age (SD) y   
      Males %   
      Race / Ethnicity %   
      Severity of heart failure (at index admission) NYHA:
LVEF%:
NYHA:
LVEF%:
      Severity of heart failure (at baseline) NYHA:
LVEF%:
NYHA:
LVEF%:
      Duration of CHF   
      History - Myocardial infarction   
      History of other CVD disease   
      ACE inhibitor use   
      B-blockers   
      Diuretics   
      Other medications   
Interventions  
      Duration of intervention  
      Intervention group name  
      Description of intervention
      During index hospitalization
  
      After discharge  
Description of comparator  
Followup times  
Statistical Analyses  
Intention to treat  
Adjusted analyses  
Outcomes description  
Primary endpoint (with definition)  
Secondary endpoint (with definition)  
Notes  
Rationale for sample size  
Reasons for exclusion  
List biases  
Funding source  
Is there any difference between groups at baseline  

 

Discharge Plan data extraction/summary tables

APPLICABILITYQUALITY
 Wide Applicability:sample representative of
Medicare population in relevant setting.
Patient’s age (older adult), gender, spectrum of
disease severity and type, etc are
representative of population of interest.
 A Good quality:Prospective, no obvious biases or
reporting errors, <20% dropout, complete reporting of data.
 Moderate Applicability:sample is an important
sub-group of population of interest. Possibly
limited to a narrow or young age range, type of
disease, gender etc.
 B Fair quality:Problems with study/paper unlikely to
cause major bias..
 Narrow Applicability:sample represents only a
narrow, atypical subgroup of population of
interest, or old study.
 C Poor quality:Cannot exclude possible significant
biases. Poor methods, incomplete data, reporting
errors.
If applicability is graded narrow or moderate,
what are the limiting factors?
If Quality is rated B or C, what are the limiting factors?
(i.e., incomplete data, errors in analysis, definitions not
clear, poor follow-up, dropouts)
  

 

Summary table templates

Randomized Controlled Studies (Intervention vs. Control), For event rates

Population recruited:

OutcomeStudy,
Year
Country
Followup
Duration
(Intervention
y)
No. AnalyzedControl
Used
Severity
of CHF
Intervention
components
Event RateNet
change
P
within
P
Between
Quality
IntervControlIntervControl
 
 
 
 

 

Randomized Controlled Studies (Intervention vs. Control), For continuous measures or that provide odds/risk ratio

Population recruited:

OutcomeStudy,
Year
Country
Followup
Duration
(Intervention
y)
No. AnalyzedControl
Used
Severity
of CHF
Intervention
components
BaselineResults/FinalQuality
IntervControlMetric/
Units
IntervControlP
Between
 
 
 
 

 

Text results:
 

 

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Current as of February 2009
Internet Citation: Appendix A: Technology Assessment: Non-Pharmacological Interventions for Post-Disc. February 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/ta/heart-failure-discharge-care/appendix-a.html