| Quality assessment | No of patients | Effect | Quality | Importance | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No of studies | Design | Risk of bias | Inconsistency | Indirectness | Imprecision | Other considerations | Structured | Unstructured | Relative (95% CI) | Absolute | ||
| Mortality | ||||||||||||
| 1 | observational studies | serious1 | no serious inconsistency | no serious indirectness | very serious2 | none |
26/389 (6.7%) | 8.5% | RR 0.71 (0.43 to 1.17) | 26 fewer per 1000 (from 48 fewer to 14 more) |
⨁◯◯◯ VERY LOW | CRITICAL |
| Re-admission <48hours | ||||||||||||
| 1 | observational studies | serious1 | no serious inconsistency | no serious indirectness | very serious2 | none |
21/431 (4.9%) | 3.6% | RR 1.35 (0.7 to 2.63) | 13 more per 1000 (from 11 fewer to 59 more) |
⨁◯◯◯ VERY LOW | CRITICAL |
| Length of Stay (Better indicated by lower values) | ||||||||||||
| 1 | observational studies | serious1 | no serious inconsistency | no serious indirectness | no serious imprecision | none | 431 | 389 | - | MD 2.78 lower (4.68 to 0.88 lower) |
⨁◯◯◯ VERY LOW | IMPORTANT |
| Staff satisfaction | ||||||||||||
| 1 | observational studies | serious1 | no serious inconsistency | no serious indirectness | no serious imprecision | none |
34/57 (59.6%) | 18.2% | RR 3.09 (1.7 to 5.61) | 380 more per 1000 (from 127 more to 839 more) |
⨁◯◯◯ VERY LOW | IMPORTANT |
| Staff satisfaction - Attending Physician | ||||||||||||
| 1 | observational studies | serious1 | no serious inconsistency | no serious indirectness | serious2 | none |
6/11 (54.5%) | 18.2% | RR 3 (0.77 to 11.74) | 364 more per 1000 (from 42 fewer to 1000 more) |
⨁◯◯◯ VERY LOW | IMPORTANT |
| Staff satisfaction – Fellows | ||||||||||||
| 1 | observational studies | serious1 | no serious inconsistency | no serious indirectness | very serious2 | none |
6/16 (37.5%) | 43.8% | RR 0.86 (0.37 to 1.99) | 61 fewer per 1000 (from 276 fewer to 434 more) |
⨁◯◯◯ VERY LOW | IMPORTANT |
| Staff satisfaction – Nurses | ||||||||||||
| 1 | observational studies | serious1 | no serious inconsistency | no serious indirectness | no serious imprecision | none |
22/30 (73.3%) | 6.7% | RR 11 (2.83 to 42.7) | 670 more per 1000 (from 123 more to 1000 more) |
⨁◯◯◯ VERY LOW | IMPORTANT |
All non-randomised studies automatically downgraded due to selection bias. Studies may be further downgraded by 1 increment if other factors suggest additional high risk of bias, or 2 increments if other factors suggest additional very high risk of bias.
Downgraded by 1 increment if the confidence interval crossed 1 MID or by 2 increments if the confidence interval crossed both MIDs.
From: Chapter 32, Structured patient handovers
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