Literature Search Methods

A limited literature search was conducted on key resources including Medline, PubMed, The Cochrane Library, ECRI, University of York Centre for Reviews and Dissemination (CRD) databases, Canadian and major international health technology agencies, as well as a focused Internet search. Methodological filters were applied to limit retrieval to health technology assessments, systematic reviews, meta-analyses, randomized controlled trials, non-randomized studies, economic studies and guidelines. Where possible, retrieval was limited to the human population. The search was also limited to English language documents published between January 1, 2008 and April 28, 2015.

Rapid Response reports are organized so that the evidence for each research question is presented separately.

Selection Criteria and Methods

One reviewer screened citations and selected studies. In the first level of screening, titles and abstracts were reviewed and potentially relevant articles were retrieved and assessed for inclusion. The final selection of full-text articles was based on the inclusion criteria presented in Table 1.

Table 1

Selection Criteria.

Exclusion Criteria

Articles were excluded if they did not meet the selection criteria outlined in Table 1, they were duplicate publications, or were published prior to January 1 2008. Duplicate publications and studies that reported only culture results from room surfaces without patient infection outcomes were excluded. Review articles not based upon a systematic literature search, and guidance documents or consensus statements that did not include a description of the methodology used in their development were also excluded. Studies included in a previous Rapid Response report were also excluded.⁴

Critical Appraisal of Individual Studies

The non-randomized studies were critically appraised using the Downs and Black checklist for measuring study quality.¹⁴ Summary scores were not calculated for the included studies; rather, a review of the strengths and limitations of each included study were described. Appendix 3 provides summary of critical appraisal of the included studies.