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Table 3 Transitional care intervention compared to usual care for readmission, emergency department visit, and quality of life

From: Effectiveness of nurse-led transitional care interventions for adult patients discharged from acute care hospitals: a systematic review and meta-analysis

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect

(95% CI)

№ of participants

(studies)

Certainty of the evidence

(GRADE)

Risk with usual care

Risk with Transitional are intervention (ver. 1)

Readmission (Duration of data collection: 12 weeks and more)

333 per 1,000

223 per 1,000

(163 to 307)

RR 0.67

(0.49 to 0.92)

3739

(9 RCTs)

Moderatea

Readmission: Subgroup (Duration of intervention: within six weeks versus seven weeks and more) Data collection duration for 3 RCTs [28, 30, 35]: less than 12 weeks

187 per 1,000

131 per 1,000

(97 to 172)

RR 0.70

(0.52 to 0.92)

4803

(13 RCTs)

Moderateb, d

ED visit

149 per 1,000

94 per 1,000

(73 to 121)

RR 0.63

(0.49 to 0.81)

3464

(4 RCTs)

High

Quolity of life: SF-36 -Mental component 2–4 weeks

The mean quolity of life: SF-36 -Mental component 2–4 weeks was 0

MD 0.72 higher

(0.34 higher to 1.11 higher)

-

449

(3 RCTs)

Moderatec

Quality of life: Subgroup analysis of SF-36 subscale (Up to 5 weeks)

The mean quality of life: SF-36(Up to 5 weeks) was 0

MD 1.27 higher

(0.52 higher to 2.02 higher)

-

225

(2 RCTs)1)

Lowb, c

Quality of life: Subgroup analysis of SF-36 subscale (6weeks and more) Sensitvity analysis

The mean quality of life: SF-36(6weeks and more) Sensitvity analysis was 0

MD 2.46 higher

(1.67 higher to 3.25 higher)

-

225

(2 RCTs) 1)

Lowb, c

  1. 1) The sample size for the Subgroup analysis of the SF-36 subscale reflects the total number of participants in the two RCTs [30, 34] that analyzed the subscale
  2. *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI)
  3. CI: confidence interval; MD: mean difference; RR: risk ratio GRADE Working Group grades of evidence
  4. High certainty: we are very confident that the true effect lies close to that of the estimate of the effect
  5. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
  6. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect
  7. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect
  8. Explanations (a) I-square was 66% (-1), (b) Estimate based on small sample size (-1), (c) Most trials were unclear risk of bias (-1), (d) I-square was 52% (-1)