Background
Funders and scientific journals use peer review to decide which projects to fund or articles to publish. Reviewer training is an intervention to improve the quality of peer review. ...However, studies on the effects of such training yield inconsistent results, and there are no up‐to‐date systematic reviews addressing this question.
Objectives
To evaluate the effect of peer reviewer training on the quality of grant and journal peer review.
Search methods
We used standard, extensive Cochrane search methods. The latest search date was 27 April 2022.
Selection criteria
We included randomized controlled trials (RCTs; including cluster‐RCTs) that evaluated peer review with training interventions versus usual processes, no training interventions, or other interventions to improve the quality of peer review.
Data collection and analysis
We used standard Cochrane methods. Our primary outcomes were 1. completeness of reporting and 2. peer review detection of errors. Our secondary outcomes were 1. bibliometric scores, 2. stakeholders' assessment of peer review quality, 3. inter‐reviewer agreement, 4. process‐centred outcomes, 5. peer reviewer satisfaction, and 6. completion rate and speed of funded projects. We used the first version of the Cochrane risk of bias tool to assess the risk of bias, and we used GRADE to assess the certainty of evidence.
Main results
We included 10 RCTs with a total of 1213 units of analysis. The unit of analysis was the individual reviewer in seven studies (722 reviewers in total), and the reviewed manuscript in three studies (491 manuscripts in total).
In eight RCTs, participants were journal peer reviewers. In two studies, the participants were grant peer reviewers. The training interventions can be broadly divided into dialogue‐based interventions (interactive workshop, face‐to‐face training, mentoring) and one‐way communication (written information, video course, checklist, written feedback). Most studies were small.
We found moderate‐certainty evidence that emails reminding peer reviewers to check items of reporting checklists, compared with standard journal practice, have little or no effect on the completeness of reporting, measured as the proportion of items (from 0.00 to 1.00) that were adequately reported (mean difference (MD) 0.02, 95% confidence interval (CI) −0.02 to 0.06; 2 RCTs, 421 manuscripts).
There was low‐certainty evidence that reviewer training, compared with standard journal practice, slightly improves peer reviewer ability to detect errors (MD 0.55, 95% CI 0.20 to 0.90; 1 RCT, 418 reviewers).
We found low‐certainty evidence that reviewer training, compared with standard journal practice, has little or no effect on stakeholders' assessment of review quality in journal peer review (standardized mean difference (SMD) 0.13 standard deviations (SDs), 95% CI −0.07 to 0.33; 1 RCT, 418 reviewers), or change in stakeholders' assessment of review quality in journal peer review (SMD −0.15 SDs, 95% CI −0.39 to 0.10; 5 RCTs, 258 reviewers).
We found very low‐certainty evidence that a video course, compared with no video course, has little or no effect on inter‐reviewer agreement in grant peer review (MD 0.14 points, 95% CI −0.07 to 0.35; 1 RCT, 75 reviewers).
There was low‐certainty evidence that structured individual feedback on scoring, compared with general information on scoring, has little or no effect on the change in inter‐reviewer agreement in grant peer review (MD 0.18 points, 95% CI −0.14 to 0.50; 1 RCT, 41 reviewers, low‐certainty evidence).
Authors' conclusions
Evidence from 10 RCTs suggests that training peer reviewers may lead to little or no improvement in the quality of peer review. There is a need for studies with more participants and a broader spectrum of valid and reliable outcome measures. Studies evaluating stakeholders' assessments of the quality of peer review should ensure that these instruments have sufficient levels of validity and reliability.
Background
Healthcare professionals are important contributors to healthcare quality and patient safety, but their performance does not always follow recommended clinical practice. There are many ...approaches to influencing practice among healthcare professionals. These approaches include audit and feedback, reminders, educational materials, educational outreach visits, educational meetings or conferences, use of local opinion leaders, financial incentives, and organisational interventions. In this review, we evaluated the effectiveness of patient‐mediated interventions. These interventions are aimed at changing the performance of healthcare professionals through interactions with patients, or through information provided by or to patients. Examples of patient‐mediated interventions include 1) patient‐reported health information, 2) patient information, 3) patient education, 4) patient feedback about clinical practice, 5) patient decision aids, 6) patients, or patient representatives, being members of a committee or board, and 7) patient‐led training or education of healthcare professionals.
Objectives
To assess the effectiveness of patient‐mediated interventions on healthcare professionals' performance (adherence to clinical practice guidelines or recommendations for clinical practice).
Search methods
We searched MEDLINE, Ovid in March 2018, Cochrane Central Register of Controlled Trials (CENTRAL) in March 2017, and ClinicalTrials.gov and the International Clinical Trials Registry (ICTRP) in September 2017, and OpenGrey, the Grey Literature Report and Google Scholar in October 2017. We also screened the reference lists of included studies and conducted cited reference searches for all included studies in October 2017.
Selection criteria
Randomised studies comparing patient‐mediated interventions to either usual care or other interventions to improve professional practice.
Data collection and analysis
Two review authors independently assessed studies for inclusion, extracted data and assessed risk of bias. We calculated the risk ratio (RR) for dichotomous outcomes using Mantel‐Haenszel statistics and the random‐effects model. For continuous outcomes, we calculated the mean difference (MD) using inverse variance statistics. Two review authors independently assessed the certainty of the evidence (GRADE).
Main results
We included 25 studies with a total of 12,268 patients. The number of healthcare professionals included in the studies ranged from 12 to 167 where this was reported. The included studies evaluated four types of patient‐mediated interventions: 1) patient‐reported health information interventions (for instance information obtained from patients about patients' own health, concerns or needs before a clinical encounter), 2) patient information interventions (for instance, where patients are informed about, or reminded to attend recommended care), 3) patient education interventions (intended to increase patients' knowledge about their condition and options of care, for instance), and 4) patient decision aids (where the patient is provided with information about treatment options including risks and benefits). For each type of patient‐mediated intervention a separate meta‐analysis was produced.
Patient‐reported health information interventions probably improve healthcare professionals' adherence to recommended clinical practice (moderate‐certainty evidence). We found that for every 100 patients consulted or treated, 26 (95% CI 23 to 30) are in accordance with recommended clinical practice compared to 17 per 100 in the comparison group (no intervention or usual care). We are uncertain about the effect of patient‐reported health information interventions on desirable patient health outcomes and patient satisfaction (very low‐certainty evidence). Undesirable patient health outcomes and adverse events were not reported in the included studies and resource use was poorly reported.
Patient information interventions may improve healthcare professionals' adherence to recommended clinical practice (low‐certainty evidence). We found that for every 100 patients consulted or treated, 32 (95% CI 24 to 42) are in accordance with recommended clinical practice compared to 20 per 100 in the comparison group (no intervention or usual care). Patient information interventions may have little or no effect on desirable patient health outcomes and patient satisfaction (low‐certainty evidence). We are uncertain about the effect of patient information interventions on undesirable patient health outcomes because the certainty of the evidence is very low. Adverse events and resource use were not reported in the included studies.
Patient education interventions probably improve healthcare professionals' adherence to recommended clinical practice (moderate‐certainty evidence). We found that for every 100 patients consulted or treated, 46 (95% CI 39 to 54) are in accordance with recommended clinical practice compared to 35 per 100 in the comparison group (no intervention or usual care). Patient education interventions may slightly increase the number of patients with desirable health outcomes (low‐certainty evidence). Undesirable patient health outcomes, patient satisfaction, adverse events and resource use were not reported in the included studies.
Patient decision aid interventions may have little or no effect on healthcare professionals' adherence to recommended clinical practice (low‐certainty evidence). We found that for every 100 patients consulted or treated, 32 (95% CI 24 to 43) are in accordance with recommended clinical practice compared to 37 per 100 in the comparison group (usual care). Patient health outcomes, patient satisfaction, adverse events and resource use were not reported in the included studies.
Authors' conclusions
We found that two types of patient‐mediated interventions, patient‐reported health information and patient education, probably improve professional practice by increasing healthcare professionals' adherence to recommended clinical practice (moderate‐certainty evidence). We consider the effect to be small to moderate. Other patient‐mediated interventions, such as patient information may also improve professional practice (low‐certainty evidence). Patient decision aids may make little or no difference to the number of healthcare professionals' adhering to recommended clinical practice (low‐certainty evidence).
The impact of these interventions on patient health and satisfaction, adverse events and resource use, is more uncertain mostly due to very low certainty evidence or lack of evidence.
Background
Workplace aggression constitutes a serious issue for healthcare workers and organizations. Aggression is tied to physical and mental health issues at an individual level, as well as to ...absenteeism, decreased productivity or quality of work, and high employee turnover rates at an organizational level. To counteract these negative impacts, organizations have used a variety of interventions, including education and training, to provide workers with the knowledge and skills needed to prevent aggression.
Objectives
To assess the effectiveness of education and training interventions that aim to prevent and minimize workplace aggression directed toward healthcare workers by patients and patient advocates.
Search methods
CENTRAL, MEDLINE, Embase, six other databases and five trial registers were searched from their inception to June 2020 together with reference checking, citation searching and contact with study authors to identify additional studies.
Selection criteria
Randomized controlled trials (RCTs), cluster‐randomized controlled trials (CRCTs), and controlled before and after studies (CBAs) that investigated the effectiveness of education and training interventions targeting aggression prevention for healthcare workers.
Data collection and analysis
Four review authors evaluated and selected the studies resulting from the search. We used standard methodological procedures expected by Cochrane. We assessed the certainty of evidence using the GRADE approach.
Main results
We included nine studies—four CRCTs, three RCTs, and two CBAs—with a total of 1688 participants. Five studies reported episodes of aggression, and six studies reported secondary outcomes. Seven studies were conducted among nurses or nurse aides, and two studies among healthcare workers in general. Three studies took place in long‐term care, two in the psychiatric ward, and four in hospitals or health centers. Studies were reported from the United States, Switzerland, the United Kingdom, Taiwan, and Sweden.
All included studies reported on education combined with training interventions. Four studies evaluated online programs, and five evaluated face‐to‐face programs. Five studies were of long duration (up to 52 weeks), and four studies were of short duration. Eight studies had short‐term follow‐up (< 3 months), and one study long‐term follow‐up (> 1 year). Seven studies were rated as being at "high" risk of bias in multiple domains, and all had "unclear" risk of bias in a single domain or in multiple domains.
Effects on aggression
Short‐term follow‐up
The evidence is very uncertain about effects of education and training on aggression at short‐term follow‐up compared to no intervention (standardized mean difference SMD ‐0.33, 95% confidence interval CI ‐1.27 to 0.61, 2 CRCTs; risk ratio RR 2.30, 95% CI 0.97 to 5.42, 1 CBA; SMD ‐1.24, 95% CI ‐2.16 to ‐0.33, 1 CBA; very low‐certainty evidence).
Long‐term follow‐up
Education may not reduce aggression compared to no intervention in the long term (RR 1.14, 95% CI 0.95 to 1.37, 1 CRCT; low‐certainty evidence).
Effects on knowledge, attitudes, skills, and adverse outcomes
Education may increase personal knowledge about workplace aggression at short‐term follow‐up (SMD 0.86, 95% CI 0.34 to 1.38, 1 RCT; low‐certainty evidence). The evidence is very uncertain about effects of education on personal knowledge in the long term (RR 1.26, 95% CI 0.90 to 1.75, 1 RCT; very low‐certainty evidence). Education may improve attitudes among healthcare workers at short‐term follow‐up, but the evidence is very uncertain (SMD 0.59, 95% CI 0.24 to 0.94, 2 CRCTs and 3 RCTs; very low‐certainty evidence). The type and duration of interventions resulted in different sizes of effects. Education may not have an effect on skills related to workplace aggression (SMD 0.21, 95% CI ‐0.07 to 0.49, 1 RCT and 1 CRCT; very low‐certainty evidence) nor on adverse personal outcomes, but the evidence is very uncertain (SMD ‐0.31, 95% CI ‐1.02 to 0.40, 1 RCT; very low‐certainty evidence).
Measurements of these concepts showed high heterogeneity.
Authors' conclusions
Education combined with training may not have an effect on workplace aggression directed toward healthcare workers, even though education and training may increase personal knowledge and positive attitudes. Better quality studies that focus on specific settings of healthcare work where exposure to patient aggression is high are needed. Moreover, as most studies have assessed episodes of aggression toward nurses, future studies should include other types of healthcare workers who are also victims of aggression in the same settings, such as orderlies (healthcare assistants). Studies should especially use reports of aggression at an institutional level and should rely on multi‐source data while relying on validated measures. Studies should also include days lost to sick leave and employee turnover and should measure outcomes at one‐year follow‐up. Studies should specify the duration and type of delivery of education and should use an active comparison to prevent raising awareness and reporting in the intervention group only.
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:
To assess the effects of patient‐mediated interventions on healthcare professionals' performance (adherence to ...clinical practice guidelines, recommendations or procedures in clinical practice).
Background
Chronic exposure to stress has been linked to several negative physiological and psychological health outcomes. Among employees, stress and its associated effects can also result in ...productivity losses and higher healthcare costs. In‐person (face‐to‐face) and computer‐based (web‐ and mobile‐based) stress management interventions have been shown to be effective in reducing stress in employees compared to no intervention. However, it is unclear if one form of intervention delivery is more effective than the other. It is conceivable that computer‐based interventions are more accessible, convenient, and cost‐effective.
Objectives
To compare the effects of computer‐based interventions versus in‐person interventions for preventing and reducing stress in workers.
Search methods
We searched CENTRAL, MEDLINE, PubMed, Embase, PsycINFO, NIOSHTIC, NIOSHTIC‐2, HSELINE, CISDOC, and two trials registers up to February 2017.
Selection criteria
We included randomised controlled studies that compared the effectiveness of a computer‐based stress management intervention (using any technique) with a face‐to‐face intervention that had the same content. We included studies that measured stress or burnout as an outcome, and used workers from any occupation as participants.
Data collection and analysis
Three authors independently screened and selected 75 unique studies for full‐text review from 3431 unique reports identified from the search. We excluded 73 studies based on full‐text assessment. We included two studies. Two review authors independently extracted stress outcome data from the two included studies. We contacted study authors to gather additional data. We used standardised mean differences (SMDs) with 95% confidence intervals (CIs) to report study results. We did not perform meta‐analyses due to variability in the primary outcome and considerable statistical heterogeneity. We used the GRADE approach to rate the quality of the evidence.
Main results
Two studies met the inclusion criteria, including a total of 159 participants in the included arms of the studies (67 participants completed computer‐based interventions; 92 participants completed in‐person interventions). Workers were primarily white, Caucasian, middle‐aged, and college‐educated. Both studies delivered education about stress, its causes, and strategies to reduce stress (e.g. relaxation or mindfulness) via a computer in the computer‐based arm, and via small group sessions in the in‐person arm. Both studies measured stress using different scales at short‐term follow‐up only (less than one month). Due to considerable heterogeneity in the results, we could not pool the data, and we analysed the results of the studies separately. The SMD of stress levels in the computer‐based intervention group was 0.81 standard deviations higher (95% CI 0.21 to 1.41) than the in‐person group in one study, and 0.35 standard deviations lower (95% CI ‐0.76 to 0.05) than the in‐person group in another study. We judged both studies as having a high risk of bias.
Authors' conclusions
We found very low‐quality evidence with conflicting results, when comparing the effectiveness of computer‐based stress management interventions with in‐person stress management interventions in employees. We could include only two studies with small sample sizes. We have very little confidence in the effect estimates. It is very likely that future studies will change these conclusions.
•We carried out a systematic Cochrane review about patient-mediated interventions.•We wanted to assess their effect on healthcare professionals’ performance.•We included 26 randomised studies.•These ...interventions have the potential to improve professional practice.
To assess the effectiveness of patient-mediated interventions on healthcare professionals' performance.
We conducted a systematic Cochrane review according to established guidelines. We searched predefined databases in 2016 and 2017. Two review authors independently assessed studies for inclusion, extracted data, assessed risk of bias, performed meta-analyses, and assessed the certainty of the evidence (GRADE).
We included 25 randomised studies with a total of 12 268 patients. We found that patient-reported health information interventions and patient education interventions probably improve healthcare professionals' adherence to recommended clinical practice (moderate certainty evidence). We also found that patient information interventions may improve healthcare professionals' adherence to recommended clinical practice (low certainty evidence). Patient decision aids may make little or no difference to the number of healthcare professionals’ adhering to recommended clinical practice (low-certainty evidence).
Our findings strengthen the belief that patient-mediated interventions have the potential to improve professional practice, especially patient-reported health information interventions and patient education interventions.
Our findings show that patient-reported health information interventions and patient education interventions are relevant approaches to improve professional practice. Thus, it seems reasonable to conclude that these types of patient-mediated interventions can contribute to improving the quality of healthcare services.
Background
In national surveys, between 10% and 34% of women have reported being physically assaulted by an intimate male partner. Cognitive behavioural therapy (CBT) or programmes including elements ...of CBT are frequently used treatments for physically abusive men. Participants either enrol voluntarily or are obliged to participate by means of a court order. CBT not only seeks to change behaviour using established behavioural strategies, but also targets thinking patterns and beliefs.
Objectives
To measure effectiveness of CBT and programmes including elements of CBT on men's physical abuse of their female partners.
Search methods
We searched CENTRAL (The Cochrane Library Issue 4, 2009), C2‐SPECTR (2006), MEDLINE (1950 to 1 January 2010), EMBASE (1980 to 2009 week 53), CINAHL (1982 to December 2009), PsycINFO (1806 to week 4, December 2009), ERIC (1966 to December 2009), Social Care Online, previously CareData (13 January 2010), Sociological s (1963 to December 2009), Criminal Justice s (2003), Bibliography of Nordic Criminology (13 January 2010), and SIGLE (2003). We also contacted field experts and the authors of included studies.
Selection criteria
Randomised controlled trials that evaluated the effectiveness of cognitive behavioural therapy for men who have physically abused their female partner and included a measure of the impact on violence.
Data collection and analysis
Two reviewers independently assessed references for possible inclusion, extracted data using an online data extraction form and assessed the risk of bias in each included study. Where necessary, we contacted study authors for additional information.
Main results
Six trials, all from the USA, involving 2343 participants, were included. A meta‐analysis of four trials comparing CBT with a no‐intervention control (1771 participants) reported that the relative risk of violence was 0.86 (favouring the intervention group) with a 95% confidence interval (CI) of 0.54 to 1.38. This is a small effect size, and the width of the CI suggests no clear evidence for an effect. One study (Wisconsin Study) compared CBT with process‐psychodynamic group treatment and reported a relative risk of new violence of 1.07 (95% CI 0.68 to 1.68). Even though the process‐psychodynamic treatment did marginally better than CBT, this result is equivocal. Finally, one small study (N = 64) compared a combined CBT treatment for substance abuse and domestic violence (SADV) with a Twelve‐Step Facilitation (TSF) group. An analysis involving 58 participants investigated the effect on reduction in frequency of physical violence episodes. The effect size was 0.30 (favouring TSF) with 95% CI from ‐0.22 to 0.81.
Authors' conclusions
There are still too few randomised controlled trials to draw conclusions about the effectiveness of cognitive behaviour therapy for male perpetrators of domestic violence.
Cognitive behavioural therapy (CBT) is frequently used as treatment for men who physically abuse their female partner. Findings from a Campbell systematic review, however, reveal that there is not ...enough evidence to draw conclusions on its effect. This review included six randomized controlled trials from the USA involving a total of 2,343 participants.
Background
In national surveys, between 10% and 34% of women have reported being physically assaulted by an intimate male partner. Cognitive behavioural therapy (CBT) or programmes including elements of CBT are frequently used treatments for physically abusive men. Participants either enrol voluntarily or are obliged to participate by means of a court order. CBT not only seeks to change behaviour using established behavioural strategies, but also targets thinking patterns and beliefs.
Objectives
To measure effectiveness of CBT and programmes including elements of CBT on men's physical abuse of their female partners.
Search strategy
We searched CENTRAL (The Cochrane Library Issue 4, 2009), C2‐SPECTR (2006), MEDLINE (1950 to 1 January 2010), EMBASE (1980 to 2009 week 53), CINAHL (1982 to December 2009), PsycINFO (1806 to week 4, December 2009), ERIC (1966 to December 2009), Social Care Online, previously CareData (13 January 2010), Sociological s (1963 to December 2009), Criminal Justice s (2003), Bibliography of Nordic Criminology (13 January 2010), and SIGLE (2003). We also contacted field experts and the authors of included studies.
Selection criteria
Randomised controlled trials that evaluated the effectiveness of cognitive behavioural therapy for men who have physically abused their female partner and included a measure of the impact on violence.
Data collection and analysis
Two reviewers independently assessed references for possible inclusion, extracted data using an online data extraction form and assessed the risk of bias in each included study. Where necessary, we contacted study authors for additional information.
Main results
Six trials, all from the USA, involving 2343 participants, were included. A meta‐analysis of four trials comparing CBT with a no‐intervention control (1771 participants) reported that the relative risk of violence was 0.86 (favouring the intervention group) with a 95% confidence interval (CI) of 0.54 to 1.38. This is a small effect size, and the width of the CI suggests no clear evidence for an effect. One study (Wisconsin Study) compared CBT with process‐psychodynamic group treatment and reported a relative risk of new violence of 1.07 (95% CI 0.68 to 1.68). Even though the process‐psychodynamic treatment did marginally better than CBT, this result is equivocal. Finally, one small study (N = 64) compared a combined CBT treatment for substance abuse and domestic violence (SADV) with a Twelve‐Step Facilitation (TSF) group. An analysis involving 58 participants investigated the effect on reduction in frequency of physical violence episodes. The effect size was 0.30 (favouring TSF) with 95% CI from ‐0.22 to 0.81.
Authors' conclusions
There are still too few randomised controlled trials to draw conclusions about the effectiveness of cognitive behaviour therapy for male perpetrators of domestic violence.
Plain language summary
Cognitive behavioural therapy for men who physically abuse their female partner
Violence by men against an intimate female partner is a serious and common problem, with between 10% and 34% of women reporting in national surveys that they have been assaulted by a male partner. Cognitive behavioural therapy (CBT) is used to reduce male violence by bringing about changes in how men think about violence and how they manage their behaviour. Some men volunteer to attend CBT treatment, while others are court mandated to participate. We included trials that involved both types of participants. The review found all randomised controlled evaluations of the effects of CBT on men's physical violence to their female partners worldwide, but there were only six small trials with a total of 2343 participants that met the inclusion criteria. The results of four of these trials, which compared men who received CBT with men getting no treatment, were combined. This was not able to show us whether or not CBT was better than no treatment. Similarly, the individual results of the other two trials, which compared CBT with another treatment, were inconclusive. Overall, the evidence from the included studies is insufficient to draw any conclusions.
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