Appendix Document A1: Search strategy for Medline (1960 ...Appendix Document A1: Search strategy for...
Transcript of Appendix Document A1: Search strategy for Medline (1960 ...Appendix Document A1: Search strategy for...
Appendices:
Appendix Document A1: Search strategy for Medline (1960 – November 2015)
Appendix Table A1: Detailed Risk of Bias Table
Appendix Figure A1: Funnel plot
Appendix Figure A2: Sensitivity analysis excluding cluster randomized trials
Appendix Figure A3: Subgroup analysis of studies by control intervention method
Appendix Figure A4: Subgroup analysis of studies by method of peer support
Appendix Figure A5: Subgroup analysis of studies by presence or absence of peer supervision
Appendix Figure A6: Meta-regression plot of effect of peer training hours on effect size
Appendix Figure A7: Meta-regression plot of effect of baseline Hemoglobin A1C on effect size
Appendix Figure A8: Meta-regression plot of effect of duration of observation on effect size
Appendix Document A1: Search strategy for Medline (1960 – November 2015)
01. exp Diabetes Mellitus/ or diabetes.ti.
02. Hemoglobin A, Glycosylated/ or (HbA1c or A1c or glycated h?emoglobin* or glycosylated h?emoglobin* or glyc?emic control or clinical
outcome*).mp.
03. Peer group/ or (peer*1 or peer health or peer support or peer led or peer educator* or peer coach* or peer counsel* or peer advis*).mp.
04. Patient Education as Topic/ or patient education.mp.
05. Self-Help Groups/ or self help group*
06. Social Support/ or (social support or promotora).mp.
This supplemental material has been supplied by the author and has not been edited by Annals of Family Medicine.
07. 4 or 5 or 6
08. peer*1.mp.
09. 7 and 8
10. 1 and 2 and 3 and 9
11. limit 10 to yr=”1960-Current”
12. randomized controlled trial.pt. or randomized controlled trials as topic/ or random*.ti,ab.
13. 11 and 12
Summary of Results
Ovid Medline and Ovid Medline In Process
62 MASR
68 RCT
Cochrane Central Register of Controlled Trials
62 RCT
Cochrane Database of Systematic Reviews
37 MASR
Scopus
16 MASR
44 RCT
CINAHL – Medline excluded
3 MASR
21 RCT
PsycINFO
1 MASR
This supplemental material has been supplied by the author and has not been edited by Annals of Family Medicine.
7 RCT
ProQuest Dissertations & Theses A&I, BioOne Abstracts & Indexes, Social Service Abstracts, and Sociological Abstracts
0 results
OCLC First Search
34 RCT
Author searches of Scopus, CINAHL, PsycINFO and Google Scholar
45 citations
Total 400 citations retrieved
Minus 195 duplicates removed
Leaves 205 unique citations
This supplemental material has been supplied by the author and has not been edited by Annals of Family Medicine.
Appendix Table A1: Detailed Risk of Bias Table
Study Name Adequate Sequence Generation
Allocation Concealment
Blinding of Participants, Personnel and Outcome
Assessors
Complete Outcome Data
Keyserling 2002 Stratified block randomization with randomly permuted blocks of size 3 and 6 from random numbers generated by a personal computer
Sealed envelopes No Yes: Dropout < 20%. Similar dropout in both groups. Follow-up data were analyzed according to group assignment
Lorig 2008 Yes: Random-number tables a
Yes: Random-number tables for each allocation that were used randomly a
No: “Participants could not be blinded.”
Yes: Dropout < 20%. Attrition reported. The “proportion of intervention non-completers compared with that of usual-care control non-completers was not statistically significant.”
Lorig 2009 Yes: Randomization using random-number tables
Yes: Random-number tables for each allocation that were used randomly a
No: “Participants could not be blinded.”
Yes: Dropout < 20%. Attrition reported. Proportion of intervention non-completers compared to usual-care control non-completers was not significant.
Dale 2009 Yes: Randomization protocol mentioned
Yes: Opaque sealed envelopes
Not reported Yes: Dropout < 20%.Attrition mentioned with some reasons.
Cade 2009 Yes?: Participants were randomized into intervention or the control arm but no information on sequence generation available.
Not reported Not reported Yes: Dropout < 20% from baseline measurements Attrition mentioned “Dropout between randomization and baseline measurements.” “At 12 months, clinical data (HbA1C) was available on 86 (77%) of the
This supplemental material has been supplied by the author and has not been edited by Annals of Family Medicine.
intervention participants and 118 (93%) control participants.”
Heisler 2010 Yes: “Random sequence generation and treatment group assignment were determined centrally just before the initial session.”
Yes: “Sequence was concealed until interventions were assigned.”
Yes: “Patients, research staff, and care managers were blinded to randomization results until after the baseline surveys and physiologic measures were completed. Data assessors remained blinded to group assignment throughout the study.”
Yes: Dropout < 20%. Attrition with reasons mentioned in flow diagram.
Philis-Tsamakas 2011
Yes: Blocked random assignment using a randomly generated numbers sequence
Allocation concealment was done a
No a Yes: Dropout > 20%Attrition mentioned with reasons of attrition. “Fifty-one (25%) participants were lost to follow-up (Project Dulce group, n = 35 [33.5%]; control group, n = 16 [15.5%]); however, at baseline, these participants did not differ significantly from those who completed at least one follow-up assessment on any demographic or outcome variable (p = 0.05).”
Smith 2011 Yes: Cluster randomization using minimization
Yesa: Allocation carried out independently of the research team Minimization was undertaken by an independent statistician
No Yes: 15% dropout Attrition with reasons mentioned.
Long 2012 Yes: Using the random-number generator function, each group assignment given a random number and put the ordered numbers in envelopes
Yes: “Envelopes were sealed, shuffled, and stacked, and the research assistant took the top envelope after consent was obtained to determine group assignment.”
Yes: “Study investigators were blinded to allocation and results until study completion.”
Yes: Dropout < 20% Attrition mentioned in flow diagram with some reasons.
This supplemental material has been supplied by the author and has not been edited by Annals of Family Medicine.
Yes indicates low risk of bias; Yes? Likely low risk of bias but no details on sequence generation available from article and author; No indicates high risk of bias; ?No is not reported or no response from author. a author response to email requests Selective outcome reporting risk was considered minimal since we only selected studies which reported hemoglobin A1C as the outcome. There were no significant other biases noted in the included studies.
Gagliardino 2013
Yes?: Random assignment mentioned in Methods but no information received on sequence generation
Not reported Not reported Attrition unclear
Siminerio 2013 Yes: Randomization was done by a computer program a
No a No a Yes: Dropout < 20% Attrition with reasons mentioned.
Thom 2013 Yes: “Assigned to usual care or peer-coaching study arm using randomly ordered opaque envelopes.”
Yes: Opaque envelopes.
No a Yes: Dropout < 20%.Attrition mentioned.
Chan 2014 Yes: Computer-generated, block randomization 1:1 assignment.
Yes: Opaque envelop opened by non-nursing staff not involved in research.
Not reported Yes: Dropout < 20% Attrition with reasons mentioned.
Simmons 2014 Yes: Clusters were randomized in blocks of four
Yes: Randomization by statistician who had no trial involvement after all clusters enrolled
Yes: Outcomes assessors and investigators were masked to arm allocation.
Yes: 23.9% dropout. Attrition mentioned.
Safford 2015 Yes: Random-number generator.
Yes: Randomization at the cluster level predated participant recruitment and was secure.
No: Participants and peer coaches were not blinded.
Dropout < 20% Attrition mentioned.
Ayala 2015 Yes: Conducted by study biostatistician and stratified by clinic.
?No: Not reported Not reported 27% dropout Attrition with reasons mentioned.
McGowan 2015 Yes: Block randomization, for each block random-number generator used
Yes: Anonymized study identification numbers were assigned to each subject.
No: Participants were not blinded.
34% dropout Attrition with reasons mentioned.
This supplemental material has been supplied by the author and has not been edited by Annals of Family Medicine.
-2.0 -1.5 -1.0 -0.5 0.0 0.5 1.0 1.5 2.0
0.0
0.1
0.2
0.3
0.4
Sta
nd
ard
Err
or
Std diff in means
Funnel Plot of Standard Error by Std diff in means
Appendix Figure A1: Funnel plot
This supplemental material has been supplied by the author and has not been edited by Annals of Family Medicine.
Study name Statistics for each study Std diff in means and 95% CI
Std diff Lower Upper in means limit limit p-Value
Keyserling 0.029 -0.311 0.369 0.866
Lorig 2008 0.240 0.047 0.433 0.015
Lorig 2009 -0.067 -0.279 0.144 0.534
Dale -0.306 -0.594 -0.017 0.038
Cade -0.159 -0.435 0.117 0.258
Heisler 0.377 0.124 0.630 0.004
Philis-Tsimakas 0.371 0.097 0.646 0.008
Long 0.661 0.202 1.120 0.005
Gagliardino 0.000 -0.279 0.279 1.000
Siminerio 0.108 -0.369 0.584 0.658
Thom 0.357 0.129 0.586 0.002
Chan 0.007 -0.150 0.163 0.934
Ayala 0.205 -0.009 0.419 0.061
McGowan 0.248 0.029 0.467 0.027
Pooled SMD 0.137 0.021 0.254 0.021
-1.00 -0.50 0.00 0.50 1.00
Favors control Favors peer support
I2 of 66.030%
p for heterogeneity <0.001
Appendix Figure A2: Sensitivity analysis excluding cluster randomized trials
This supplemental material has been supplied by the author and has not been edited by Annals of Family Medicine.
Supplement eFigure 3: Subgroup analysis of studies by control intervention
method
Group by control intervention
Study name Statistics for each study Std diff in means and 95% CI
Std diff Lower Upper in means limit limit p-Value
Education or Nurse care Keyserling 0.029 -0.311 0.369 0.866
Education or Nurse care Gagliardino 0.000 -0.279 0.279 1.000
Education or Nurse care Siminerio 0.108 -0.369 0.584 0.658
Education or Nurse care Chan 0.007 -0.150 0.163 0.934
Education or Nurse care Safford 0.181 -0.104 0.465 0.213
Education or Nurse care pooled effect 0.041 -0.072 0.153 0.477
Usual care Lorig 2008 0.240 0.047 0.433 0.015
Usual care Lorig 2009 -0.067 -0.279 0.144 0.534
Usual care Dale -0.306 -0.594 -0.017 0.038
Usual care Cade -0.159 -0.435 0.117 0.258
Usual care Heisler 0.377 0.124 0.630 0.004
Usual care Philis-Tsimakas 0.371 0.097 0.646 0.008
Usual care Smith 0.000 -0.208 0.208 1.000
Usual care Long 0.661 0.202 1.120 0.005
Usual care Thom 0.357 0.129 0.586 0.002
Usual care Simmons 0.029 -0.153 0.211 0.753
Usual care Ayala 0.205 -0.009 0.419 0.061
Usual care McGowan 0.248 0.029 0.467 0.027
Usual care pooled effect 0.147 0.021 0.273 0.023
-1.00 -0.50 0.00 0.50 1.00
Favors control Favors peer support
Appendix Figure A3: Subgroup analysis of studies by control intervention method
Group education or nurse care management control intervention: I2= 0.00,
p for heterogeneity 0.86
Usual care: I2= 70.53%, p for heterogeneity<0.001
This supplemental material has been supplied by the author and has not been edited by Annals of Family Medicine.
Supplement eFigure 4: Subgroup analysis of studies by method of peer support
Group by peer intervention method
Study name Statistics for each study Std diff in means and 95% CI
Std diff Lower Upper in means limit limit p-Value
group education Lorig 2008 0.240 0.047 0.433 0.015
group education Lorig 2009 -0.067 -0.279 0.144 0.534
group education Cade -0.159 -0.435 0.117 0.258
group education Philis-Tsimakas 0.371 0.097 0.646 0.008
group education Smith 0.000 -0.208 0.208 1.000
group education McGowan 0.248 0.029 0.467 0.027
group education pooled effect 0.106 -0.050 0.262 0.182
group+telephone Keyserling 0.029 -0.311 0.369 0.866
group+telephone Gagliardino 0.000 -0.279 0.279 1.000
group+telephone Simmons 0.029 -0.153 0.211 0.753
group+telephone Ayala 0.205 -0.009 0.419 0.061
Group + telephone pooled effect 0.076 -0.040 0.193 0.201
Telephone Dale -0.306 -0.594 -0.017 0.038
Telephone Heisler 0.377 0.124 0.630 0.004
Telephone Long 0.661 0.202 1.120 0.005
Telephone Siminerio 0.108 -0.369 0.584 0.658
Telephone Thom 0.357 0.129 0.586 0.002
Telephone Chan 0.007 -0.150 0.163 0.934
Telephone Safford 0.181 -0.104 0.465 0.213
Telephone pooled effect 0.179 -0.028 0.386 0.091
-1.00 -0.50 0.00 0.50 1.00
Favors control Favors peer support
Group education: I2 64.67%, p for heterogeneity 0.01
Group education + telephone support: I2 0.00%, p for heterogeneity 0.57
Telephone: I2 74.83%, p for heterogeneity 0.001
Supplement Figure A4: Subgroup analysis of studies by method of peer support
This supplemental material has been supplied by the author and has not been edited by Annals of Family Medicine.
Supplement eFigure 5: Subgroup analysis of studies by presence or absence of peer supervision
No supervision: I2 77.09%, p for heterogeneity 0.001
Supervised peers: I2 43.24%, p for heterogeneity 0.06
Group by peer supervision
Study name Statistics for each study Std diff in means and 95% CI
Std diff Lower Upper in means limit limit p-Value
No supervision Keyserling 0.029 -0.311 0.369 0.866
No supervision Dale -0.306 -0.594 -0.017 0.038
No supervision Cade -0.159 -0.435 0.117 0.258
No supervision Long 0.661 0.202 1.120 0.005
No supervision Thom 0.357 0.129 0.586 0.002
No supervision Simmons 0.029 -0.153 0.211 0.753
No supervision pooled effect 0.078 -0.157 0.313 0.515
Supervised Peers Lorig 2008 0.240 0.047 0.433 0.015
Supervised Peers Lorig 2009 -0.067 -0.279 0.144 0.534
Supervised Peers Heisler 0.377 0.124 0.630 0.004
Supervised Peers Philis-Tsimakas 0.371 0.097 0.646 0.008
Supervised Peers Smith 0.000 -0.208 0.208 1.000
Supervised Peers Gagliardino 0.000 -0.279 0.279 1.000
Supervised Peers Siminerio 0.108 -0.369 0.584 0.658
Supervised Peers Chan 0.007 -0.150 0.163 0.934
Supervised Peers Safford 0.181 -0.104 0.465 0.213
Supervised Peers Ayala 0.205 -0.009 0.419 0.061
Supervised Peers McGowan 0.248 0.029 0.467 0.027
Supervised Peers pooled effect 0.143 0.050 0.237 0.003
-1.00 -0.50 0.00 0.50 1.00
Favors control Favors peer support
No supervision: I2 77.09%, p for heterogeneity 0.001
Supervised peers: I2 43.24%, p for heterogeneity 0.06
Appendix Figure A5: Subgroup analysis of studies by presence or absence of peer supervision
This supplemental material has been supplied by the author and has not been edited by Annals of Family Medicine.
Regression of Std diff in means on Peer training hours
Peer training hours
-20.0 -10.0 0.0 10.0 20.0 30.0 40.0 50.0 60.0
Std
dif
f in
me
an
s0.80
0.60
0.40
0.20
0.00
-0.20
-0.40
-0.60
-0.80
Appendix Figure A6: Meta-regression plot of effect of peer training hours on effect size
Slope: 0.001
p = 0.8
This supplemental material has been supplied by the author and has not been edited by Annals of Family Medicine.
Regression of Std diff in means on baseline a1c
baseline a1c
5.5 6.0 6.5 7.0 7.5 8.0 8.5 9.0 9.5 10.0 10.5 11.0 11.5 12.0
Std
dif
f in
me
an
s
1.00
0.80
0.60
0.40
0.20
0.00
-0.20
-0.40
-0.60
-0.80
Appendix Figure A7: Meta-regression plot of effect of baseline Hemoglobin A1C on effect size
Slope 0.0657
P = 0.09
This supplemental material has been supplied by the author and has not been edited by Annals of Family Medicine.
Regression of Std diff in means on Months of observation after intervention completed
Months of observation after intervention completed
0.0 2.0 4.0 6.0 8.0 10.0 12.0
Std
dif
f in
me
an
s
0.80
0.60
0.40
0.20
0.00
-0.20
-0.40
-0.60
-0.80
Appendix Figure A8: Meta-regression plot of effect of duration of observation on effect size
Slope -0.004
P = 0.8
This supplemental material has been supplied by the author and has not been edited by Annals of Family Medicine.