Despite the increasing numbers of published trials of quality improvement (QI) interventions in diabetes, little is known about the risk of bias in this literature.
Although some trials of quality improvement strategies have demonstrated small improvements in the process of care delivery, demonstrating improvement in control of A1C, LDL, and systolic blood pressure (SBP) has been more challenging (15– 15).
A relatively recent systematic review of 142 trials of quality improvement strategies or financial incentives to improve the management of adult outpatients with diabetes, identified that nearly half the trials were judged to have high risk of bias, and it emphasised the need to improve reporting of quality improvement trials.
There were 574 women in that group, which makes it one of the largest clinical trials for quality of life," she said.
We identified only one randomised trial of moderate quality.
The study is a prospective, cluster-randomised controlled trial of a quality-improvement intervention.
Although these studies were of variable quality, one trial of somehow higher quality also had a bigger sample (N > 3000).
Although the included trials scarcely reported on the key indicators of trial quality, the quality of the trials was also assessed by the Jadad score [ 19].
More trials, a better understanding of trial quality and bias, and a reclassification of certain drugs necessitate a new review.
Sensitivity analyses were conducted to explore the effects of trial quality and trial design on the outcomes.
Conclusions: The use of summary scores to identify physical therapy trials of high quality is questionable.
