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Table 3 Summary of findings and certainty of evidence for included study outcomes

From: The effectiveness of allied health and nurse practitioner models-of-care in managing musculoskeletal conditions in the emergency department: a systematic review and meta-analysis

 

Summary of findings

Certainty of evidence

No of participants (No of RCTs)

Effect size (95% CI)

Study design

Inconsistency

Imprecision

Certainty of evidence

Patient-flow

     

Proportion of patients that had contact-time with clinicians of 20 min or less

260 (1)

Physician: 98% of patients

Nurse: 86% of patients

Physiotherapist: 77% of patients

Downgraded

Not assessed#

Downgraded

Very-low1

Pain (0-100)

     

ED-discharge

155 (2)

MD -10.9 (-24.8 to 2.9)

Downgraded

Downgraded

Downgraded

Very-low

1-month

163 (2)

MD -10.5 (-25.0 to 4.1)

Downgraded

Downgraded

Downgraded

Very-low

3-months

161 (2)

MD -8.1 (-24.7 to 8.6)

Downgraded

Downgraded

Downgraded

Very-low

Disability

     

1-month

386 (3)

SMD − 0.2 (-0.4 to 0.0)

Downgraded

Unchanged

Downgraded

Low

3-months

374 (3)

SMD − 0.2 (-0.4 to 0.0)

Downgraded

Unchanged

Downgraded

Low

Inpatient admission

     

Within 1-month

186 (1)

Difference in proportions 4% (-18 to 9%)

Unchanged

Not assessed#

Downgraded

Very-low

Re-presentation rate

    

Within 1-month

186 (1)

Difference in proportions 3.5% (-6 to 13%)

Unchanged

Downgraded

Very-low

Medication prescription

    

At ED-visit

260 (1)

Physician: 42% of patients,

Nurse: 23% of patients, Physiotherapist: 4% of patients

Downgraded

Downgraded

Very-low2

76 (1)

Difference in proportions − 24% (-46% to -2%)

Downgraded

Downgraded

Very-low

1-month

76 (1)

Difference in proportions − 40% (-62% to -18%)

Downgraded

Downgraded

Very-low

3-months

62 (1)

Difference in proportions − 11% (-29 to 9%)

Downgraded

Downgraded

Very-low

Recommended use of medications (over-the-counter medications)

    

At ED-visit

76 (1)

Difference in proportions 59% (41 to 76%)

Downgraded

Downgraded

Very-low

1-month

63 (1)

Difference in proportions -19% (-42 to 2%)

Downgraded

Downgraded

Very-low

3-months

62 (1)

Difference in proportions -25% (-40% to -2%)

Downgraded

Downgraded

Very-low

  1. Key: RCTs; randomised controlled trials, MD; mean difference, SMD; standardised mean difference
  2. Note: Unable to assess small study effects due to few studies included
  3. #Inconsistency was not assessed as findings were based in single studies or heterogeneity existed between measurement of outcome
  4. 1Study provided categorical data regarding time patients spent with healthcare professional, 2Study provided no confidence intervals around estimates