Click to start (11 pages)

1. Click to start (11 pages)

2. SUPPORT summaries Getting started One reason for slow progress with the maternal and child health Millennium Development Goals is the difficulty policymakers and others have in accessing high quality information about effective interventions. To improve access, SUPPORT is searching global databases for systematic reviews of interventions relevant to maternal and child health, and for ways of effectively delivering, financing and regulating such interventions, and then preparing structured summaries of the review we find. This short tutorial will tell you how SUPPORT summaries are organised. Click the mouse for the next slide, or use the arrow keys on your keyboard to move backwards and forwards

3. Moving around a summary Summaries have a standard format. Boxes on the right give general information about a SUPPORT summary and the methods used to prepare it. The front page is a self-contained overview of the summary and gives an outline of the summary and its key messages. Click the mouse for the next slide, or use the arrow keys on your keyboard to move backwards and forwards

4. Moving around a summary The second page of every summary gives brief details of the review upon which the summary is based. A glossary at www.support-collaboration.org/summaries/explanations.htm gives explanations of the terms used. Click the mouse for the next slide, or use the arrow keys on your keyboard to move backwards and forwards

5. Summary of findings The studies in the review are described briefly as text before the most important results from the review are presented. Results are given as text, key messages and sometimes as a ‘Summary of findings’ table (see next page). The format of these tables varies depending on the result being summarised. They all use the GRADE system to grade the quality of the research evidence behind the result. Summary of findings (SoF) table Click the mouse for the next slide, or use the arrow keys on your keyboard to move backwards and forwards

6. SoF table - example 1 This summary found that reminders increased appropriate prescribing by between 0% and 34%, depending on the study in the review. The relative effect ranged from 1.0 (ie no change) to 42.0 (ie. 42 times more appropriate prescribing). Twelve studies were included (though only eight provided prescribing data). The quality of evidence was moderate according to the GRADE system (http://www.support-collaboration.org/summaries/grade.htm). Click the mouse for the next slide, or use the arrow keys on your keyboard to move backwards and forwards

7. SoF table - example 2 This summary found one study looking at the effect on maternal mortality of training traditional birth assistants. Mortality fell by 1 death per 1000 but this was not statistically significant. The relative effect was 0.74 in favour of training but the 95% confidence interval was not wholly below 1.0 so the result is equivocal. The quality of evidence was moderate according to the GRADE system (http://www.support-collaboration.org/summaries/grade.htm). Click the mouse for the next slide, or use the arrow keys on your keyboard to move backwards and forwards

8. Relevance to LMICs Each summary provides one page looking at the relevance of the summary to low and middle income countries (LMICs). There are four headings: Applicability, Equity, Economic considerations and Monitoring & evaluation. Findings are summarised on the left-hand side of the page, with an interpretation for LMICs on the right. Some examples are on the next page. Click the mouse for the next slide, or use the arrow keys on your keyboard to move backwards and forwards

9. Relevance to LMICs This summary found that trials looking at nurse practitioners were all done in high income countries, which may limit applicability of the evidence to LMICs. Nurse practitioners can potentially help to address a shortage of doctors but that more evaluation is required. Any use of nurse practitioners in LMICs should, therefore, be done carefully with monitoring and evaluation. Click the mouse for the next slide, or use the arrow keys on your keyboard to move backwards and forwards

10. Additional information The last page of the summary gives additional information, such as other relevant reviews or studies, the authors and peer reviewers of the summary and details of the SUPPORT project. Click the mouse for the next slide, or use the arrow keys on your keyboard to move backwards and forwards

11. More information? Hopefully you will now have a feel for how a SUPPORT summary is organised and how you can interpret its results. If you would like more information about the SUPPORT project you can go to: http://www.support-collaboration.org/ or email Susan Munabi-Babigumira at Susan.Munabi-Babigumira@kunnskapssenteret.no If you would like to give feedback on the SUPPORT summaries you can go to http://www.support-collaboration.org/feedback/. The SUPPORT Collaboration: Supporting Policy Relevant Reviews and Trials. EC contract INCO-CT-2006-031939. 8th June 2009