Title: An evidence synthesis meta-analysis and decision analytic modelling following a systematic review of quantitative and qualitative studies evaluating the effectiveness cost-effectiveness safety and acceptability of interventions to prevent PND.
Funder: Department of Health (England)

Abstract: Design: Systematic review evidence synthesis and meta-analysis of quantitative and qualitative studies. Search strategy: We will 1. use major health-related and health economic electronic bibliographic databases; 2. consult via the internet key health service organisations and guideline producing bodies; 3. consult national/international experts in research/practice in preventing PND; 4. search the UK CRN Portfolio Database archive of NRR CCT and its links Clinical Trials.gov HSRProj and Index to Theses to identify ongoing/recently completed research; 5. use existing systematic reviews to identify relevant studies; 6. identify Grey literature; 7. examine reference lists of included studies for further relevant references and if appropriate use the citation facility in Web of Science to search for specific papers/authors; 8. restrict searches to English language trials or systematic reviews with no date restriction. For the qualitative literature synthesis we will include qualitative research which: 1. examined acceptability by reports from women who received PND preventative interventions; 2. identified promising components of candidate interventions by reports from women who did not develop PND; 3. examined how acceptability may affect clinical effectiveness using data within trial reports or process evaluations; and 4. reported the acceptability of interventions to health care practitioners with data from separately conceived research or within trial reports. We will 1. use a three-line strategy to identify studies using wide ranging multi-disciplinary databases with sifting to examine title and abstract then article full-text; 2. use complementary strategies of citation tracking citation pearl growing and Related Articles; 3. target Dissertation Abstracts and Index to Theses for qualitative research reports; 4. identify “sibling studies” e.g. process evaluations and identify mixed methods studies blending quantitative and qualitative research within a common context; to maximise external validity; and 5. track studies through citation linkage from included RCTs and follow-up of principal investigator web sites. Review strategy: We will include reports of systematic reviews RCTs and economic evaluations of prescribed medicines supplements social support “mind-body interventions” complementary and alternative medicines and maternity care organisation used in the prevention of PND for antenatal or early postnatal women in all settings using controls or specific comparators. The outcomes of interest are maternal infant and family. We will assess the quality of the quantitative and qualitative studies. Data will be extracted using a standardised data extraction tool then double checked. Where appropriate for cost-effectiveness modelling clinical effectiveness estimates will be obtained by meta-analysis of available evidence and network meta-analyses where appropriate with the cost per QALY as the final outcome. Qualitative meta-synthesis will provide added value to the quantitative analysis. Expected output: We plan to disseminate findings in high profile journals national/international conferences guideline development bodies and feed results into curricula for professional education. Team expertise: The team have extensive experience in literature searches systematic reviews evidence synthesis value of information analyses Bayesian statistics in health economics decision analytic models health economic modelling and mapping plus mental health technologies mental health research PND clinical experience and research with antenatal and postnatal women maternity care organisation public health primary care parenting and infant outcomes. Study timetable: 15 months from 01.11.12 – 31.01.13. Search and quantitative studies review; then Critical appraisal of quantitative literature; Data analysis and report from meta-analysis; Search and review qualitative studies; Dissemination of reviews Decision Analysis Cost-effectiveness modelling Final Value of Information analyses; Final report and continuing dissemination.


Research activity codes: 7.3 MANAGEMENT AND DECISION MAKING
Health categories: MENTAL HEALTH;REPRODUCTIVE HEALTH AND CHILDBIRTH