Summary Tables
69

Table 1: Scheme for Grading the Evidence to Support the Use or Positive Impact of Interventions

Overall Assessment

Quality

Quantity Consistency of Findings

Study Designs Objective

Assessment a

A Excellent at least one RCTb

$ 75% studies $ 4 studies consistent

B Good at least one controlled trial $ 50% studies $ 3 studies reasonably consistent

C Fair no controlled trials < 50% studies $ 2 studies inconsistent

D Poor no controlled trials < 50% studies < 2 studies too few studies to determine

a

 Objective assessment as rated on the Quality Assessment Form, Question 15

b RCT= Randomized controlled trial
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Table 2. Summary of selected aspects of study quality for the 27 articles addressing Question 1

Selected Quality Assessment Domains and

Items

Number of Articles

Yes No

Representativeness

- Healthcare providers clearly described? 20 7

Bias/confounding

- Adequate comparison group? 26 1

- Randomized? 11 16

Intervention description

- Complete description (able to replicate)? 24 3

Outcome assessment

- Blinding? 9 18

- Pre- and post-test? 13 14

- Objective evaluation? 27 0

Analysis

- Numbers and reasons of non-inclusion? 18 9

- Complete statistical analysis? 24 3
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Table 3. Results of studies presented by clinical area and type of outcome for articles addressing Question 1a

Main

Intervention

Method b

Healthcare Process Outcomes Patient Outcomes

Utilization Quality of

Providers

Appropriateness

of Care

Efficacy of

Treatment

Patient

Adherence

Health

Status

Patient

Satisfaction

PREVENTION, ADULT

Adult General Prevention

Gemson, 1995 Education NA/++/++/++/NA/

NA/NA/++/++

McDonald, 1984 T/R ++/0 ++/++ 0

Turner, 1989 T/R NA/NA/NA/NA/

NA/NA 

Adult Cancer Screening

Burack, 1994 T/R ++/++/NA

Burack, 1996 T/R 0 +

Burack, 1997 T/R ++

Burack, 1998 T/R 0 ++

Burack, 2003 T/R ++/0 ++/0

Chambers, 1989 T/R ++

Dietrich, 1998 multi ++ 0/0/0/0/0/0/0

Mandelblatt, 1993 bypass MD ++/++

Manfredi, 1998 multi ++/++/0/++

McCarthy, 1997 bypass MD NA

Adult Tobacco Cessation

Ahluwalia, 1999 T/R ++/++/+/++

Allen, 1998 multi + 0/0/0/0

Adult Cholesterol

Keyserling, 1997 multi 0 0/0 ++ ++/+/+

PREVENTION, CHILDREN

Health Behavior Screening

Schubiner, 1994 STQ +/+/++/+/+ 0
Main

Intervention

Method b

Healthcare Process Outcomes Patient Outcomes

Utilization Quality of

Providers

Appropriateness

of Care

Efficacy of

Treatment

Patient

Adherence

Health

Status

Patient

Satisfaction

72

Injury Prevention

Gielen, 2001 Education + 0 0 ++
Table 3. Results of studies presented by clinical area and type of outcome for articles addressing question 1a

 (continued)

Main

Intervention

Method b

Healthcare Process Outcomes Patient Outcomes

Utilization Quality of

Providers

Appropriateness

of Care

Efficacy of

Treatment

Patient

Adherence

Health

Status

Patient

Satisfaction

73

Well Baby Care

Hornberger, 1996 Translation 0 +/+/+/+/+/+ +

MENTAL HEALTH

Alcohol

Burge, 1997 multi 0/++/0/0/0/

0/0/0

Depression

Miranda, 2003 multi ++ ++/0

Callahan, 1994 multi ++/++/0/0 0

OTHER CLINICAL AREAS

Acute Respiratory Infections

Harris, 2003 multi 0/0

Asthma

Evans, 1997 multi NA/NA ++/++/NA

Chronic Renal Disease

Harris, 1998 NC ++/0/0/+ 0 0/0/0

Emergency Systems

Kellerman, 1993 defib 0/0/0

End of Life

Dexter, 1998 T/R ++/+ +/+/+

a: The outcome assessments in this table are based on between-group comparisons. “++” indicates significant improvement, “+” indicates improvement, “0" indicates no

improvement, and “NA” indicates between-group comparison not available. If a cell is left blank, then the outcome type was not measured for that study. Outcomes separated by

“/” indicate more than one outcome type. b: “T/R” indicates tracking and reminder, “multi” indicates multifaceted, “bypass MD” indicates bypass doctor with nurse, “STQ”

indicates safe times questionnaire, “NC” indicates nephrologist consultation, and “defib” indicates defibrillators on emergency medical vehicles.
73

Table 4: Summary of interventions, clinical areas, and outcomes of studies addressing Question 1

Intervention

Typea

Clinical Area (# studies) Total #

Studies

Overall Outcome Assessment

across Studies

Rating of

Evidence

Tracking/

Reminders

Adult, Prevention (9) 10 All studies reported favorable

outcomes.

A

End of Life (1)

Multifaceted Adult, Prevention (4) 9 Although almost all studies reported

some positive impact on one or more

outcome type, results within outcome

type were inconsistent across studies.

C

Depression (2)

Alchohol Abuse (1)

Asthma (1)

Upper Respiratory Tract

Infections (1)

Bypass MD Adult, Prevention (2) 2 Both studies reported favorable

outcomes in the provision of

preventive services to patients.

C

Provider

Education

Adult, Prevention (1) 2 Both studies reported favorable

impact on provider counseling

behaviors.

C

Child, Prevention (1)

Use of STQb Child, Prevention (1) 1 One study reported favorable impact

on provider counseling behavior.

D

Use of RSTc Child, Prevention (1) 1 One study reported favorable

outcomes on accuracy of translation

and provider/patient satisfaction.

D

Use of Specialty

Consult

Chronic Renal Disease (1) 1 One study did not demonstrate

improvement.

D

Use of

Defibrillators

Emergency Medicine (1) 1 One study did not demonstrate

improvement.

D

a

 Note that characterization of interventions for purposes of synthesis reflects a simplification of employed methods. Consult

Evidence Table 2 for details on methods for individual studies.

bSTQ = safe times questionnaire

cRST = remote simultaneous translation
74

Table 5. Summary of selected aspects of study quality for the 64 articles addressing Question 2

Selected Quality Assessment Domains and

Items

Number of Articles

Yes No 

Representativeness

- Healthcare providers clearly described? 21 43

Bias/confounding

- Adequate comparison group? 8 56

- Randomized? 1 63

Intervention description

- Based on theoretical model? 17 47

- Complete description (able to replicate)? 21 43

Outcome assessment

- Blinding? 3 61

- Pre- and post-test? 33 31

- Objective evaluation? 27 37

Analysis

- Numbers and reasons of non-inclusion? 14 50

- Complete statistical analysis? 15 49
75

Table 6. Results of studies presented by type of outcome for the 34 articles addressing Question 2a

Provider Outcomes Patient Outcomes

Knowledge Attitudes Skills Satisfaction Patient Adherence Health Status

Physicians

Beagan, 2003 0 / 0 / 0

Copeman, 1989 ? + / ?

Crandall, 2003 ++ ++ ++

Culhane-Pera, 1997 ++ + / + ++ / ++

Dogra, 2001 0 / ?

Farnill, 1997 ++ / ++

Godkin, 2001 ++ ++

Godkin, 2003 ++ / ? / ++

Haq, 2000 ++ / + ++

Mao, 1988 + ++

Mazor, 2002 + ++ / ? ++ / ++ / ++ / ++

Nora, 1994 ++ + +

Rubenstein, 1992 ++ / ++

Tang, 2002 ++ / ++ / ++

Nurses

Alpers, 1996 + / -

Flavin, 1997 0

Frank-Stromborg, 1987 ++ / + +

Frisch, 1990 ++ / 0 / +

Inglis, 2000 ++

Jeffreys, 1999 ++ ++ ++

Lasch, 2000 ++ ++
Table 6. Results of studies presented by type of outcome for the 34 articles addressing question 2a

 (continued)

Provider Outcomes Patient Outcomes

Knowledge Attitudes Skills Satisfaction Patient Adherence Health Status

76

Napholz, 1999 +

Scisney-Matlock, 2000 ++ / ++

Smith, 2001 ++ ++

St. Clair, 1999 ++ / ++ / +

Underwood, 1999 + + / + +

Williamson, 1996 ++ ++ ++

Mixed healthcare provider groups

Erkel, 1995 + + / + / +

Gallagher Thompson, 2000 ++ / ++ ++

Gany, 1996 ++ ++

Way, 2002 + + / ++ ++

Other healthcare providers

Hansen, 2002 ++

Strumphauzer, 1983 ++ ++

Wade, 1991 ++ ++

a: “++” indicates significant positive effect, “+” indicates positive effect,“–“ indicates negative effect, “?" indicates partial/mixed effect, “?” indicates unclear, and “0” indicates no

effect. If cell is left blank, then outcome type is not measured for that study. Outcomes separated by “/” indicate more than one outcome type