• Patient and public involvement in systematic reviews: A systematic review of literature

      Shokraneh, Farhad; Adams, Clive E. (2018)
      Background: Patient and public involvement (PPI) is part of any research including the systematic reviews. However, the body of evidence on this matter is not clear about the methods, process and challenges and opportunities. Objectives: To report the existing evidence of PPI in systematic review and lessons to learn for future projects. Methods: We conducted a systematic review searching CINAHL, the Cochrane Library, Embase, HMIC, and MEDLINE (31 January 2018) and checking the references of included studies. Results: We identified eight reports that met our inclusion criteria: Serrano-Aguilar 2009, Boote 2011, Boote 2012, Kreis 2012, Vale 2012, Oliver 2015, Hyde 2016, and Brütt 2017. Research focussed on embedding PPI in research, methods of PPI, effect of PPI, and outcome of PPI. PPI is reported in all steps of systematic reviews, including writing the protocol and identifying relevant outcomes, searching and screening the literature, critical appraisal, interpreting the results for dissemination and writing the final report. Conclusions: PPI for systematic reviews adds value in all steps including identification outcomes step. PPI in systematic reviews could be more useful if the primary studies consider PPI as well. Cochrane should continue leading use of PPI in systematic reviews through briefing policies and guidelines. Patient or healthcare consumer involvement: PPI should be part of every systematic review. Our study shows the impact of PPI in systematic reviews and shares lessons to be learnt by research organisations.
    • Patient characteristics and outcome measurement in a forensically informed predischarge unit

      Sales, Christian P.; Matumbike, Itai; Khalifa, Najat (2018)
      Purpose: This study sought to describe the demographic and clinical characteristics of patients admitted to forensically informed pre-discharge unit in England. Design: Using a prospective service evaluation framework and a clinical case register (n=30) patients were assessed for any change over admission. Findings: The results showed a statistically significant reduction in the security items and total scores on the Health of the Nation Outcome Scale (HoNOS), and the Clinical and Risk management items and total scores on the Historical Clinical Risk factor-20 (HCR-20), alongside a significance improvement in the Model of Human Occupation Screening Tool (MOHOST) total scores. Furthermore, when contrasted with each other the sample of community discharges showed similar significant improvements to the above whereas the recalled patients showed mostly declining scores evidencing the HCR-20, HoNOS and MOHOSTs ability as predictors of discharge. Originality / value: These findings are relevant to both users and providers of forensic mental health services as this unit is unique in the sense of it not existing in other services.
    • Performance of methods for meta-analysis of diagnostic test accuracy with few studies or sparse data

      Guo, Boliang (2017)
      Hierarchical models such as the bivariate and hierarchical summary receiver operating characteristic (HSROC) models are recommended for meta-analysis of test accuracy studies. These models are challenging to fit when there are few studies and/or sparse data (for example zero cells in contingency tables due to studies reporting 100% sensitivity or specificity); the models may not converge, or give unreliable parameter estimates. Using simulation, we investigated the performance of seven hierarchical models incorporating increasing simplifications in scenarios designed to replicate realistic situations for meta-analysis of test accuracy studies. Performance of the models was assessed in terms of estimability (percentage of meta-analyses that successfully converged and percentage where the between study correlation was estimable), bias, mean square error and coverage of the 95% confidence intervals. Our results indicate that simpler hierarchical models are valid in situations with few studies or sparse data. For synthesis of sensitivity and specificity, univariate random effects logistic regression models are appropriate when a bivariate model cannot be fitted. Alternatively, an HSROC model that assumes a symmetric SROC curve (by excluding the shape parameter) can be used if the HSROC model is the chosen meta-analytic approach. In the absence of heterogeneity, fixed effect equivalent of the models can be applied.<br/>Copyright &#xa9; The Author(s) 2017.
    • Practice-based evidence: Benchmarking NHS primary care counselling services at national and local levels

      Evans, Chris (2003)
      There are a number of problems for evidence-based practice (EBP) including limited generalizability of efficacy research results, the consequent lack of confidence in the relevance of such research, and the conceptual distance of most practitioners from the research process. The result is that EBP, although sound in principle, often fails to achieve its aim of improving practice. Practice-based evidence (PBE) provides a complementary bridge for the gap between research and practice to offset some of these problems, promoting collaboration between mental health services and academic institutions. This paper presents the initial results of such a collaboration via three phases: (1) the development of a referential database for primary care counselling services, (2) 'practitioner-friendly' feedback on grouped data to services, and (3) the combination of the two to build an evidence base for work with ethnic minorities-an area in which research trials are not well adapted to provide much evidence. Copyright (C) 2003 John Wily Sons, Ltd.
    • Pragmatic design in randomized controlled trials

      Adams, Clive E. (2015)
      At more than 10 years after the paper by Hotopf and colleagues regarding pragmatic trials in psychiatry, the field has evolved and is evolving further. There have been many developments in our understanding of what pragmatism really means, and excellent examples of truly pragmatic trials in psychiatry are currently available. Funders have helped encourage more emphasis on the need for such studies, but ‘local’ and trans-national regulations could help more. Consumers of the evidence should have a greater voice in generating the research agenda and, as this happens, the questions generated are more likely to be answered by a pragmatic approach to trials. (PsycINFO Database Record (c) 2016 APA, all rights reserved) (Source: journal abstract)
    • Principles for the production and dissemination of recruitment material for three clinical trials of an online intervention

      Rennick-Egglestone, Stefan (2021)
      Some health research studies recruit participants through electronic mechanisms such as the placement of messages on social media platforms. This raises questions for ethics committee oversight, since effective social media campaigns might involve the production and dissemination of hundreds of contemporaneous messages. For the Narrative Experiences Online (NEON) study, we have developed nine principles to control the production and dissemination of promotional material. These have been approved by an ethics committee and enable the audit of our recruitment work. We propose that the drafting for approval of recruitment principles by health research studies may, in many cases, strike an appropriate balance between enabling ethical oversight of online recruitment work and the potential burden of message review.
    • Professionals' perceptions of the obstacles to education for people using mental health services

      Atkinson, Sue; Schneider, Justine (2009)
      Objective: This article focuses on the preliminary findings of a research project investigating the barriers to participation in education for persons using mental health services.; Methods: A questionnaire was administered to 380 care coordinators in community health teams in the Nottinghamshire Healthcare NHS Trust to elicit their views on three areas where possible obstacles may be encountered: physical and psychological barriers found at an individual level, and structural barriers at the service level. Seventy care coordinators, predominantly community psychiatric nurses, replied and reported the barriers they saw facing 140 service users, all of whom were diagnosed with a severe mental illness.; Results: Analysis of the physical and psychological obstacles indicated that fluctuating illness was the major barrier, with mobility the least problematic issue. The average number of substantial barriers faced by an individual was five. Lack of funding for courses was the biggest service-related obstacle, closely followed by lack of information and opportunities for education. Low expectations on the part of mental health practitioners were seen as the least important service-related issue.; Conclusions: Recommendations for service development highlight the role of education in recovery from mental illness.;
    • Proportionate methods for evaluating a simple digital mental health tool

      Davies, E. Bethan; Craven, Michael P.; Martin, Jennifer L.; Simons, Lucy (2017)
      BACKGROUND: Traditional evaluation methods are not keeping pace with rapid developments in mobile health. More flexible methodologies are needed to evaluate mHealth technologies, particularly simple, self-help tools. One approach is to combine a variety of methods and data to build a comprehensive picture of how a technology is used and its impact on users. OBJECTIVE: This paper aims to demonstrate how analytical data and user feedback can be triangulated to provide a proportionate and practical approach to the evaluation of a mental well-being smartphone app (In Hand). METHODS: A three-part process was used to collect data: (1) app analytics; (2) an online user survey and (3) interviews with users. FINDINGS: Analytics showed that >50% of user sessions counted as 'meaningful engagement'. User survey findings (n=108) revealed that In Hand was perceived to be helpful on several dimensions of mental well-being. Interviews (n=8) provided insight into how these self-reported positive effects were understood by users. CONCLUSIONS: This evaluation demonstrates how different methods can be combined to complete a real world, naturalistic evaluation of a self-help digital tool and provide insights into how and why an app is used and its impact on users' well-being. CLINICAL IMPLICATIONS: This triangulation approach to evaluation provides insight into how well-being apps are used and their perceived impact on users' mental well-being. This approach is useful for mental healthcare professionals and commissioners who wish to recommend simple digital tools to their patients and evaluate their uptake, use and benefits.
    • Proportionate translation of study materials and measures in a multinational global health trial: methodology development and implementation

      Charles, Ashleigh; Slade, Mike (2022)
      OBJECTIVESCurrent translation guidelines do not include sufficiently flexible translation approaches for different study materials. We aimed to develop a proportionate methodology to inform translation of all types of study materials in global health trials.DESIGNThe design included three stages: (1) categorisation of study materials, (2) integration of existing translation frameworks and (3) methodology implementation (Germany, India, Israel, Tanzania and Uganda) and refinement.PARTICIPANTSThe study population comprised 27 mental health service users and 27 mental health workers who were fluent in the local language in stage 7 (pretesting), and 54 bilingual mental health service users, aged 18 years or over, and able to give consent as judged by a clinician for step 9 (psychometric evaluation).SETTINGThe study took place in preparation for the Using Peer Support in Developing Empowering Mental Health Services (UPSIDES) randomised controlled trial (ISRCTN26008944).PRIMARY OUTCOME MEASUREThe primary outcome measure was the Social Inclusion Scale (SIS).RESULTSThe typology identifies four categories of study materials: local text, study-generated text, secondary measures and primary measure. The UPSIDES Proportionate Translation Methodology comprises ten steps: preparation, forward translation, reconciliation, back translation, review, harmonisation, pretesting, finalisation, psychometric evaluation and dissemination. The translated primary outcome measure for the UPSIDES Trial (SIS) demonstrated adequate content validity (49.3 vs 48.5, p=0.08), convergent validity and internal consistency (0.73), with minimal floor/ceiling effects.CONCLUSIONThis methodology can be recommended for translating, cross-culturally adapting and validating all study materials, including standardised measures, in future multisite global trials. The methodology is particularly applicable to multi-national studies involving sites with differing resource levels. The robustness of the psychometric findings is limited by the sample sizes for each site. However, making this limitation explicit is preferable to the typical practice of not reporting adequate details about measure translation and validation.TRAIL REGISTRATION NUMBERISRCTN26008944.
    • Qualitative research with staff in forensic settings: A grounded theory example

      Gordon, Neil (2012)
      This book explores applied research methods used in forensic settings – prisons, the probation service, courts and forensic mental health establishments – and provides a comprehensive 'how-to' guide for forensic practitioners and researchers. It provides practitioners and researchers with grounding in the practical techniques appropriate for research in applied forensic settings. This includes knowledge and skills of the research process and the wide range of research methods (both quantitative and qualitative) being applied in this arena. The text provides a critical understanding of the problems, challenges and ethical issues which can arise and ideas for managing these. Specific attention is paid to empirical research within forensic populations and settings including researching vulnerable groups (e.g. offenders and the mentally ill in secure settings), evaluating treatment programmes, and the uses and problems of randomised control trials. The book is clearly structured, with each methodology chapter describing the background of the approach; the type of research questions addressed; design principles and issues; the types of analysis that can be utilised; strengths and limitations of the method; future directions and further sources of information. Through the inclusion of case studies and illustrative examples from forensic researchers and practitioners who have extensive experience of conducting applied research, this book tackles real-life problems typically faced by researchers and practitioners. Research in Practice for Forensic Professionals is an essential one-stop resource for practitioners (such as psychologists, nursing and medical staff, prison and probation workers, social workers, occupational therapists) who have an interest in research and in evaluating their own work and the services in which they work. It will also be of interest to students studying areas of applied research, such as forensic psychology or applied criminology and those teaching them.
    • Questioning the community: A guide to research for therapeutic community members: Part one: The bare bones of a research project

      Evans, Chris (2007)
      In what is to become a regular column in the TC journal, we want to devote some time and space to 'de-mystifying' the practice of research: methods and methodologies (why one is not the other, and vice versa); practical applications of research; interpretations and implementations of 'evidence-based practice'; as well as notes from our own experiences as researchers. In this issue, we will open up the debate with a quick introduction to some of the central issues in conducting research in general, and try to define some of the more difficult terms and concepts used by researchers. © The Author(s).
    • Reporting and understanding the safety and adverse effect profile of mobile apps for psychosocial interventions: An update

      Shokraneh, Farhad; Adams, Clive E. (2016)
      Recent years have seen a rapidly increasing trend towards the delivery of health technology through mobile devices. Smartphones and tablet devices are thus becoming increasingly popular for accessing information and a wide range of services, including health care services. Modern mobile apps can be used for a variety of reasons, ranging from education for the patients and assistance to clinicians to delivery of interventions. Mobile phone apps have also been established to benefit patients in a scope of interventions across numerous medical specialties and treatment modalities. Medical apps have their advantages and disadvantages. It is important that clinicians have access to knowledge to make decisions regarding the use of medical apps on the basis of risk-benefit ratio. Mobile apps that deliver psycho social interventions offer unique challenges and opportunities. A number of reviews have highlighted the potential use of such apps. There is a need to describe, report and study their side effects too. The adverse effects associated with these apps can broadly be divided into: (1) those resulting from the security and safety concerns; (2) those arising from the use of a particular psycho social intervention; and (3) those due to the interaction with digital technology. There is a need to refine and reconsider the safety and adverse effects in this area. The safety profile of a mobile PSI app should describe its safety profile in: (1) privacy and security; (2) adverse effects of psychotherapy; and (3) adverse effects unique to the use of apps and the internet. This is, however, a very new area and further research and reporting is required to inform clinical decision making.
    • Research matters

      Evans, Chris (2007)
      Chris Evans makes a plea for the creativities of both genders and both sexes in psychological therapy research...
    • Research matters

      Evans, Chris (2008)
      Chris Evans debates the merits of putting patients first in research.
    • Research matters

      Evans, Chris (2008)
      Chris Evans explains how to become confident in using confidence intervals.
    • RevManHAL: Towards automatic text generation in systematic reviews

      Adams, Clive E. (2017)
      BACKGROUND: Systematic reviews are a key part of healthcare evaluation. They involve important painstaking but repetitive work. A major producer of systematic reviews, the Cochrane Collaboration, employs Review Manager (RevMan) programme-a software which assists reviewers and produces XML-structured files. This paper describes an add-on programme (RevManHAL) which helps auto-generate the abstract, results and discussion sections of RevMan-generated reviews in multiple languages. The paper also describes future developments for RevManHAL. METHODS: RevManHAL was created in Java using NetBeans by a programmer working full time for 2 months. RESULTS: The resulting open-source programme uses editable phrase banks to envelop text/numbers from within the prepared RevMan file in formatted readable text of a chosen language. In this way, considerable parts of the review's 'abstract', 'results' and 'discussion' sections are created and a phrase added to 'acknowledgements'. CONCLUSION: RevManHAL's output needs to be checked by reviewers, but already, from our experience within the Cochrane Schizophrenia Group (200 maintained reviews, 900 reviewers), RevManHAL has saved much time which is better employed thinking about the meaning of the data rather than restating them. Many more functions will become possible as review writing becomes increasingly automated.
    • Rivers of evidence

      Adams, Clive E. (2013)
      There has been too much of a one-way flow drift down a river of evidence. Researchers from rich countries have produced the primary evidence which they proceed to summarise within reviews. These summaries have directed care worldwide. However, things are changing and the river of evidence can flow in the other direction. The care of women with eclampsia has been changed or refined throughout the world because of a large low and middle income country trial. The global care of people with heart disease has been greatly modified by studies originating in China. The care of people who are acutely aggressive because of psychosis has to be reconsidered in the light of the evidence coming from Brazil and India. Healthcare is an issue everywhere and evaluation of care is not the premise of any one culture-the evidence-river must run both ways.