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We share an interest in how best to report in systematic reviews
trials that use multiple assessments. The purpose of our letter is to add
to this debate. In your paper you did not mention a possible alternative
suggested by Grimshaw 2001. This is to select one of the multiple
assessments, for example, the primary if one is defined as such, or the one
with the median effect size. This approach, although it may not maximise
the use of the information as would a multivariate analysis, is an
attractive alternative for its simplicity and ease of understanding the
results, particularly if available data are limited. We recently used this
approach for a systematic review on supportive interventions for informal
carers of patients in the terminal phase of a disease (Candy 2011).
J Grimshaw, L M McAuley, L A Bero, R Grilli, A D Oxman, C Ramsay, L
Vale, M Zwarenstein. Systematic reviews of the effectiveness of quality
improvement strategies and programmes. Qual Saf Health Care 2003;12:298-
Candy B, Jones L, Drake R, Leurent B, King M.Interventions for
supporting informal caregivers of patients in the terminal phase of a
disease. Cochrane Database Syst Rev. 2011 Jun 15;(6):CD007617.
No competing interests
30 September 2011
Bridget Candy, Systematic Reviewer
Marie Curie Palliative Care Research Unit, UCL Mental Health Sciences Unit