Systematic reviews and lifelong diseases

Effectiveness of innovations in nurse led chronic disease management for patients with chronic obstructive pulmonary disease: systematic review of evidence

“…Generic interventions aimed at high risk individuals may be more effective than disease specific interventions for COPD or the effect size of interventions for COPD that have been tested may be too small to be seen in the limited evaluations carried out to date, most of which had potential methodological weaknesses. Elphick and colleagues have suggested that systematic reviews of randomised controlled trials often fail to give adequate information on the long term outcomes of chronic diseases and have called for consideration of the inclusion of data from observational studies as well 36. We attempted this in our extended review12 but found that the inclusion of other types of study contributed little to our current findings.…”

Clinical and economic choices in the treatment of respiratory infections in cystic fibrosis: Comparing hospital and home care

“…Furthermore, a randomised controlled trial may not be the best study design for patients with chronic or lifelong diseases such as CF as they rarely evaluate long-term outcomes [19].…”

Long term clinical outcome of home and hospital intravenous antibiotic treatment in adults with cystic fibrosis

“…Anecdotal evidence suggests that patients have strong preferences regarding site of treatment and refuse to be randomised, although it may be possible to build patient preferences into the trials. 17 Furthermore, a randomised controlled trial may not be the best study design for patients with chronic or lifelong diseases such as CF as they rarely evaluate long term outcomes, 18 and alternative study designs such as well conducted observational studies should be considered.…”