Rushforth 2006.
| Methods | Single‐centre quasi‐randomized trial in paediatric day surgery unit, university hospital, Southampton, UK. Designed as an equivalence trial | |
| Participants | 617 children attending for day surgery unit 3 months to 15 years of age. 22 families did not complete the study Similar age and sex distribution across two allocation groups. Most children < 5 years of age |
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| Interventions | Each child seen by either non‐specialist doctor or nurse, and then by an expert verifying paediatric anaesthetist (specialist registrar or consultant), who acted as reference standard. Differences in two assessments judged by panel of paediatric anaesthetists and then by investigator, verifying anaesthetist and research assistant. 288 children allocated to one of eight nurses. Nurses given 40 hours of training 307 children allocated to one of 27 non‐specialist doctors (junior doctor commencing paediatric training). No specific training given |
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| Outcomes | Correct identification of abnormality of potential perioperative significance—divided into history and examination No relevant outcomes for this systematic review |
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| Notes | Two earlier publications from a pilot study, which included day surgery unit and ward clerking. Not clear whether day surgery participants were included in main trial Smith & Nephew nursing fellowship underpinned background and pilot work. NHS executive southeast funded the main study |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | High risk | Alternate group allocation, first one in groups decided by lots |
| Allocation concealment (selection bias) | High risk | No concealment |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Staff and participants aware of allocation |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Standardized forms used to record assessment. Verifying anaesthetist unaware of allocation Not clear whether panel of anaesthetists who compared results were blinded, but paper states that investigator, verifying anaesthetist and research assistant were blinded |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | 22 children did not complete the study |
| Selective reporting (reporting bias) | Unclear risk | All prespecified outcomes reported |
| Other bias | Low risk | |