Editor—Øvretveit and Gustafson say that the Cochrane Effective Practice and Organisation of Care Group (EPOC, www.epoc/uottawa.ca) has developed methods to assess observational studies.1 This is incorrect, and we here clarify the group's scope.
The group reviews interventions designed to improve professional practice and the delivery of effective health services. This includes various forms of continuing education, quality assurance, and informatics, as well as financial, organisational, and regulatory interventions that can affect the ability of healthcare professionals to deliver services more effectively and efficiently.
Although we consider randomised controlled trials to be the gold standard for evaluating quality improvement interventions,2 EPOC recognises that it may not be feasible to evaluate many organisational, professional, or financial interventions in a randomised controlled trial.
Therefore, in addition to randomised controlled trials, the group allows any of the following study designs be included in its reviews: patient randomised controlled trials, cluster randomised controlled trials, patient or cluster allocated controlled clinical trials, controlled before and after studies, and interrupted time series designs. Members have worked to advance the methods of reviewing in our area. For example, we have developed appraisal criteria for controlled before and after studies and interrupted time series designs.
Competing interests: None declared.
References
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- 2.Eccles M, Grimshaw J, Campbell M, Ramsay C. Research designs for studies evaluating the effectiveness of change and improvement strategies. Qual Safe Health Care 2003;12: 47-52. [DOI] [PMC free article] [PubMed] [Google Scholar]