Summary of findings 3. Summary of findings: Email counselling compared with telephone counselling.

Email counselling compared with telephone counselling
Patient or population: Adults (25‐60 years) Settings: Independent research clinic Intervention: Email counselling Comparison: Telephone counselling
Outcomes	No of Participants (studies)	Quality of the evidence (GRADE)	Impact
Patient health status and wellbeing	105 (1 study)	⊕⊝⊝⊝ very low1,2,3,4,5	Telephone counselling leads to greater change than email counselling for some, but not all, measures of patient health status and wellbeing. There was no difference between groups for the majority of measures.
Patient behaviours and actions	105 (1 study)	⊕⊝⊝⊝ very low6,7	Telephone counselling leads to greater change than email counselling for some, but not all, measures of patient behaviours and actions. There was no difference between groups for the majority of measures.
Health service outcomes	0 (0)	See impact	NOT MEASURED
Health professional outcomes	0 (0)	See impact	NOT MEASURED
Harms	105 (1 study)	⊕⊝⊝⊝ very low6,7	There is no difference in harms between the email and telephone counselling groups.
GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate.

¹ For this study 4 of 6 domains have high risk of bias. 
 ² One study with twelve different measures from the same study for this outcome. No comparison data, but 9 measures in favour of telephone and 3 in favour of email. Two post hoc measures favoured the telephone. 
 ³ Population is patients meeting very specific criteria for obesity and drug intake. Setting is research clinic, which is not very applicable in the real world sense intended by this review. 
 ⁴ Only one study. Confidence intervals visibly wide for three measures. 
 ⁵ Two measures presented that were from a post hoc analysis. 
 ⁶ For this study 4 of 6 domains with high risk of bias. 
 ⁷ Population is patients meeting very specific criteria for obesity and drug intake. Setting is research clinic, which is not very applicable in the real world sense intended by this review.