Robertson 1990.
| Methods | RCT Setting: UK |
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| Participants | 30 (see Notes) inpatients of Edinburgh hospitals who showed left visual field neglect on BIT Experimental: n = 17, control: n = 13 (The following data describe the 36 initial participants: see Notes) Mean age (SD): experimental 64.2 years (12.6), control 63.1 years (9.6) Sex (male/female): experimental 9/11, control 10/6 Onset of neglect (SD): experimental 19.2 weeks (21.1), control 10.8 weeks (6.3) Inclusion: presence of neglect (failure on at least 3/9 behavioural tests), oriented for time and place, ability to consent, ability to concentrate sufficiently to sit at computer‐based task for at least 15 minutes | |
| Interventions | 15½ hours (14 sessions of 75 minutes each, 2 x week for 7 weeks) computerised scanning and attention training (intensive briefing about nature of participant's problems, feedback on left and right latencies, trainer reinforcement and encouragement) versus 11.4 hours recreational computing (to minimise scanning and timed attention tasks, without any potential neuropsychological mechanism to improve cognitive function, but exposed to computer activities such as games, quizzes and simple logical games) For analysis of bottom‐up and top‐down rehabilitation approaches this review coded the experimental condition as top‐down | |
| Outcomes | The study collected several types of outcomes:
The BIT was the principal outcome measure. (Although not explicitly stated it is assumed from the description on page 664 and the low scores in Table 2 that only the BIT behavioural subtests were given.) The outcomes were given immediately after training and after 6 months. The study also collected data on several other tests including the GHQ and the FAI to ensure matching of groups (see Notes).These were collected at each time point This review used the BIT, immediately and after 6 months |
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| Notes | This review entered n = 30 of initial 36 (33 with CVA, 2 HI, 1 had surgery for excision of meningioma). 3/36 not followed up immediately and 9/36 not seen at 6 months but no information on which group these were from so data entered to this review subtracted 3 and 9 from each group at first (n = 30) and second assessments respectively. Information on allocation concealment provided by personal communication. 6 months follow‐up Exclusion: participants with BIT score > 70 Cancellation data reported as errors rather than correct performance The review could not include the FAI data as these were not reported | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Allocation concealment (selection bias) | Low risk | External randomisation.Randomisation restricted in blocks of patients with severe or mild neglect, therefore stratifies by severity. Randomisation was carried out by a third party |
| Blinding of outcome assessment (detection bias) All outcomes | Low risk | Blinded outcome assessor |
| Incomplete outcome data (attrition bias) All outcomes | High risk | 3/36 not followed up immediately and 9/36 not seen at 6 months but no information on which group these were |
| Free of systematic differences in baseline characteristics of groups compared? | Unclear risk | Slight difference in letter cancellation errors and Wisconsin at baseline |
| Did authors adjust for baseline differences in their analyses? | Low risk | Not necessary |