Kerse 1999

Methods	Purpose: to compare an educational programme for General Practitioners about social and physical activity, prescribing and vaccination practices for elderly participants with audit, to no intervention Design: RCT, general practices were unit of allocation Duration of study: November 1995 to April 1997 Interval between intervention and when outcome was measured: November 1995 to April 1997 Power computation: website stated 93 participants needed in each group to detect 20% change with α = 0.05, β = 0.8, allowing for clustering Statistics: ITT. "We adjusted for the effect of clustered design with a cross sectional time series iterative programed least squares regression."
Participants	Country: Australia Setting: 42 GPs in Melbourne Eligible participants: (health status) a number was assigned to 398 GPs in metropolitan Melbourne then randomly selected 193 with no computerised recall system for influenza vaccination; exclusions from the 193 were: 6 were not contactable, 25 moved or had died, 28 had partners already enrolled in trial, 25 worked < 12 hours/week, 7 were retiring, 13 had no elderly participants or participants who did not speak English, and 7 had computerised recall systems. Then 42 of 82 eligibles were enrolled; then using random number table average 397 charts were reviewed per practitioner and 10 elderly participants identified per practitioner; 267 (64%) of invited participants participated Age: ≥ 65 Gender: 54% f
Interventions	Intervention 1: educational programme in 5 stages for GPs about social and physical activity, prescribing and vaccination practices for elderly participants Control: no intervention
Outcomes	Outcome measured: % influenza vaccination Time points from the study that are considered in the review or measured or reported in the study: November 1995 to February 1996 and at 1‐year follow‐up (December 1996 to April 1997) % vaccinated by: April 1997 E‐mail from Dr. Kerse indicated data on baseline influenza uptake for the year before the intervention would be supplied but further e‐mail not received
Notes	Funding: Victoria Health Promotion Foundation; doctoral scholarship for Dr. Kerse
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	"An independent research assistant at a distant site used computer randomisation to allocate general practitioners to intervention or control group and this was concealed until the interview began."
Allocation concealment (selection bias)	Low risk	"An independent research assistant at a distant site used computer randomization to allocate general practitioners to intervention or control group and this was concealed until the interview began."
Blinding (performance bias and detection bias) All outcomes	Low risk	"Interviewers evaluating outcomes were blinded to the intervention group of participants and general practitioners at all times, and participants were unaware of the group allocation of their general practitioner."
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	In Table 1 135 participants are listed in the intervention group (but only 120 are listed as either "yes" or "no" for influenza vaccination) and 132 in the control (but only 112 listed "yes" or "no" for influenza vaccination status) "Influenza vaccination rates increased by almost 10% in both groups" (but no n's for these outcomes are cited) After 1 year 34 participants could not be followed up, and they were correctly counted in the groups to which they were randomised in an ITT analysis Immunisation data ascertained by chart review (all practices were deliberately selected as being not computerised)
Selective reporting (reporting bias)	Low risk	No selective reporting