Kumar 1999
| Methods | Purpose: to assess the effect of a physician‐targeted intervention to increase the influenza vaccination uptake among seniors Design: RCT, physicians randomised Duration of study: 1 September to 31 December 1997 Power computation: none provided Statistics: percentage of total Medicare beneficiaries immunised | |
| Participants | Country: USA Setting: Louisiana physician offices Participants: non‐HMO Medicare providers. 750 physicians assigned to intervention group; 1167 assigned to control group Age: patients >= 65 Gender: not reported |
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| Interventions | Intervention group received a "... cover letter and their Medicare patient pool influenza immunization and missed opportunity indicator uptake in October 1997" and "... were encouraged to evaluate ways in which their practices might improve upon the baseline immunization status and were offered assistance in designing quality improvement projects to effect such a change. The information provided to the physicians included computed rates for all selected physicians which allowed them to compare their rates with rates of other physicians." The control group did not receive any educational or other materials | |
| Outcomes | % influenza vaccination Although the influenza vaccination uptake increased from 1996 to 1997 in both the intervention group (4.21% versus 5.23%) and the control (3.74% versus 4.5%) the intervention group uptake increased significantly more (P = 0.03) than that of the control |
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| Notes | — | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | "Randomly selected "intervention group" of physicians (n = 750)" and "... another group of physicians, with similar characteristics, was also randomly selected and designated as the "control group" (n= 1,167).)" (no statement about method of randomisation) |
| Allocation concealment (selection bias) | Unclear risk | No statement |
| Blinding (performance bias and detection bias) All outcomes | Low risk | No statement, but outcomes ascertained from Medicare Part B claims |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | Identified all Louisiana Medicare‐certified providers; analysed 1996 and 1997 Medicare Part B claims files for influenza vaccinations |
| Selective reporting (reporting bias) | Low risk | No selective reporting |