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. 2019 May 23;2019(5):CD008388. doi: 10.1002/14651858.CD008388.pub3

Summary of findings 2. Summary of findings: Compensative interventions versus control.

Compensative interventions compared with control for visual field defects in patients with stroke
Patient or population: stroke survivors with visual field defects
Settings: any rehabilitation setting
Intervention: compensative interventions
Comparison: control, placebo, or no intervention
Outcomes Relative effect
(95% CI) No of Participants
(studies) Quality of the evidence
(GRADE) Comments
Functional ability in activities of daily living (no data) No studies Insufficient evidence  
Visual field
(Functional field score and relative change in visual field score, combined)
After intervention
SMD ‐0.11 (‐0.92 to 0.70
(no significant effect)
95
(2 studies, De Haan 2015; Rowe 2010)
⊕⊝⊝⊝
very low Reasons for downgrades:
  • Risk of bias ‐ one study judged as high risk of bias for at least one domain

  • Inconsistency ‐ one study had baseline differences

  • Inconsistency ‐ I2 = 75%

  • Indirectness ‐ studies explored very different compensatory interventions

Extended activities of daily living
(Mobility questionnaire and change in Nottingham EADL, combined)
After intervention
SMD 0.49 (‐0.01 to 0.99)
(no significant effect)
97
(2 studies, De Haan 2015; Rowe 2010)
⊕⊝⊝⊝
very low Reasons for downgrades:
  • Risk of bias ‐ one study judged as high risk of bias for at least one domain

  • Indirectness ‐ outcome measures were very different; for one study outcome was a mobility measure, rather than a general measure of EADL

  • Indirectness ‐ studies explored very different compensatory intervention


s
Reading ability
(Reading speed; various tests)
After intervention
SMD 0.26 (‐0.05 to 0.58)
(no significant effect)
162
(4 studies, Aimola 2011; De Haan 2015; Rowe 2010; Spitzyna 2007)
⊕⊕⊝⊝
low Reasons for downgrades:
  • Risk of bias ‐ three studies judged as high risk of bias for at least one domain

  • Indirectness ‐ studies explored very different compensatory intervention

Falls (no data) No studies Insufficient evidence  
Quality of life
(National Eye Institute Visual Function Questionnaire (NEI ‐ VFQ‐25) total score)
After intervention
MD 9.36 (3.10 to 15.62)
(favours compensatory)
96
(2 studies, De Haan 2015; Rowe 2010)
⊕⊕⊝⊝
low Reasons for downgrades:
  • Risk of bias ‐ two studies judged as high risk of bias for at least one domain

  • Indirectness ‐ studies explored very different compensatory interventions

Scanning ‐ cancellation
(cancellation tests ‐ time to complete)
After intervention
SMD ‐0.01 (‐0.40 to 0.39)
(no significant effect)
97
(2 studies, Aimola 2011; De Haan 2015)
⊕⊕⊝⊝
low Reasons for downgrades:
  • Risk of bias ‐ two studies judged as high risk of bias for at least one domain

  • Indirectness ‐ studies explored very different compensatory interventions

Adverse events
(number of participants with reported events during intervention period)
OR 5.18 (0.24 to 112.57
(favours control)
108
(2 studies, De Haan 2015; Rowe 2010)
(NB. no events recorded in De Haan 2015, which did not explicitly report adverse events as an outcome measure)
⊕⊕⊝⊝
low Reason for downgrades:
  • Inconsistency ‐ no events from one study, means pooled result was not estimable for that study; large confidence intervals

  • Indirectness ‐ studies explored very different compensatory interventions

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.

CI: confidence intervals
EADL: extended activities of daily living
MD: mean difference
NEI‐VFQ‐25: National Eye Institute Visual Function Questionnaire
OR: odds ratio
SMD: standardised mean difference