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. 2019 Aug 8;2019(8):CD006869. doi: 10.1002/14651858.CD006869.pub3

Wang 2015.

Methods Design: RCT
Participants Setting: emergency department of a hospital
Type of trauma exposure: severe MVA survivors. Patients were suspected to have experienced possible severe injuries that required specialised acute medical care.
Inclusion criteria: aged 18–65 years, and able to communicate in verbal and written Chinese.
Exclusion criteria: history of neurological problems, brain surgery, brain damage and spinal cord injuries; current alcohol or drug abuse (or both), and current or past schizophrenic or psychotic disorders.
Sample size: 76 individuals assessed for eligibility; 52 randomised.
Mean age: 40.3 (SD 14.8) years, based on available data from 46 completers.
Gender: 19 (41.3%) men; 27 (58.7%) women, based on available data from 46 completers.
Ethnicity: not reported but likely to be Chinese.
Country: China
Interventions Group 1: creative arts: n = 26
Intervention delivered in small groups of 4–6 participants in hospital led by a psychologically trained and supervised artist. The primary modalities utilised were creative writing and drawing. Participants were offered 8 weekly 40 min sessions. In the first 2 weeks, participants were requested to perform simple drawing techniques. Weeks 3–5 explored present emotions and issues. Final sessions focused on bringing together resources for moving forward.
Group 2: waiting list: n = 26
Outcomes PTSD: CAPS; IES‐R
Other: HADS (depression and anxiety); PTGI
Follow‐up: 2, 6 and 12 months
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Not reported
Allocation concealment (selection bias) Unclear risk Not reported
Blinding of outcome assessment (detection bias) 
 All outcomes Low risk Participants were asked not to share information to the assessors to ensure that they were blind to interventions.
Incomplete outcome data (attrition bias) 
 All outcomes Low risk Completer‐only analysis, although follow‐up data was available for all participants at 2‐month follow‐up and the majority of participants at subsequent follow‐ups.
Selective reporting (reporting bias) High risk No study protocol identified. The study authors reported no statistically significant differences between intervention and controls, which meant that it was not possible to include this study in meta‐analysis. This has the potential to lead to an overestimate of effectiveness for those outcomes.
Other bias High risk Intervention was not manualised so it could not be guaranteed that the therapy was delivered in the same manner to all of the participants. Sample size was small.