Summary of findings for the main comparison. SOCIAL SKILLS versus STANDARD CARE for schizophrenia.
| SOCIAL SKILLS versus STANDARD CARE for schizophrenia | ||||||
| Patient or population: patients with schizophrenia Settings: Intervention: SOCIAL SKILLS versus STANDARD CARE | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | SOCIAL SKILLS versus STANDARD CARE | |||||
| Social functioning Various scales Follow‐up: 8‐52 weeks | See comment | See comment | Not estimable | 585 (4 studies) | ⊕⊝⊝⊝ very low1,2,3,4 | The four RCTs that provided data for this comparison used different scales to measure social functioning and so data were not pooled for this comparison. |
| Relapse Follow‐up: 6‐12 months | 351 per 1000 | 183 per 1000 (119 to 277) | RR 0.52 (0.34 to 0.79) | 263 (2 studies) | ⊕⊝⊝⊝ very low4,6,7 | |
| Rehospitalisation Follow‐up: 12 months | 366 per 1000 | 194 per 1000 (110 to 340) | RR 0.53 (0.3 to 0.93) | 143 (1 study) | ⊕⊝⊝⊝ very low4,8 | |
|
Mental state: general symptoms (BPRS) Follow‐up: 12 weeks |
The mean mental state: general symptoms in the intervention groups was 4.01 lower (7.52 to 0.50 lower) | 91 (1 study) | ⊕⊝⊝⊝ very low4,8 | |||
| Global state: not clinically improved. CGI Follow‐up: 6 months | 529 per 1000 | 153 per 1000 (63 to 360) | RR 0.29 (0.12 to 0.68) | 67 (1 study) | ⊕⊝⊝⊝ very low4,5 | |
| General functioning MRSS Follow‐up: 8 weeks | The mean General functioning: average endpoint score (various scales) ‐ MRSS in the intervention groups was 10.6 lower (17.47 to 3.73 lower) | 112 (1 study) | ⊕⊝⊝⊝ very low4,5 | |||
| Quality of life GWB. Scale from: 10 to 40. Follow‐up: 8 weeks | The mean Quality of life in the intervention groups was 7.6 lower (12.18 to 3.02 lower) | 112 (1 study) | ⊕⊝⊝⊝ very low4,5 | |||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; | ||||||
| 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. | ||||||
1 Risk of bias: very serious. Only one of the trials had adequate sequence generation. Allocation concealment was unclear in all trials and none were blinded. Two trials addressed incomplete data adequately and three were free from selective reporting. It was unclear in all trials whether they were free from other biases. 2 Inconsistency: serious. See comment. 3 Imprecision: very serious. Data were not combined, but for each single study the 95% confidence intervals around the pooled effect estimate are very wide. 4 Publication bias: strongly suspected. Less than five studies provided data for this outcome. 5 Risk of bias: very serious. The RCT that provided data for this outcome did not have adequate sequence generation, allocation concealment and blinding. It was unclear whether there were other biases. 6 Risk of bias: very serious. Neither of the two RCTs were blinded, and it was unclear in both if there was adequate allocation concealment. Only one had adequate sequence generation and one addressed incomplete data adequately. It was unclear in both if they were free from other biases. 7 Inconsistency: serious. There was moderate heterogeneity for this outcome. This may be explained by differences in type of social skills training. Ma 2003 included sessions on medication and symptom management as well as social skills, whereas in Saren 2004 the focus was on interpersonal interaction. 8 Risk of bias: very serious. The RCT that provided data for this outcome had unclear allocation concealment and was not blinded. It was unclear if it was free from other biases.