Summary of findings 1. Summary of findings.
| 1. Environmental intervention compared with social/home visits for older adults with visual impairment | |||||
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Patient or population: older adults (aged 60 and over) with irreversible visual impairment Settings: living independently Intervention: home safety modification by occupational therapists Comparison: social/home visits, such as social support to discuss general topics about lifestyles without providing clinical advice | |||||
| Outcomes | Anticipated absolute effects (95% CI) | Relative effects* | No of participants (studies) | Certainty of the evidence (GRADE) | |
| Risk with control | Risk with environmental intervention | ||||
| Physical activity at 6 months Assessed with different measures (step counts, walking time, and self‐reported physical activity) |
1 trial reported no difference in mean estimates between groups. Step counts: MD 321 (95% CI, ‐1981 to 2622); average walking time (minutes): MD 1.70 (95% CI, ‐24.03 to 27.43); self‐reported physical activity: MD ‐3.68 scores (95% CI, ‐20.6 to 13.24) |
28 (1 RCT) | ⊕⊕⊝⊝ low1 | ||
| Fall measures Assessed with different measures (proportion of fallers at 6 months) |
8/13 | 7/15 | RR 0.76, 95% CI 0.38 to 1.51 | 28 (1 RCTs) | ⊕⊕⊝⊝ low1 |
| Fear of falling scores at 6 months Assessed by Short Falls Efficacy Scale‐International |
Mean fear of falling was 10.38 scores | Mean fear of falling was 12.93 scores | MD 2.55 scores higher (95% CI, 0.51 lower to 5.61 higher) | 28 (1 RCT) | ⊕⊕⊝⊝ low1 |
| Quality of life at 6 months Assessed by 12‐Item Short Form Health Survey |
Mean quality of life was 46.03 scores | Mean quality of life was 42.89 scores | MD 3.14 scores lower (95% CI, 10.86 lower to 4.58 higher) | 28 (1 RCT) | ⊕⊕⊝⊝ low1 |
| *The relative effect of the intervention (and its 95% CI). CI: Confidence interval; MD: Mean Difference; RR: Risk Ratio. | |||||
| GRADE Working Group grades of evidence High‐certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate‐certainty: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low‐certainty: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low‐certainty: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | |||||
1Downgraded 1 level due to study limitations (high risk of performance bias) and 1 level due to imprecision (small sample size)