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. 2021 Oct 12;2021(10):CD011589. doi: 10.1002/14651858.CD011589.pub2

Simons 2015.

Study characteristics
Methods Randomised trial, the Netherlands
Participants 102 depressed out‐patients receiving psychopharmacological treatment
Interventions Three arms: (i) an experimental group receiving six weeks of experience sampling method (ESM) self‐monitoring combined with weekly feedback sessions, (ii) a pseudo‐experimental group participating in six weeks of ESM self‐monitoring without feedback, and (iii) a control group (treatment as usual only).
 
Intervention features
Multiple complex feedback (multiple PROMs at multiple times) 
PROM(s) used as intervention: Experience sampling method (ESM) a validated, structured diary technique consisting of repeated in‐the‐moment micro‐measurements of affect and context
Constructs measured: Symptoms, Functioning
Instrument categories/domains: Domain/Disease specific (mental health)
 
Administration features
Where PROMs administered: Non‐clinical setting
How administered: Self‐administered
Format of PROMs questionnaire(s): Electronic
 
Feedback features
Format of PROMs feedback: Paper
How often information fed back: 6 feedback sessions over 6 weeks
Who information fed back to: Clinicians, Patients
Information fed back: Scores, Previous scores, Interpretation guidance
Outcomes Main outcomes: empowerment (Dutch Empowerment questionnaire, economic evaluation, depression (HDRS), quality adjusted life years (QALYs)
Notes The study was funded by the Dutch Health Research Council (ZON‐MW) (grants nos. 171001002 and 91501003). The study recruited between 2010 and February 2012. Conflicts of interest were not reported. 
 
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Stratified randomisation method.
Allocation concealment (selection bias) Low risk Allocation took place using opaque, sealed, sequentially numbered envelopes (prepared by an independent research coordinator) with a number sequence produced by an electronic random sequence generator (http://www.random.org), in blocks of six.
Blinding of participants and personnel (performance bias)
All outcomes High risk Owing to the nature of the intervention, it was not possible to blind participants.
Blinding of outcome assessment (detection bias)
All outcomes High risk Interviewers were not blind to the patients’ treatment allocation due to nature of the intervention.
Baseline outcome measurements similar Low risk There was no significant difference in baseline HDRS depressive symptoms between patients who fully completed the intervention period and those who did not.
Baseline characteristics similar Low risk Baseline characteristics of the study and control providers are reported and similar.
Incomplete outcome data (attrition bias)
All outcomes Low risk Of the 69 patients allocated to the experimental or pseudo‐experimental group, 59 (85.5%) completed the six‐week intervention period; Pre‐intervention empowerment scores were available for
respectively 32 of 33 (control), 35 of 36 (pseudo‐experimental), and 33 of 33 (experimental) participants. Post‐intervention empowerment scores were available for 30 (control), 32 (pseudo‐ experimental), and 27 (experimental) participants. Two participants had incomplete assessments of empowerment (front page only, i.e. 15 items), their total scores (mean item score 40) were retained in the analyses.
Was study protected against contamination High risk As the psychologist or psychiatrist performing the interview were aware that the patient was a participant in the study.
Selective reporting (reporting bias) Low risk None apparent.