Summary of findings 4. Comparison 6: therapeutic assessment versus treatment as usual (i.e., standard assessment).
| Therapeutic assessment compared to treatment as usual (i.e., standard psychosocial assessment) for self‐harm in children and adolescents | ||||||
| Patient or population: children and adolescents who engage in SH. Settings: outpatients. Intervention: therapeutic assessment. Comparison: treatment as usual (i.e., standard psychosocial assessment). | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Standard psychosocial assessment | Therapeutic assessment | |||||
| Repetition of SH at 12 months | Study population | OR 0.75 (0.18 to 3.06) | 69 (1 RCT) | ⊕⊕⊝⊝ LOW1,2 | Quality was downgraded as the nature of this intervention means it is unlikely participants and clinical personnel would have been blind to treatment allocation. Quality was further downgraded due to imprecision in the effect size estimate. | |
| 147 per 1000 | 115 per 1000 (30 to 345) | |||||
| Repetition of SH at 24 months | Study population | OR 0.69 (0.23 to 2.14) | 69 (1 RCT) | ⊕⊕⊝⊝ LOW1,2 | Quality was downgraded as the nature of this intervention means it is unlikely participants and clinical personnel would have been blind to treatment allocation. Quality was further downgraded due to imprecision in the effect size estimate. | |
| 265 per 1000 | 199 per 1000 (76 to 435) | |||||
| *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% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; OR: odds ratio; RCT: randomised controlled trial; SH: self‐harm. | ||||||
| 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 was rated as SERIOUS as the nature of the intervention means that clinical personnel could not have remained blind to treatment allocation suggesting that performance and detection bias may have been present.
2 Imprecision was rated as SERIOUS owing to the wide confidence interval associated with the estimate of treatment effect.