Summary of findings 5. Comparison 7: compliance enhancement plus treatment as usual (i.e., standard disposition planning) versus treatment as usual.
| Compliance enhancement plus treatment as usual (i.e., standard disposition planning) compared to treatment as usual | ||||||
| Patient or population: children and adolescents who engage in SH. Settings: outpatient. Intervention: compliance enhancement plus standard disposition planning. Comparison: treatment as usual (i.e., standard disposition planning). | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | Number of participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Treatment as usual | Standard disposition planning | |||||
| Repetition of SH by six months | Study population | OR 0.67 (0.15 to 3.08) | 63 (1 RCT) | ⊕⊝⊝⊝ VERY 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 as details on blinding of outcome assessors, incomplete data and selective reporting was not adequately described. Lastly, due to imprecision in the effect size estimate, quality was further downgraded. | |
| 147 per 1000 | 104 per 1000 (25 to 347) | |||||
| *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 VERY SERIOUS as the nature of the intervention means that participants and clinical personnel could not have remained blind to treatment allocation suggesting that performance and detection bias may have been present. Additionally, details on blinding of outcome assessors, incomplete data and selective reporting was not adequately described.
2 Imprecision was rated as SERIOUS owing to the wide confidence interval associated with the estimate of treatment effect.