Xu 2014.
| Methods | Community‐based cluster‐randomised trial that evaluated an intervention package promoting effective neonatal resuscitation training at county level hospitals across China | |
| Participants | The study was conducted in Shandong and Heilongjiang, 2 eastern provinces of China. 8 counties (4 from each province) were randomly selected to participate in the study. Of those 8 counties, 2 counties from each province were randomly assigned to the intervention group. Intervention group: 11 hospitals and 97 healthcare providers and the control group consisted of 11 hospitals and 87 healthcare providers | |
| Interventions | The intervention package was implemented across 4 counties and the neonatal resuscitation programme was based on ILCOR guidelines that included the initial steps of resuscitation, physiology, PPV, intubation, CC and medication administration | |
| Outcomes | Incidence of birth asphyxia defined as Apgar scores ≤ 7 at 5 minutes, asphyxia‐related deaths in the delivery room and healthcare providers' knowledge and self confidence by questionnaires | |
| Notes | The definition of asphyxia in this study was different from our a priori definition | |
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Unclear risk | Not specified |
| Allocation concealment (selection bias) | Unclear risk | Not explicitly stated |
| Blinding of participants and personnel (performance bias) All outcomes | High risk | Not applicable |
| Blinding of outcome assessment (detection bias) All outcomes | Unclear risk | Blinding of outcome assessment not clear |
| Incomplete outcome data (attrition bias) All outcomes | Low risk | No attrition noted |
| Selective reporting (reporting bias) | Unclear risk | All specified outcomes were reported |
| Other bias | Unclear risk | No loss of clusters were reported and clusters were similar with no baseline imbalance but unit of analysis error noted |
ANTS: Anaesthetists' Non‐Technical Skills; CC: cardiac compression; CPR: cardiopulmonary resuscitation; FiO2: fraction of inspired oxygen; ICC: intracluster coefficient; ILCOR: International Liaison Committee on Resuscitation; NICHD: National Institute of Child Health and Human Development; NICU: neonatal intensive care unit; NRP: Neonatal Resuscitation Program; NRT: newborn resuscitation training; PPV: positive pressure ventilation; VLBW: very low birthweight.