Journal of Clinical Epidemiology
Volume 50, Issue 2 , Pages 137-146, February 1997

Are community health interventions evaluated appropriately? A review of six journals☆

  • Pamela J. Smith

      Affiliations

    • Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada R3E OW3
    • ,
  • Michael E.K. Moffatt

      Affiliations

    • Corresponding Author InformationAddress for correspondence: Dr. Michael Moffatt, Department of Community Health Sciences, University of Manitoba, S100-750 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E OW3.
    • Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada R3E OW3
    • Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada R3E OW3
    • ,
  • Shirley C. Gelskey

      Affiliations

    • Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada R3E OW3
    • Department of Dental Diagnostics and Surgical Sciences, University of Manitoba, Winnipeg, Manitoba, Canada R3E OW3
    • ,
  • Shauna Hudson

      Affiliations

    • Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada R3E OW3
    • ,
  • Kelly Kaita

      Affiliations

    • Department of Internal Medicine, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada R3E OW3

Accepted 11 September 1996.

Abstract 

Objectives: To determine if Randomized Controlled Trial (RCT) methodology was used appropriately in community health, we: (1) determined the proportion of non-randomized studies that should have been RCTs, and (2) assessed the quality of the RCTs. Methods: The 1992 issues of six community health journals were manually searched. Intervention studies were analyzed. Studies that did not use randomization were analyzed for feasibility and practicality of RCT methods; RCTs were analyzed for quality using a checklist. RCTs were compared with community health RCTs from The New England Journal of Medicine. The proportion of studies meeting each criterion was determined. Results: Fourteen percent of 603 studies were interventions and 4% were RCTs. Of those not using randomization, 42% should have. Mean RCT scores were significantly lower for the community health journals than for The New England Journal of Medicine. Many criteria important to quality scored poorly. Conclusions: RCTs are underused and lack méthodologic rigor in community health. Conclusions regarding the effectiveness of interventions are therefore suspect.

Keywords:  Interventions, randomized controlled trials, literature search, methodology, quality assessment

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☆ This research was made possible in park by Health Canada through a National Health Research and Development Program research training fellowship to Pamela J. Smith.

PII: S0895-4356(96)00338-1

Journal of Clinical Epidemiology
Volume 50, Issue 2 , Pages 137-146, February 1997

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