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Interventions for treating proximal humeral fractures in adults (Review)

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A development of the Cochrane Bone, Jo<strong>in</strong>t and Muscle Trauma<br />

Group quality assessment tool (see Group details) was used <strong>in</strong><br />

the evaluation of all the <strong>in</strong>cluded trials. At m<strong>in</strong>imum, two review<br />

authors <strong>in</strong>dependently assessed each paper, without mask<strong>in</strong>g of<br />

journal sources, authors and support<strong>in</strong>g <strong>in</strong>stitutions. Table 1 shows<br />

the scor<strong>in</strong>g scheme based on 11 aspects of trial methodology. From<br />

the fourth update (Issue 2, 2007) of this review, the scores of the<br />

<strong>in</strong>dividual items <strong>for</strong> each trial were no longer summed.<br />

Table 1. Methodological quality assessment scheme<br />

Items Scores Notes<br />

1. Was the assigned treatment adequately<br />

concealed prior to allocation?<br />

2. Were the outcomes of trial participants<br />

who withdrew described and <strong>in</strong>cluded <strong>in</strong><br />

the analyses, and all participants analysed<br />

accord<strong>in</strong>g to the group allocated at randomisation<br />

(<strong>in</strong>tention to treat)?<br />

3. Were the outcome assessors bl<strong>in</strong>ded to<br />

treatment status?<br />

4. Were important basel<strong>in</strong>e characteristics<br />

reported and comparable?<br />

5. Were the trial participants bl<strong>in</strong>d to assignment<br />

status after allocation?<br />

6. Were the treatment providers bl<strong>in</strong>d to<br />

assignment status?<br />

3 = method did not allow disclosure of assignment.<br />

1 = small but possible chance of disclosure<br />

of assignment or unclear.<br />

0 = quasi-randomised or open list/tables.<br />

3 = withdrawals well described and accounted<br />

<strong>for</strong> <strong>in</strong> analysis.<br />

1 = withdrawals described and analysis not<br />

possible.<br />

0 = no mention, <strong>in</strong>adequate mention, or<br />

obvious differences and no adjustment.<br />

3 = effective action taken to bl<strong>in</strong>d assessors.<br />

1 = small or moderate chance of unbl<strong>in</strong>d<strong>in</strong>g<br />

of assessors, or some bl<strong>in</strong>d<strong>in</strong>g of outcomes<br />

attempted.<br />

0 = not mentioned or not possible.<br />

3 = good comparability of groups, or confound<strong>in</strong>g<br />

adjusted <strong>for</strong> <strong>in</strong> analysis.<br />

1 = confound<strong>in</strong>g small, mentioned but not<br />

adjusted <strong>for</strong>, or comparability reported <strong>in</strong><br />

text without confirmatory data.<br />

0 = large potential <strong>for</strong> confound<strong>in</strong>g, or not<br />

discussed.<br />

3 = effective action taken to bl<strong>in</strong>d participants.<br />

1 = small or moderate chance of unbl<strong>in</strong>d<strong>in</strong>g<br />

of participants.<br />

0 = not possible, not mentioned, or possible<br />

but not done.<br />

3 = effective action taken to bl<strong>in</strong>d treatment<br />

providers.<br />

1 = small or moderate chance of unbl<strong>in</strong>d<strong>in</strong>g<br />

of treatment providers.<br />

<strong>Interventions</strong> <strong>for</strong> <strong>treat<strong>in</strong>g</strong> <strong>proximal</strong> <strong>humeral</strong> <strong>fractures</strong> <strong>in</strong> <strong>adults</strong> (<strong>Review</strong>)<br />

Copyright © 2008 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.<br />

Cochrane code (see Handbook): Clearly<br />

Yes = A; Not sure = B; Clearly no = C.<br />

The pr<strong>in</strong>cipal confounders were considered<br />

to be age, gender and type of fracture.<br />

5

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