Guidelines for a Palliative Approach in Residential Aged Care

1.1.5 Exclusion Criteria
Although the academically accepted 5-year norm for the cut off date was considered, the review
working party adopted 1990 as the cut-off date for exclusion of studies based on the significant
seminal work completed in the early 1990s in palliative care. Hence, studies prior to 1990 have
been excluded from this review unless they were considered by the project working party to be
significant seminal work. Articles published in languages other than English were excluded as
were unpublished studies.
1.1.6 Evaluation Strategies
No suitable tool was available to assess quantitative studies according to NHMRC (1999) [9]
criterion of quality, strength or relevance. To overcome this difficulty, the Cochrane [10] and
Campbell [11] Guidelines were substantially modified by the review working party to provide an
evaluation tool that was appropriate for intervention studies (quantitative) (See Appendix C).
Quantitative Evidence
The tool that was developed for use with intervention studies used the level of evidence
categories outlined by the NHMRC [9] directly as shown below:
Table 2: Quantitative levels of evidence
Levels
I
II
III-1
III-2
III-3
IV
Criteria
Systematic review of all relevant randomised controlled trials (RCTs)
At least one properly designed RCT
Well-designed pseudo-RCT
Comparative studies with concurrent controls and allocation not randomised, case-control
studies or interrupted time series with a control group
Comparative studies with historical control, two or more single-arm studies, or interrupted
time series without a parallel control group
Case series, either post-test or pre-test and post-test
To measure the quality, strength and relevance of quantitative studies, additional criteria were
developed by the review working party (these criteria were not part of the NHMRC [1999]
levels of evidence), as shown in the following table.
20 Guidelines for a Palliative Approach in Residential Aged Care