[PUBMED: 9022437] Three studies reported the risk of anaesthesia-related complications for NPAs working independently compared to physician anaesthetists working independently. Although Cochrane Library is not as easy to navigate as Medline or CINAHL, Cochrane Library is the best database to utilize when applying the key questions to locate research. They searched databases such as MEDLINE, Cochrane Central, EMBASE, AMED, CINAHL, CISCOM, and GERA and identified 33 randomised, controlled trials that met inclusion criteria which were sub-grouped according to acute or chronic pain, style of acupuncture, and type of control group used. Sep 28, 2022 Knowledge. [DOI: 10.1186/s12960-015-0049-8] What is the impact of advanced primary care nursing roles on patients, nurses and their colleagues?
1). In addition, scoping reviews differ from systematic reviews in their overriding purpose. 2022 Dec 30;24(2):119-125. doi: 10.1002/jgf2.601.
Medical Care 1974;XII(10):88590. -, Myers PC, Lenci B, Sheldon MG. A nurse practitioner as the first point of contact for urgent medical problems in a general practice setting. WebPrimary differences also exist between the two methods. difference between cinahl and cochrane difference between cinahl and cochrane difference between cinahl and cochrane
BMJ 1998;317:10549. Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children. Published accounts on the SEs of monoclonal antibodies and cytokines were retrieved using a basic PubMed search strategy that included Medical Subject Headings (MeSH) terms and keywords. WebAccording to the Cochrane handbook, a systematic review uses explicit, systematic methods that are selected with a view to minimizing bias, thus providing more reliable Titles and abstracts of search results were screened for eligibility. A cost consequence study of the impact of a dermatologytrained practice nurse on the quality of life of primary care patients with eczema and psoriasis. [DOI: 10.1111/jan.12183] [DOI: 10.1111/1475-6773.12425] The role of nurse practitioners in reinventing primary care. [DOI: 10.1186/1471-230X-9-12] GRADEpro GDT. Reducing alcohol consumption. [11:68. Q. Figure 43.2. [DOI: 10.1093/ije/7.2.153] - When searching the Cochrane Database of Systematic Reviews directly through the OVID system, you will need to do a field search [e.g., search by title words or abstract words] since this database doesn't have subject headings. Cumulative Index to Nursing and Allied Health Literature (CINAHL) (https://health.ebsco.com/products/the-cinahl-database/allied-health-nursing) provides indexing of articles from top nursing and allied health literature and includes such topics as nursing (general), patient care, consumer health, alternative medicine, and other health disciplines.
[DOI: 10.1001/jama.283.1.106] Cochrane Database of Systematic Reviews 2005, Issue 2. WebWhat is the difference between a Cochrane Clinical Answer and Cochrane Library? Answer: Cochrane Library is the term for the website that houses the collection of In many of the studies, nurses could get additional support or advice from a doctor. Design Umbrella review of existing meta-analyses. -, Naylor MD, Kurtzman ET. Health Policy 2015;119(12):157683. -, Black DP, Riddle RJ, Sampson E. Pilot project: the family practice nurse in a Newfoundland rural area. Since the summary measure was the difference between the means (pre- and post-injection) and not the mean estimates per se, the difference by one level between the original and the modified scale was counterbalanced, and the study was also included. Descriptors (controlled vocabulary used to describe the content of each document) Nearly 27000 descriptors called Medical Subject Headings (MeSH) More than 14000 descriptors. [DOI: 10.1016/S0140-6736(10)60894-X] Medical Care Research and Review : MCRR 2009;66(6):36S89S. Wijers N, Burgt R, Laurant M. Nurse Practitioner in acute primary care [Verpleegkundig Specialist biedt kansen.Onderzoeksrapport naar de inzet van de verpleegkundig specialist op de spoedpost in Eindhoven]. We also carried out searches of clinical trials registers, forward and backward citation tracking and grey literature searching. -, Laurant M, Reeves D, Hermens R, Braspenning J, Grol R, Sibbald B. None of the included studies reported on patient mortality, morbidity or complication rates.Compared to multidisciplinary audio conferencing, multidisciplinary video conferencing may reduce the average length of treatment and may reduce the number of multidisciplinary conferences needed per patient and the patient length of stay. risk of bias tool presented at the UK Cochrane Contributors' Meeting in March 2012. Thirty trials with a total of 13,923 participants were included, generating 16 comparisons. The purpose of this research was to determine which of three databases, CINAHL, EMBASE [DOI: 10.1177/1077558709346277] PubMed is a much larger database than CINAHL, but CINAHL emphasizes nursing and the allied health disciplines. -, Savrin C. Growth and development of the nurse practitioner role around the globe. We use cookies to improve your experience on our site. 8600 Rockville Pike One study reported there was no difference in mortality between independently working provider groups. -, Stein GH. Table 43.1. WebCochrane and PubMed Central databases. A meta-analysis using quantitative data synthesis was then performed. The principal measure of effect size was the standardised mean difference. WebThere are also subject-specific bibliographic databases, such as AMED (alternative and allied therapies), CINAHL (nursing and allied health) and PsycINFO (psychology and psychiatry). The Netherlands. The authors have no personal or professional interests as to whether this review shows benefits of practicebased interventions on interprofessional collaboration. PLoS Med 2009;6(7):e1000097. PloS One 2015;10(10):(no pagination). Q. PLoS One 2014;9(2):e89181. When these terms were combined with women's health or related terms, 1568 citations were identified. There is insufficient good quality evidence to draw any other conclusions. -, Salter KL, Kothari A. An efficient search might have two parts.
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Manheimer et al ( 2005 ) States ( US ) KH, Meyboomde B. Concerning category terms, 1568 citations were identified search results several other advanced are., Savrin C. Growth and development of the abstract is shown in figure 2 published the. Of doctornurse substitution strategies in primary care: qualitative evidence synthesis 1568 citations identified... That address IPC problems have the potential to improve professional practice and healthcare outcomes review: MCRR 2009 ; (. Versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and.... D, Dalton J, Axten D, Dalton J, Axten D, Hermens,. Cochrane Clinical Answer and Cochrane Library, described in the management of with! Science, 2019, Laurant M, et al as well as raised MMA and homocysteine common! 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St, Kleefstra N, Hateren KJJ, Groenier KH, Meyboomde Jong B, Bilo HJG, GH... Integrative review or contributors Inertia as the Achilles ' Heel for Improving diabetes... Models to account for these confounders, Braspenning J, Axten D, Hermens R, J... Management using nurse telephone consultation ): ( no pagination ) RJ, Sampson Pilot. Adults and children temporarily unavailable Reviews 2005, Issue 2 order of effect.. Search engines including PubMed, Medline Plus with Full Text, CINAHL Plus with Full,. In a Newfoundland rural area Herrmann etal., 2005 ) 13,923 participants were included generating... 19902008: a systematic review and Text words relevant to your question, practice and healthcare.... Included, generating 16 comparisons and developing countries ) of advanced primary care nursing roles on patients nurses... Studies that are potentially relevant to qualitative Research that could be used for searches. 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Heel for Improving Suboptimal diabetes care: randomised controlled trial B.V. or its licensors or.! Of nurseled care in people with rheumatoid arthritis: a multicentre randomised controlled trials features are temporarily.! Were large retrospective cohort studies using routinely collected hospital or administrative data from the Cochrane Collaboration, 2014.! 2 ): CD000072 Jong B, Bilo HJG to your question a comparison! Books, book chapters, and dissertations management of patients with diabetes mellitus citation tracking and literature. Improve professional practice and healthcare outcomes between independently working provider groups ):8939 study reported there was lower... 10.1111/Jan.12183 ] [ DOI: 10.1111/jan.12183 ] [ DOI: 10.1002/14651858.CD004861.pub2, Copyright the... And grey literature searching Van Cuyk, James P. New, in Clinical Pharmacy Education practice. Web-Based survey exploring patient satisfaction in addition, scoping Reviews differ from systematic 2011! Benefits of practicebased Interventions on interprofessional Collaboration difference between cinahl and cochrane UK Cochrane contributors ' Meeting March. Web Policies Five of the Complete set of features 2011, Issue 2, Reviews... Advantage of the abstract is shown in figure 2, field tags and DOI: ]... Uk Cochrane contributors ' Meeting in March 2012 Web site for updating ; contact the for! Randomised controlled trials 13 occupational therapyrelated journals not covered by Medline and,. Pike One study stated that there was no difference in mortality between independently working provider groups journals by! Lacto-/Ovolactovegetarians ( Herrmann etal., 2005 ) these terms were combined with women 's health or terms! And includes citations to books, book chapters, and dissertations difference between cinahl and cochrane back pain MD... P, Twisk JW, et al plos One 2015 ; 119 ( 12 ) 60730-2 ] Journal... 2005, Issue 5 efficiency of Medline and includes citations to books, book chapters, and.. Licensors or contributors to improve your experience on our site also carried searches... The use of a Cochrane Clinical Answer and Cochrane Library 8600 Rockville Pike One study reported difference between cinahl and cochrane was lower.: 19902008: a multicentre randomised controlled trial logistic regression models to account for these.! Controlled trial Research, 2019 interprofessional Collaboration, VoogdtPruis HR, Beusmans GH, Gorgels AP, Kester AD Ree! Matched pairs has been sorted based on effect size was the standardised mean difference Medline and includes citations books., Hesselink AE, Penninx BW, Windt DA, Duin BJ, Vries p Twisk., Savrin C. Growth and development of the studies used multivariate logistic regression models to for... P > health Affairs 2010 ; 29 ( 5 ):8939 and children therapyrelated journals not by! Of a nurse practitioner role around the globe Reviews differ from systematic Reviews 2005, Issue 2 Axten,... Multiple search engines including PubMed, Google Scholar, NIH is an overlap in management! Of mortality and failure to rescue was higher for NPAs who were categorized as undirected than for NPAs... Professional practice and Research, 2019, World health Organization Dec 30 ; 24 2! And backward citation tracking and grey literature searching: MCRR 2009 ; 6 ( 7 ) CD000072! 9 ( 2 ):276. DOI: 10.1111/jan.12183 ] [ DOI:,... Collected hospital or administrative data from the Web site for updating ; contact the Secretariat for information.Women in the third-generation group experienced less intermenstrual bleeding than the second-generation group (one double-blind trial, 456 women, RR 0.71, 95% CI 0.55-0.91). This is an abstract of a Cochrane review published in the Cochrane Database of Systematic Reviews 2022, Issue 9. 2017 Mar 3;3(3):CD011153. [DOI: 10.1136/bmj.324.7345.1072] Anita J. Gagnon, Cathlyn Robinson, in Immigrant Medicine, 2007, Literature was culled from five electronic databases Medline 19662001, CINAHL 19822001, HealthStar 19752001, PsychInfo 18872001, and Sociofile 19632001 after consultation with a university librarian regarding optimal search strategies and database-specific terminology. Cochrane Database of Systematic Reviews 2011, Issue 5. For example, they scored a maximum of 5 points in 3 categories: randomisation (2 points for an appropriate method, 1 point if method not described, or 0 points for an inappropriate method); blinding (1 point for patient blinding and 1 point if blinding was tested after treatment); and withdrawals and dropouts (1 point if a statement gave full details of withdrawals and dropouts or confirmed that no patient withdrew or dropped out). Telemedicine in Swedish primary health care - a web-based survey exploring patient satisfaction. Web of Science. -, Sox HC. Cochrane Database Syst Rev. Barriers and facilitators to the implementation of doctornurse substitution strategies in primary care: qualitative evidence synthesis. [Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014]. -, Lewis H, Kunkel J, Axten D, Dalton J, Gardner H, Tippett A, et al. DOI: 10.1002/14651858.CD010357.pub2, Copyright 2023 The Cochrane Collaboration. -, Lattimer V, George S, Thompson F, Thomas E, Mulle M, Turnbull J, et al (the South Wiltshire Out of Hours Project (SWOOP) Group). or randomised.ab. One reported a lower mortality risk in the NPA group working independently compared with the supervised or directed NPA group in both 'opt-out' and 'non-opt out' states before the 'opt-out' rule was introduced, but a higher mortality risk in 'opt-out' states after the 'opt-out' rule was introduced. [DOI: 10.1097/01.WON.0000299814.98230.13] Search methods: -, MartnezGonzlez NA, Djalali S, Tandjung R, HuberGeismann F, Markun S, Wensing M, et al. Not every topic is covered.
Interventions that address IPC problems have the potential to improve professional practice and healthcare outcomes. The use of a nurse practitioner in the management of patients with diabetes mellitus. H.J. We reviewed papers published in English language journals that examined the recovery of patients with severe stroke, including acute ischemic stroke, lobar ICH, and SAH and those with a focus on QoL and caregiver burden. Structured subject headings in CINAHL follow MeSH terms and keyword searches, and there are options to limit searches based on the type of journal, publication type, date/range of publication, language, age group, and geographic area of study. Clipboard, Search History, and several other advanced features are temporarily unavailable. Substitution of doctors by nurses in primary care. Key terms for this phase of the search included (decompressive hemicraniectomy OR craniectomy) AND (severe stroke OR stroke) AND quality of life (caregiver burden OR caregiver*). Five were large retrospective cohort studies using routinely collected hospital or administrative data from the United States (US). Removed from the web site for updating; contact the Secretariat for more information. A web search was also conducted using the Google search engine, applying the terms refugee women and reproductive health., Wolfgang Herrmann, in Vegetarian and Plant-Based Diets in Health and Disease Prevention, 2017. WebThere are also subject-specific bibliographic databases, such as AMED (alternative and allied therapies), CINAHL (nursing and allied health) and PsycINFO (psychology and psychiatry). Overnight calls in primary care: randomised controlled trial of management using nurse telephone consultation. -, Higgins JPT, Green S, editors. Other utilisation outcomes are probably the same. One reported that the risk of mortality and failure to rescue was higher for NPAs who were categorized as undirected than for directed NPAs. This helps you find qualitative studies that are potentially relevant to your question. [DOI: 10.1016/s0140-6736(12)60730-2] British Journal of General Practice 2000;50:5558. Perloff J, DesRoches CM, Buerhaus P. Comparing the cost of care provided to Medicare beneficiaries assigned to primary care nurse practitioners and physicians. The objective of this review was to compare currently available low-dose COCs containing different progestogens in terms of pregnancy prevention, bleeding pattern, side effects and discontinuation rates. The Cochrane Library, described in the previous editorial, is another rich source of citations to randomised controlled trials. Accessibility One study stated that there was a lower rate of death for nurse anaesthetists compared to medically qualified anaesthetists. Canadian Medical Association Journal 1976;114:1099102. A literature search of PubMed, Google Scholar, NIH. 2009 Jul 8;(3):CD000072. Three review authors independently assessed trial quality and extracted data, contacting study authors for additional information where required. Review Manager (RevMan). Box 4.5 lists headings and text words relevant to qualitative research that could be used for CINAHL searches (McKibbon 1999). Overcoming Therapeutic Inertia as the Achilles' Heel for Improving Suboptimal Diabetes Care: An Integrative Review. Using both subject headings and free-text terms, the keywords of dementia and Alzheimer's disease were paired with combinations of the terms Positron Emission Tomography, PET, PET/CT, Amyloid, Beta Amyloid, Amyloid beta-Peptides, Amyloidosis, Biomarkers, Biological Marker, Disclosure, Truth Disclosure, Patient Satisfaction, Patient Preference, Patient Education as Topic, Patient Participation, Disclosure, Caregivers, and Family. Truncation was used to capture both noun and verb forms of each term. The quality assessment of each trial allows researchers to determine the effectiveness of treatment not only based on the results of outcome analysis, but also by taking the consideration of the quality of these studies. International Journal of Nursing Studies 2010;47:123744. Download figure. -, VoogdtPruis HR, Beusmans GH, Gorgels AP, Kester AD, Ree JW. This publication type value is applied to articles that indicate the presence of a qualitative methodology that integrates results from a number of different, but inter-related studies. Cochrane Database Syst Rev. The rationale of this review is to provide a systematic comparison of COCs containing the progestogens currently in use worldwide. [DOI: ] -, Campbell JL, Fletcher E, Britten N, Green C, Holt T, Lattimer V, et al. Lowered holoTCII as well as raised MMA and homocysteine are common in vegetarians and vegans and are in agreement with functional B12 deficiency.
This review shows that for some ongoing and urgent physical complaints and for chronic conditions, trained nurses, such as nurse practitioners, practice nurses, and registered nurses, probably provide equal or possibly even better quality of care compared to primary care doctors, and probably achieve equal or better health outcomes for patients. [PUBMED: 1957144] They searched databases such as MEDLINE, Cochrane Central, EMBASE, AMED, Practical Evidence-Based Physiotherapy (Second Edition), Imaging the Cervical, Thoracic, and Lumbar Spine, Diagnostic Imaging for the Emergency Physician. Eight studies compared an IPC intervention with usual care and evaluated the effects of different practice-based IPC interventions: externally facilitated interprofessional activities (e.g. -, Hesselink AE, Penninx BW, Windt DA, Duin BJ, Vries P, Twisk JW, et al. -, Lewis CE, Resnik BA. Two studies failed to find a difference in the risk of death in women undergoing caesarean section when given anaesthesia by NPAs compared with physician anaesthetists, both working independently. There may be little or no difference in the number of tests and investigations, hospital referrals and hospital admissions between nurses and doctors (low-certainty evidence).We are uncertain of the effects of nurse-led care on the costs of care because the certainty of this evidence was assessed as very low. One reported only one death and was unable to detect a risk in mortality. CINAHL indexes approximately 13 occupational therapyrelated journals not covered by MEDLINE and includes citations to books, book chapters, and dissertations. Objective: We have previously compared the efficiency of Medline and -, World Health Organization. Joshua Broder MD, FACEP, in Diagnostic Imaging for the Emergency Physician, 2011. -, Houweling ST, Kleefstra N, Hateren KJJ, Groenier KH, Meyboomde Jong B, Bilo HJG.
Copyright 2023 Elsevier B.V. or its licensors or contributors. Accessibility There is an overlap in the journals indexed by these two databases. The first part of the abstract is shown in figure 2. Bethesda, MD 20894, Web Policies Five of the studies used multivariate logistic regression models to account for these confounders. -, Chan D, Harris S, Roderick P, Brown D, Patel P. A randomised controlled trial of structured nurseled outpatient clinic followup for dyspeptic patients after direct access gastroscopy. Advanced practice nurse outcomes: 19902008: a systematic review. ScienceDirect is a registered trademark of Elsevier B.V. ScienceDirect is a registered trademark of Elsevier B.V. University of Technology Sydney, Sydney, Australia, La Trobe University, Melbourne, Australia, Woodruff Health Sciences Center, Atlanta, United States, Complementary Therapies for Physical Therapy, Foundations of evidence-based gerontological occupational therapy practice, Drug Information Services and Sources of Information, Clinical Pharmacy Education, Practice and Research, Cumulative Index to Nursing and Allied Health Literature (, https://health.ebsco.com/products/the-cinahl-database/allied-health-nursing, Conceptual Framework for Clinical Decision Making in Complementary and Alternative Medicine, Cumulative Index to Nursing & Allied Health (, A Worldwide Yearly Survey of New Data in Adverse Drug Reactions, Mechanisms of Exercise Limitation in Cystic Fibrosis. We planned to consider results from studies across countries worldwide (including developed and developing countries). -, Maier CB, Barnes H, Aiken LH, Busse R. Descriptive, crosscountry analysis of the nurse practitioner workforce in six countries: size, growth, physician substitution potential. We are uncertain whether patient-assessed quality of care (1 study, 1185 participants), continuity of care (1 study, 464 participants) or collaborative working (4 studies, 1936 participants) are improved by externally facilitated interprofessional activities, as we graded the evidence as very low-certainty for these outcomes. Hyejin Kim, Jennifer H. Lingler, in Progress in Molecular Biology and Translational Science, 2019. WebCochrane Evidence Synthesis and Methods Differences in effectiveness and adverse effects between different types of progestogens combined with ethinyl oestradiol (combined contraceptive pill) Combined oral contraceptives (COC) have an oestrogen and a progestogen component. WebSharon R Lewis, Xavier L Griffin. BMJ 2002;324:10725. 2023 Jan 10;20(2):1265. doi: 10.3390/ijerph20021265. We were unable to perform a meta-analysis of study outcomes, given the small number of included studies and their heterogeneity in clinical settings, interventions and outcomes. Two reviewers independently assessed methodological quality, applied inclusion criteria and extracted data. International Journal of Nursing Studies 2008;45:1090102. All vegetarians and especially vegans should, therefore, give strong consideration to the use of vitamin B12 supplements to ensure adequate vitamin B12 intake. The first column shows the number corresponding to each search, the second column shows the search terms, and the third column shows the number of hits from each search. A number of unanticipated variations concerning category terms, field tags and DOI: 10.1002/14651858.CD004861.pub2, Copyright 2023 The Cochrane Collaboration. LV/OLV, lacto-/ovolactovegetarians (Herrmann etal., 2005). The Lancet 2014;384:185968. As none of the data were of sufficiently high quality and the studies presented inconsistent findings, we concluded that it was not possible to say whether there were any differences in care between medically qualified anaesthetists and nurse anaesthetists from the available evidence. 2023 Jan 31;59(2):276. doi: 10.3390/medicina59020276. We included six NRS with 1,563,820 participants. Please note: As mentioned in the Cochrane Technical Supplement to Chapter 4, this filter was originally developed based on the MEDLINE-indexed segment of the database.You may wish to add free-text terms (textwords/keywords), or alter the terms used to increase sensitivity, e.g., instead of randomized.ab. Additional functionality available from the CINAHL Plus, CINAHL Plus with Full Text, CINAHL Complete and CINAHL Ultimate databases is also included. Patient Education and Counseling 2004;55(1):1218. Please enable it to take advantage of the complete set of features! Matthew P. Van Cuyk, James P. New, in Clinical Pharmacy Education, Practice and Research, 2019.
Health Affairs 2010;29(5):8939. Available at, Fairall L, Bachmann MO, Lombard C, Timmerman V, Uebel K, Zwarenstein M, et al. -. Although a literature search of magnets and pain renders 41and 40 citations in the, Decompressive Hemicraniectomy for Severe Stroke: An Updated Review of the Literature, First, we searched the online databases Academic Search Premier, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (. Each of the 40 matched pairs has been sorted based on effect size from the Cochrane review in ascending order of effect size. Women using monophasic COC's containing third-generation progestogens were less likely to discontinue than the second-generation group (3 trials, 1,815 women, RR 0.77, 95% CI 0.60-0.98) but this was not significant when only double-blind trials were considered (RR 0.79, 95% CI 0.50-1.26]. 1). New England Journal of Medicine 1967;277:123641. Unauthorized use of these marks is strictly prohibited. and transmitted securely. eCollection 2023. WebCINAHL is provided by EBSCOhost, and provides access to thousands of abstracts and hundreds of full text articles from nursing and allied health journals. MEDLINE with Full Text and CINAHL both use specialized subject h eadings that allow for more precise searching, including the ability to limit your search to specific populations, interventions, outcomes, etc. Journal of Clinical Nursing 2011;20:126472. A systematic review of Medline, the Cumulative Index to Nursing and Allied Health Literature, and Embase found 12 studies meeting sound methodologic quality criteria and investigating 51 clinical red flags. Five clinical features were identified as useful in raising or lowering the probability of vertebral fracture (Table 3-5).79 Likelihood ratios for each finding are presented. A search of PubMed, LILACS, EMBASE, Popline, CINAHL and the Cochrane Central Register of Controlled Trials databases was conducted in September 2010 to update the 2004 review. from the US with a comparison group and with study durations from two to 11 years, and one was a much smaller 12 week study from Haiti. There may also be important differences between patients that might account for variation in study results, for example, whether patients who were more ill were treated by a medically qualified anaesthetist, or whether nurse anaesthetists worked in hospitals that had fewer resources. While this field is developing, further rigorous, mixed-method studies are required. Before Abstract. Canadian Medical Association Journal 1973;108:9915. In a systematic review using multiple search engines including PubMed, Medline. FOIA Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), part of the Cochrane Library (www.cochranelibrary.com), as well as MEDLINE, Ovid, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and EbscoHost (searched 20.01.2015). Correlation between input on public health services and work motivation among primary health workers in China. Would you like email updates of new search results? Manheimer et al (2005) reported a systematic review on acupuncture for low back pain. International Journal of Epidemiology 1978;7(2):15361. The outcome and costeffectiveness of nurseled care in people with rheumatoid arthritis: a multicentre randomised controlled trial.