ArticleClinical epidemiology2013
A sensitivity analysis of the Children's Treatment Network trial: a randomized controlled trial of integrated services versus usual care for children with special health care needs.
Article in Clinical epidemiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 4 syntheses or guidelines pooled it, 13 citations in OpenAlex.
- Integrated care for children and young people with special health and care needs: a systematic review.Archives of disease in childhood · 2024Pooled it
- Patient navigator programmes for children and adolescents with chronic diseases.The Cochrane database of systematic reviews · 2024Pooled it
- Comprehensive care programmes for children with medical complexity.The Cochrane database of systematic reviews · 2024Pooled it
- Education support services for improving school engagement and academic performance of children and adolescents with a chronic health condition.The Cochrane database of systematic reviews · 2023Pooled it
- "It cannot depend solely on the parents"-professionals' perspectives on patient journeys of children with chronic conditions across health and social care in Germany.European journal of pediatrics · 2026Article
- "One has to beg and fight for everything" - a qualitative study on patient journeys of children with chronic conditions in Germany.BMC health services research · 2026Article
- [Not Available].Canadian journal of public health = Revue canadienne de sante publique · 2016Article
- Estimating treatment effects in randomised controlled trials with non-compliance: a simulation study.BMJ open · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe value of integrated care through comprehensive, coordinated, and family-centered services has been increasingly recognized for improving health outcomes of children with special health care needs (CSHCN). In a randomized controlled trial (RCT), the integrated care provided through the Children's Treatment Network (CTN) was compared with usual care in improving the psychosocial health of target CSHCN. In this paper, we aimed to estimate the effect of CTN care by conducting multiple analyses to handle noncompliance in the trial.
methodsThe trial recruited target children in Simcoe County and York Region, ON, Canada. Children were randomized to receive CTN or usual care and were followed for 2 years. The CTN group received integrated services through multiple providers to address their specific needs while the usual care group continued to receive care directed by their parents. The outcome was change in psychosocial quality of life at 2 years. We conducted intention-to-treat, as-treated, per-protocol, and instrumental variable analyses to analyze the outcome.
resultsThe trial randomized 445 children, with 229 in the intervention group and 216 in the control group. During follow-up, 52% of children in the intervention group did not receive complete CTN care for various reasons. At 2 years, we did not find a significant improvement in psychosocial quality of life among the children receiving CTN care compared with usual care (intention-to-treat mean difference 1.50, 95% confidence interval -1.49 to 4.50; P = 0.32). Other methods of analysis yielded similar results.
conclusionAlthough the effect of CTN care was not significant, there was evidence showing benefits of integrated care for CSHCN. More RCTs are needed to demonstrate the magnitude of such an effect. The CTN study highlights the key challenges in RCTs when assessing interventions involving integrated care, and informs further RCTs including similar evaluations.
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