Evidence map›Paper›PMID 25258683›Full record

ReviewNursing research and practice2014

A systematic review of the cost-effectiveness of nurse practitioners and clinical nurse specialists: what is the quality of the evidence?

Faith Donald, Kelley Kilpatrick, Kim Reid, Nancy Carter, Ruth Martin-Misener, Denise Bryant-Lukosius, Patricia Harbman, Sharon Kaasalainen, Deborah A Marshall, Renee Charbonneau-Smith and 12 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Nursing research and practice, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Nurse-led versus doctor-led care for bronchiectasis.The Cochrane database of systematic reviews · 2018
    Review
  17. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Faith DonaldDaphne Cockwell School of Nursing, Ryerson University, 350 Victoria Street, Toronto, ON, Canada M5B 2K3.ORCID 0000-0002-0400-627X
Kelley KilpatrickFaculty of Nursing, Université de Montreal and Research Centre of Hôpital Maisonneuve-Rosemont, CSA-RC-Aile Bleue-Room F121, 5415 boulevard l'Assomption, Montréal, QC, Canada H1T 2M4.ORCID 0000-0003-2137-6560
Kim ReidKJ Research, Rosemere, QC, Canada J7A 4N8.ORCID 0000-0001-5484-7205
Nancy CarterSchool of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4L8.ORCID 0000-0002-4506-7167
Ruth Martin-MisenerSchool of Nursing, Dalhousie University, Box 15000, 5869 University Avenue, Halifax, NS, Canada B3H 4R2.
Denise Bryant-LukosiusSchool of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4L8 ; Department of Oncology, McMaster University, 1280 Main Street West, HSC-3N28G, Hamilton, ON, Canada L8S 4L8.ORCID 0000-0002-8269-7977
Patricia HarbmanSchool of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4L8 ; Health Interventions Research Centre, Ryerson University, 350 Victoria Street, Toronto, ON, Canada M5B 2K3.ORCID 0000-0001-5626-875X
Sharon KaasalainenSchool of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4L8.
Deborah A MarshallDepartment of Community Health Sciences, Faculty of Medicine, University of Calgary, Health Research Innovation Centre, Room 3C56, 3280 Hospital Drive NW, Calgary, AB, Canada T2N 4Z6.
Renee Charbonneau-SmithSchool of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4L8.ORCID 0000-0002-9775-0718
Erin E DonaldFraser Health Authority, Suite 400-13450 102nd Avenue, Surrey, BC, Canada V3T 0H1.
Monique LloydInternational Affairs and Best Practice Guidelines Centre, Registered Nurses' Association of Ontario, 158 Pearl Street, Toronto, ON, Canada M5H 1L3.ORCID 0000-0001-6240-6127
Abigail Wickson-GriffithsSchool of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4L8.ORCID 0000-0003-1290-5037
Jennifer YostSchool of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4L8.
Pamela BaxterSchool of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4L8.ORCID 0000-0002-8396-8476
Esther Sangster-GormleySchool of Nursing, University of Victoria, P.O. Box 1700 STN CSC, Victoria, BC, Canada V8W 2Y2.ORCID 0000-0002-3873-3846
Pamela HubleyThe Hospital for Sick Children, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 555 University Avenue, Toronto, ON, Canada M5G 1X8.
Célyne LaflammePrimary Health Care Nurse Practitioner Program, School of Nursing, University of Ottawa, 600 Peter Morand Crescent, Suite 101, Ottawa, ON, Canada K1G 5Z3.
Marsha Campbell-YeoSchool of Nursing, Dalhousie University, Box 15000, 5869 University Avenue, Halifax, NS, Canada B3H 4R2 ; School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4L8.
Sheri PriceSchool of Nursing, Dalhousie University, Box 15000, 5869 University Avenue, Halifax, NS, Canada B3H 4R2.
Jennifer BoykoSchool of Health Studies, Western University, Health Sciences Building, Room 403, London, ON, Canada N6A 5B9.
Alba DiCensoSchool of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4L8 ; Department of Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4L8.ORCID 0000-0001-6733-728X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background. Improved quality of care and control of healthcare costs are important factors influencing decisions to implement nurse practitioner (NP) and clinical nurse specialist (CNS) roles. Objective. To assess the quality of randomized controlled trials (RCTs) evaluating NP and CNS cost-effectiveness (defined broadly to also include studies measuring health resource utilization). Design. Systematic review of RCTs of NP and CNS cost-effectiveness reported between 1980 and July 2012. Results. 4,397 unique records were reviewed. We included 43 RCTs in six groupings, NP-outpatient (n = 11), NP-transition (n = 5), NP-inpatient (n = 2), CNS-outpatient (n = 11), CNS-transition (n = 13), and CNS-inpatient (n = 1). Internal validity was assessed using the Cochrane risk of bias tool; 18 (42%) studies were at low, 17 (39%) were at moderate, and eight (19%) at high risk of bias. Few studies included detailed descriptions of the education, experience, or role of the NPs or CNSs, affecting external validity. Conclusions. We identified 43 RCTs evaluating the cost-effectiveness of NPs and CNSs using criteria that meet current definitions of the roles. Almost half the RCTs were at low risk of bias. Incomplete reporting of study methods and lack of details about NP or CNS education, experience, and role create challenges in consolidating the evidence of the cost-effectiveness of these roles.

Identifiers

PMID25258683
PMCPMC4167459

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.