SynthesisBMJ global health2020
Use of interrupted time series methods in the evaluation of health system quality improvement interventions: a methodological systematic review.
Synthesis in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 120 papers, 6 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.
The Medicaid Innovation Collaborative (MIC) Experience: Transforming Care Through Digital Health: A Mixed Methods Analysis
Immersive Functional Virtual Reality in People With Acquired Brain Injury and Unilateral Spatial Neglect: A Feasibility and Usability Study
Who cites it
120 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Organizational models for acute gastrointestinal bleeding: a systematic review of hospital networks, multidisciplinary care and bloodless programs (2015-2025).Frontiers in medicine · 2026Pooled it
- Health impact of alcohol regulatory interventions: a systematic review of policies in low- and middle-income countries.Health policy and planning · 2025Pooled it
- The Effect of Severe Sepsis and Septic Shock Management Bundle (SEP-1) Compliance and Implementation on Mortality Among Patients With Sepsis : A Systematic Review.Annals of internal medicine · 2025Pooled it
- Mixed Impact of Direct Healthcare Professional Communications When Considering Proximal Outcomes and the Targeted Population: A Systematic Review.Pharmacoepidemiology and drug safety · 2025Pooled it
- Effect estimates can be accurately calculated with data digitally extracted from interrupted time series graphs.Research synthesis methods · 2023Pooled it
- Use of interrupted time series methods in the evaluation of health system quality improvement interventions: a methodological systematic review.BMJ global health · 2020Pooled it
- Transfer-workflow optimization in a regional chest pain center network reduces door-in-door-out time in ST-segment elevation myocardial infarction: An interrupted time-series study with spectral validation.International journal of cardiology. Heart & vasculature · 2026Article
- Real-Time Physical Activity Self-Monitoring in Patients Hospitalized for Cardiology Care: Interrupted Time Series Analysis.JMIR cardio · 2026Article
- Effect of a Multi-specialty E-consultation Service on Hospital Referrals: An Interrupted Time-Series Study in the Netherlands.Journal of general internal medicine · 2026Article
- Actionable osteoporosis alerts in musculoskeletal radiology reports improve secondary fracture prevention after orthopaedic fragility fractures.Archives of osteoporosis · 2026Article
- The impact of Shanghai's comprehensive smoke-free legislation on hospital admission and mortality rates for chronic obstructive pulmonary disease: an interrupted time series analysis.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- Prescribed pharmaceutical alternatives initiative coinciding with reductions in unregulated street opioid use among young people who use drugs: An interrupted time series analysis.Addiction (Abingdon, England) · 2026Article
- Epidemiology of Craniomaxillofacial Trauma in Chile: A Systematic Review and 24-Year Nationwide Interrupted Time-Series Analysis.Craniomaxillofacial trauma & reconstruction · 2026Review
- Practice model of unit-based clinical pharmacists' individualized daily antimicrobial use density monitoring report on antimicrobial stewardship in intensive care unit of a tertiary hospital in Guangxi, China: an interrupted time series analysis.Antimicrobial resistance and infection control · 2026Article
- Time series modeling to predict mortality rates and estimate years of life lost due to injuries in West Azerbaijan province, Iran, 2013-2024.BMC public health · 2026Observational
- Impacts of Hurricane-Related Flooding on Time to Initial Cancer-Directed Treatment in North Carolina.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Observational
- An investigation of discrepancies in outcome reporting and selective reporting bias in interrupted time series studies of health interventions: a methodological study.BMC public health · 2026Article
- Universal Free Contraception Coverage Policy, Out-of-Pocket Payments, and Costs.JAMA health forum · 2026Article
- Interrupted Time Series Methods for Nonrandom Sampling Study Designs With Known Sampling Weights.Statistics in medicine · 2026Article
- Trends in Use of Obesity Medications and Metabolic and Bariatric Surgery Among All of Us Participants From 2003 to 2023.Obesity (Silver Spring, Md.) · 2026Article
60 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhen randomisation is not possible, interrupted time series (ITS) design has increasingly been advocated as a more robust design to evaluating health system quality improvement (QI) interventions given its ability to control for common biases in healthcare QI. However, there is a potential risk of producing misleading results when this rather robust design is not used appropriately. We performed a methodological systematic review of the literature to investigate the extent to which the use of ITS has followed best practice standards and recommendations in the evaluation of QI interventions.
methodsWe searched multiple databases from inception to June 2018 to identify QI intervention studies that were evaluated using ITS. There was no restriction on date, language and participants. Data were synthesised narratively using appropriate descriptive statistics. The risk of bias for ITS studies was assessed using the Cochrane Effective Practice and Organisation of Care standard criteria. The systematic review protocol was registered in PROSPERO (registration number: CRD42018094427).
resultsOf 4061 potential studies and 2028 unique records screened for inclusion, 120 eligible studies assessed eight QI strategies and were from 25 countries. Most studies were published since 2010 (86.7%), reported data using monthly interval (71.4%), used ITS without a control (81%) and modelled data using segmented regression (62.5%). Autocorrelation was considered in 55% of studies, seasonality in 20.8% and non-stationarity in 8.3%. Only 49.2% of studies specified the ITS impact model. The risk of bias was high or very high in 72.5% of included studies and did not change significantly over time.
conclusionsThe use of ITS in the evaluation of health system QI interventions has increased considerably over the past decade. However, variations in methodological considerations and reporting of ITS in QI remain a concern, warranting a need to develop and reinforce formal reporting guidelines to improve its application in the evaluation of health system QI interventions.
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Registered trials
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.