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    A multilevel analysis of three randomised controlled trials of the Australian Medical Sheepskin in the prevention of sacral pressure ulcers

    153792_153792.pdf (246.7Kb)
    Access Status
    Open access
    Authors
    Mistiaen, P.
    Jolley, D.
    McGowan, Sunita
    Hickey, M.
    Spreeuwenberg, P.
    Francke, A.
    Date
    2010
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Mistiaen, Patriek J. and Jolley, Damien J. and McGowan, Sunita and Hickey, Mark B. and Spreeuwenberg, Peter and Francke, Anneke L. 2010. A multilevel analysis of three randomised controlled trials of the Australian Medical Sheepskin in the prevention of sacral pressure ulcers. Medical Journal of Australia. 193 (11/12): pp. 638-641.
    Source Title
    Medical Journal of Australia
    Additional URLs
    http://www.mja.com.au/public/issues/193_11_061210/mis10295_fm.html
    ISSN
    0025 729X
    School
    School of Nursing and Midwifery
    URI
    http://hdl.handle.net/20.500.11937/9065
    Collection
    • Curtin Research Publications
    Abstract

    Objective: To assess the effectiveness of the Australian Medical Sheepskin in preventing sacral pressure ulcers (PUs), based on combined data from existing published trials. Design and setting: Data from two randomised controlled trials (RCTs) among Australian hospital patients and one RCT among Dutch nursing home patients were pooled, comprising a total population of 1281 patients from 45 nursing wards in 11 institutions. These data were analysed in two ways: with conventional meta-analysis based on the published effect sizes; and with multilevel binary logistic regression based on the combined individual patient data. In the multilevel analysis, patient, nursing ward and institution were used as levels and we controlled for sex, age, PU risk and number of days of observation.Main outcome measure: Incidence of sacral PUs. Results: Overall, the incidence of sacral PUs was 12.2% in the control group versus 5.4% in the intervention group with an Australian Medical Sheepskin. Conventional meta-analysis showed significantly reduced odds of developing a PU while using the sheepskin (odds ratio [OR], 0.37 [95% CI, 0.17–0.77]). Multilevel analysis gave an OR of 0.35 and narrowed the confidence interval by almost 50% (95% CI, 0.23–0.55). Conclusions: These analyses of pooled data confirm that the Australian Medical Sheepskin is effective in preventing sacral PUs. Multilevel analysis of individual patient data gives a more precise effect estimate than conventional meta-analysis.

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