Abstract
The authors thank Professor Enderby for her interest in our systematic review (Zaga et al, 2020). Below the authors outline our response her comments and queries.
The aim of this systematic review was to (i) identify and (ii) report the clinimetric properties of outcome measurement tools that examined communication in mechanically ventilated patients in the Intensive Care Unit (ICU). As detailed in the Discussion, there were some outcome measurement tools that had high clinical value but either did not have established clinimetric properties and/or have not yet been studied in the ICU population. Therefore their generalisability and validity are currently unknown. For example, in the paper by John and Enderby (2000), the three populations evaluated did not represent the target population of this review. However, we are not suggesting these tools have no value in patients who are mechanically ventilated in ICU, given we proposed in the Future Directions, the potential adaptation of existing tools for the ICU environment.
As stated in the systematic review’s methodology, the search strategy for part two of the review initially yielded no relevant results. As such, it was revised to include the outcome measurement tools identified in the part one results as key words. The authors acknowledge that while the search was devised in conjunction with an experienced research Librarian and was systematic and reproducible, it is possible that relevant studies or supplementary materials, have been missed. However, 5,217 primary studies were yielded in part two of the search. As such, the authors are confident that all relevant primary source materials were identified.
The authors are familiar with the article by John and Enderby (2000) that was mentioned, as all abstracts and full-text articles were read thoroughly. Professor Enderby raised the prospect that the ‘inadequate/doubtful’ score was ‘factually incorrect’. In response, firstly, as per the instructions of how to utilise the COSMIN risk of bias checklist, an overall quality score for each item is obtained by using the lowest score recorded (Mokkink et al., 2018). As such, and as stated as a potential limitation, there may be some instances where tools were underrated as a result. Secondly, and perhaps most importantly, the aim of this systematic review was to identify and examine the outcome measurement tools for mechanically ventilated patients in the ICU.
We thank Professor Enderby for her interest and are hopeful that there is greater clarity surrounding the aims and methodology undertaken for this systematic review.
