Study designs of evaluations included in the review
Before-and-after studies with concurrent (external) controls, time series and randomised controlled trials (RCTs) were eligible for inclusion. Uncontrolled before-and-after cohort studies and studies that only used a historical control were excluded.
Specific interventions included in the review
Studies that evaluated the use of practice guidelines for CAP were eligible for inclusion. The included studies evaluated site-specific clinical pathways, American Thoracic Society guidelines with local adaptations, locally developed guidelines with and without a multifaceted implementation strategy, and a critical pathway. The interventions were conducted in teaching and community hospitals, hospitals in integrated health care systems and tertiary care hospitals.
Participants included in the review
Studies of patients with CAP were eligible for inclusion; no further participant details were reported.
Outcomes assessed in the review
It was clear that studies that assessed quality of care outcomes and process outcomes were eligible for inclusion. The outcomes reported included length of stay (LOS) or bed days per patient managed (BDPM), mortality, the decision to admit to hospital, the time till administration of first antibiotic, the use of guideline-recommended antibiotics, appropriate monotherapy and the duration of intravenous therapy.
How were decisions on the relevance of primary studies made?
The authors did not state how the papers were selected for the review, or how many reviewers performed the selection.