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The British Journal of Psychiatry (2002) 181: 17-21
© 2002 The Royal College of Psychiatrists

REVIEW ARTICLE

Assessing the evidence on case management

S.J. ZIGURAS, PhD

Brotherhood of St Laurence, Melbourne, Australia

G.W. STUART, PhD

Department of Psychiatry, University of Melbourne, Australia

A.C. JACKSON, PhD

School of Social Work, University of Melbourne, Australia

Correspondence: Dr Stephen Ziguras, Brotherhood of St Laurence, 67 Brunswick St, Fitzroy 3065, Victoria, Australia. Tel: 61-3-9483 1316; E-mail: sziguras{at}bsl.org.au

Declaration of interest None.

Background Evidence on the impact of case management is contradictory.

Aims To discuss two different systematic reviews (one conducted by the authors and one conducted through the Cochrane collaboration) that came to contradictory conclusions about the impact of case management in mental health services.

Method We summarised the findings of the two reviews with respect to case management effectiveness, examined key methodological differences between the two approaches and discuss the impact of these on the validity of the results.

Results The differences in conclusions between the two reviews result from the differences in inclusion criteria, namely non-randomised trials, data from unpublished scales and data from variables with skewed distributions. The theoretical and empirical effects of these are discussed.

Conclusions Systematic reviewers may face a trade-off between the application of strict criteria for the inclusion of studies and the amount of data available for analysis and hence statistical power. The available research suggests that case management is generally effective.


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