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Table 2 Summary of clinical significance of findings relating to each main outcome of interest

From: Impact of technology-based interventions for children and young people with type 1 diabetes on key diabetes self-management behaviours and prerequisites: a systematic review

Study Clinical significance of findings Clinical relevance
Self-monitoring of blood glucose (SMBG)
 Clements & Staggs (2017) [21] Positive link found but 1/3 did not use app so it is likely that individuals who often SMBG use the app rather than the app encouraging more SMBG. Factor of increase (2.3) reported but exact figures not given so difficult to interpret i.e. could be increase from 1 to 2.3 which would impact very little or 3 to 6.9 which would impact a great deal Likely low
 Harris et al. (2015) [16] 25-item measure but does not give any measure of frequency and so impossible to say Unclear
 Mulvaney et al. (2012) [26] 1/3 of the cohort sent through no data, percentage of missed blood glucose tests reported but actual frequency of SMBG not given and there is very high variability between the groups i.e. some participants missed very few and some missed almost all tests thus for some findings could be clinically meaningful but not for others Unclear
 Rachmiel et al. (2015) [25] Difference between continuous and intermittent users expected to have clinical significancethough would also lead to concomitant increase in discomfort from testing Likely high
 Raiff et al. (2016) [13] An increase of 2 to 4 tests per day would be expected to result in clinical improvements Likely some
Frequency of SMBG and insulin administration behaviour
 Giani et al. (2016) [23] Improvements found amongst those who monitored regularly at the beginning of the study but not those who initially monitored poorly. This suggests the intervention was effective but only for those who did not need it Likely low
 Schiaffini et al. (2016) [14] Can be assumed that the intervention increased SMBG and insulin administration to a degree that would be clinically significant. Unclear whether this is due to the electronic platform or feedback from the clinical team Likely some
 Mulvaney et al. (2012b) [39] Nature of control group (matched historical control) is inappropriate to enable estimation of clinical significance Unclear
 Pinsker et al. (2011) [40] No statistical significance found but demographic characteristics of the two groups are not provided and so it is not clear if groups were matched None
 Rami et al. (2006) [36] No statistical significance reported None
HbA1c and self-efficacy
 Franklin et al. (2006) [34] Improvements only reported in the intensive insulin group suggesting that the technology-based intervention was not primarily responsible for differences None
 Berndt et al. (2014) [30] Measure likely taken immediately after receiving information from the clinical team and so probably does not reflect real changes in self-efficacy Likely low
 Whittemore et al. (2012) [18] Intervention appears to have been no more effective than control Likely low
Need satisfaction (SDT)
 Henkemans et al. (2017) [42] Unclear how findings relate to clinical outcomes Unclear