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Table 3 Quality Assessment of the Included Longitudinal Studies using the CASP Tool

From: Systematic review of factors associated with quality of life of asylum seekers and refugees in high-income countries

CASP Tool Carlsson et al.
Baseline vs. 9-month follow-up [18]
Carlsson, Olsen, Mortensen & Kastrup
10-year follow-up [20]
Carlsson et al.
Baseline vs 9 month vs. 23 month follow-up [17]
Kinzie et al. Baseline vs- 12 month follow-up [28] Löfvander et al.
Baseline, 6- and 12-month follow-up [33]
Stammel et al.
Baselinve vs. 7 months vs. 14 months [36]
Did the study address a clearly focused issue? Yes Yes Yes No Yes Yes
Was the cohort recruited in an acceptable way? No Yes Yes Yes Yes Yes
Was the exposure accurately measured to minimise bias? Cannot tell – no control group Cannot tell – no control group Yes Cannot tell – no control group Yes Cannot tell – no control group
Was the outcome accurately measured to minimise bias? Yes Yes Yes Yes Yes Yes
Have the authors identified all important confounding factors? Yes Yes No Yes Yes Yes
Have they taken account of the confounding factors in the design and/or analysis? No No Cannot tell Cannot tell Yes Yes
Was the follow up of subjects complete enough? Yes Yes Yes Yes Cannot tell Cannot tell
What are the results of this study? After a mean of 8 months of multidisciplinary treatment, mental symptoms and health-related quality of life did not change The level of emotional distress was high at follow-up. Social relations and unemployment at follow-up were important predictors of mental health symptoms and low health-related quality of life. Reduction in trauma /depression (baseline > 23 month) means. Minimal differences due to low effect sizes. Intervention not effective. There were significant changes between means on the WHOQOL physical, mental and environmental domains after 1 year. New immigrants did not have inferior physical or psychological health, quality-of-life, well-being or social functioning compared with their age- and sex-matched Swedish born pairs during a 1-year follow-up. Quality of life increased significantly after an average of 14 months of treatment.
How precise are the results? Cannot tell Cannot tell Cannot tell Cannot tell Cannot tell Good
Do you believe the results? Cannot tell Cannot tell Yes No, more information is required Cannot tell Yes
Can the results be applied to the local population? No No No No No No
Do the results of this study fit with other available evidence? Yes Yes Cannot tell Cannot tell No No
What are the implications of this study for practice? When planning health-related and social interventions
an increased focus is needed on the present exile situation, e.g., social relations, occupation and resources available in the present situation.
Post migratory factors, such as social relations and occupation, are important for mental health and health-related quality of life. For the clinician dealing with severely traumatized refugees, it is important to be aware of a possible chronic condition. Long-term follow-ups should be included in randomized trials focusing on the effects of different treatment approaches, including the appropriate length of treatment. The results can have implications for the treatment of torture survivors. General screening in unselected settings of refugees and new immigrants seems to be of little value. Clinical consultations in selected cases are to be preferred, adopting a holistic practical approach in patient and family-focused care. It provides evidence for the efficacy of multidisciplinary treatment, more research needed.