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In Reply: Dr Riegel and colleagues are concerned about the categorization of studies in our meta-analysis. We agree that it is appealing to use concepts of intensity and complexity to categorize components of multidisciplinary interventions for congestive heart failure, such as specific education to enhance self-care behavior, discharge planning, and support after discharge.

In our meta-analysis of published data, we categorized studies according to the reported characteristics of postdischarge support. This aspect of the intervention has an impact on both the intensity and complexity of the process of care and was specifically described in the published reports, which contained little additional information about the intensity of other components. Therefore, we chose postdischarge support as the basis for our categorization scheme.

Riegel et al raise specific questions about the categorization of studies by Jaarsma et al¹ and Stewart et al.^2-3 They also suggest categories that should have included studies by Jaarsma . . . [Full Text of this Article]

Christopher O. Phillips, MD, MPH
Department of Medicine
Brigham and Women's Hospital
Boston, Mass

Scott M. Wright, MD; David E. Kern, MD, MPH; Haya R. Rubin, MD, PhD
Division of General Internal Medicine
Johns Hopkins University School of Medicine
Baltimore, Md

Sasha Shepperd, MS, DPhil
Department of Continuing Education
University of Oxford
Oxford, England

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