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Cited by 195Mobile Health and mHealth ApplicationsObesity, Physical Activity, DietDigital Mental Health Interventions

Interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people

Open access
Wieland, L. Susan, Falzon, Louise, Sciamanna, Chris N, Trudeau, Kimberlee J, Brodney Folse, Suzanne, Schwartz, Joseph E, Davidson, Karina W·2012·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd007675.pub2PMC PMC3996838
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Abstract

BACKGROUND: The World Health Organization (WHO) estimates that the number of obese or overweight individuals worldwide will increase to 1.5 billion by 2015. Chronic diseases associated with overweight or obesity include diabetes, heart disease, hypertension and stroke. OBJECTIVES: To assess the effects of interactive computer-based interventions for weight loss or weight maintenance in overweight or obese people. SEARCH METHODS: We searched several electronic databases, including CENTRAL, MEDLINE, EMBASE, CINAHL, LILACS and PsycINFO, through 25 May 2011. We also searched clinical trials registries to identify studies. We scanned reference lists of included studies and relevant systematic reviews. SELECTION CRITERIA: Studies were included if they were randomized controlled trials or quasi-randomized controlled trials that evaluated interactive computer-based weight loss or weight maintenance programs in adults with overweight or obesity. We excluded trials if the duration of the intervention was less than four weeks or the loss to follow-up was greater than 20% overall. DATA COLLECTION AND ANALYSIS: Two authors independently extracted study data and assessed risk of bias. Where interventions, control conditions, outcomes and time frames were similar between studies, we combined study data using meta-analysis. MAIN RESULTS: We included 14 weight loss studies with a total of 2537 participants, and four weight maintenance studies with a total of 1603 participants. Treatment duration was between four weeks and 30 months. At six months, computer-based interventions led to greater weight loss than minimal interventions (mean difference (MD) -1.5 kg; 95% confidence interval (CI) -2.1 to -0.9; two trials) but less weight loss than in-person treatment (MD 2.1 kg; 95% CI 0.8 to 3.4; one trial). At six months, computer-based interventions were superior to a minimal control intervention in limiting weight regain (MD -0.7 kg; 95% CI -1.2 to -0.2; two trials), but not superior to infrequent in-person treatment (MD 0.5 kg; 95% -0.5 to 1.6; two trials). We did not observe consistent differences in dietary or physical activity behaviors between intervention and control groups in either weight loss or weight maintenance trials. Three weight loss studies estimated the costs of computer-based interventions compared to usual care, however two of the studies were 11 and 28 years old, and recent advances in technology render these estimates unlikely to be applicable to current or future interventions, while the third study was conducted in active duty military personnel, and it is unclear whether the costs are relevant to other settings. One weight loss study reported the cost-effectiveness ratio for a weekly in-person weight loss intervention relative to a computer-based intervention as USD 7177 (EUR 5678) per life year gained (80% CI USD 3055 to USD 60,291 (EUR 2417 to EUR 47,702)). It is unclear whether this could be extrapolated to other studies. No data were identified on adverse events, morbidity, complications or health-related quality of life. AUTHORS' CONCLUSIONS: Compared to no intervention or minimal interventions (pamphlets, usual care), interactive computer-based interventions are an effective intervention for weight loss and weight maintenance. Compared to in-person interventions, interactive computer-based interventions result in smaller weight losses and lower levels of weight maintenance. The amount of additional weight loss, however, is relatively small and of brief duration, making the clinical significance of these differences unclear.

AI snapshot

Written from the paper’s full text.

TL;DR

This Cochrane review of 18 trials found that interactive computer-based interventions produced modest short-term weight loss and less weight regain than minimal or no treatment, but were less effective than in-person interventions. The additional weight loss was relatively small and brief, so the clinical significance of these differences is unclear.

Key findings

  • The review included 14 weight loss studies with 2537 participants and 4 weight maintenance studies with 1603 participants; treatment duration ranged from 4 weeks to 30 months.
  • At 6 months, computer-based interventions led to greater weight loss than minimal interventions (MD −1.5 kg; 95% CI −2.1 to −0.9; 2 trials) but less weight loss than in-person treatment (MD 2.1 kg; 95% CI 0.8 to 3.4; 1 trial).
  • At 6 months, computer-based interventions limited weight regain more than minimal control (MD −0.7 kg; 95% CI −1.2 to −0.2; 2 trials) but were not superior to infrequent in-person treatment (MD 0.5 kg; 95% CI −0.5 to 1.6; 2 trials).
  • No consistent differences in dietary or physical activity behaviors were observed; no data were identified on health-related quality of life, morbidity, complications, or adverse events, and cost data were limited, old, or from military personnel.

Methods

  • Systematic review and meta-analysis of randomized and quasi-randomized controlled trials in overweight or obese adults, searching CENTRAL, MEDLINE, EMBASE, CINAHL, LILACS, PsycINFO, and other sources through 25 May 2011.
  • Included interactive computer-based weight loss or weight maintenance programs; excluded interventions shorter than 4 weeks or with greater than 20% overall loss to follow-up; 18 studies (17 RCTs, 1 quasi-RCT; 4140 participants) met inclusion criteria.
  • Two authors independently extracted data and assessed risk of bias; random-effects meta-analysis was used where interventions, controls, outcomes, and time frames were similar, with GRADE assessment of evidence quality.

Limitations

  • The authors state that heterogeneity in intervention goal, timing, and control group, plus the small number of studies and many permutations, made firm conclusions difficult; most trials lacked details on randomization, allocation concealment, and blinding, and GRADE quality ranged from moderate to low.
  • The authors state that cost-effectiveness conclusions were difficult because few studies reported costs, some estimates were 11 or 28 years old, and one was conducted in active duty military personnel; no health-related quality of life, morbidity, complications, or adverse event data were identified.
  • Evident from the text: many meta-analyses were based on only 1–3 trials, most outcomes were short-term, all studies were efficacy rather than effectiveness studies, and adherence measures varied and generally declined over time.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1002/14651858.cd007675.pub2

Cites

153 of 153 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 254 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    At six months, computer-based interventions were not superior to infrequent in-person treatment in limiting weight regain (MD 0.5 kg; 95% −0.5 to 1.6; two trials).

    “but not superior to infrequent in-person treatment (MD 0.5 kg; 95% −0.5 to 1.6; two trials)”
    Quote in the paperSubstantial claim
  • Findingown data

    The review included four weight maintenance studies with a total of 1603 participants.

    “We included 14 weight loss studies with a total of 2537 participants, and four weight maintenance studies with a total of 1603 participants.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The review did not observe consistent differences in dietary behaviors between intervention and control groups in either weight loss or weight maintenance trials.

    “We did not observe consistent differences in dietary or physical activity behaviors between intervention and control groups in either weight loss or weight maintenance trials.”
    Quote in the paperSubstantial claim
  • Findingown data

    Three weight loss studies estimated the costs of computer-based interventions compared to usual care.

    “Three weight loss studies estimated the costs of computer-based interventions compared to usual care”
    Quote in the paperNot a substantial claim
  • Findingnone given

    No data were identified on adverse events, morbidity, complications or health-related quality of life.

    “No data were identified on adverse events, morbidity, complications or health-related quality of life.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 161
  • May combine two claims. 135
  • The quote only partly states this claim. 10

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The third cost-estimating study was conducted in active duty military personnel.

    “while the third study was conducted in active duty military personnel”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The review included 14 weight loss studies with a total of 2537 participants.

    “We included 14 weight loss studies with a total of 2537 participants, and four weight maintenance studies with a total of 1603 participants.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingcitation

    In Tate 2003, the control group submitted their weight and received weight loss information online, while an interactive intervention group submitted weight, calorie and fat intake, exercise information, and any comments or questions and received e-mailed feedback from investigators.

    “In Tate 2003, the control group submitted their weight and received weight loss information online, while an interactive intervention group submitted weight, calorie and fat intake, exercise information, and any comments or questions and received e-mailed feedback from investigators.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Tate 2003 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The electronic search strategies, weekly updates and additional searching of resources yielded 9195 abstracts retrieved between 14 April 2009 and 25 May 2011.

    “The electronic search strategies, weekly updates and additional searching of resources yielded 9195 abstracts retrieved between 14 April 2009 and 25 May 2011.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    From the potentially eligible 376 titles, 184 were excluded and 105 were retrieved in full text for further examination.

    “From the potentially eligible 376 titles, we excluded 184 and retrieved 105 in full text for further examination.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    All trials were conducted in adults.

    “All trials were conducted in adults.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    In the 18 trials, 2452 people were in the computer treatment groups and 1688 people were in one of the comparison groups.

    “In these 18 trials, 2452 people were in the computer treatment groups and 1688 people in one of the comparison groups.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In Gabriele 2011, all participants received an Internet-based weight loss program with weekly lessons and feedback delivered by e-mail, and were randomized to no individualized support, directive e-mail coaching, or non-directive e-mail coaching.

    “In Gabriele 2011, all participants received an Internet-based weight loss program with weekly lessons and feedback delivered by e-mail. Participants were randomized to one of three groups: no individualized support, directive e-mail coaching or non-directive e-mail coaching.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Gabriele 2011 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    In Tate 2001, following an in-person one-hour behavioral weight loss session, participants were randomized to either online education or online behavior therapy.

    “In Tate 2001, following an in-person one-hour behavioral weight loss session, participants were randomized to either online education or online behavior therapy.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Tate 2001 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In Webber 2008, both the intervention and control groups were assigned to 16 weeks of online self monitoring, but the intervention group participated in weekly online group chats in addition to the online self monitoring.

    “In Webber 2008, both the intervention and control groups were assigned to 16 weeks of online self monitoring, but the intervention group participated in weekly online group chats in addition to the online self monitoring.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Webber 2008

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    All studies were parallel-arm trials in which individuals were allocated to study arms, except Cussler 2008 and Morgan 2011, in which groups were cluster-randomized to parallel study arms.

    “All studies were parallel-arm trials in which individuals were allocated to study arms, with the exception of Cussler 2008 and Morgan 2011, in which groups were cluster-randomized to parallel study arms.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    DeLucia 1988 reported no difference between the effects of the two computer intervention arms, and the review combined these two intervention arms for analyses.

    “The study reported that there was no difference between the effects of the two computer intervention arms, and we therefore combined these two intervention arms for our analyses.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites DeLucia 1988 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In Tate 2006, all intervention groups were instructed in the use of an interactive website; the control group received no further feedback; two additional intervention groups received weekly feedback that was either e-mail counseling from a human weight loss counselor or tailored feedback from an automated computer program.

    “In Tate 2006, all intervention groups were instructed in the use of an interactive website. The control group received no further feedback. Two additional intervention groups received weekly feedback that was either 1) e-mail counseling from a human weight loss counselor or 2) tailored feedback from an automated computer program.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Tate 2006 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The review included 18 studies, of which 14 focused on weight loss and four focused on weight maintenance.

    “We included 18 studies (Bennett 2010; Cussler 2008; DeLucia 1988; Gabriele 2011; Harvey-Berino 2002; Harvey-Berino 2010; Hunter 2008; Morgan 2009; Morgan 2011; Schroder 2010; Svetkey 2008; Tate 2001; Tate 2003; Tate 2006; Threlfall 1984; Webber 2008; Wing 2006; Wylie-Rosett 2001), of which 14 focused on weight loss and four focused on weight maintenance.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    There were a total of 4140 participants in the 18 trials.

    “There were a total of 4140 participants in the 18 trials.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    In the trials which included both men and women (3759 participants in total), the gender percentages were 26% men and 74% women.

    “In the trials which included both men and women (3759 participants in total) the gender percentages were 26% men and 74% women.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    In the fourth weight maintenance trial (Wing 2006), participants had to have lost at least 10% of their body weight during the previous two years to qualify for study entry.

    “In the fourth weight maintenance trial (Wing 2006), participants had to have lost at least 10% of their body weight during the previous two years to qualify for study entry.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Across all participants, 27% were men and 73% were women.

    “Across all participants 27% were men and 73% were women.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Seventeen studies were randomized controlled trials and one study (Schroder 2010) was a quasi-randomized controlled trial.

    “Seventeen studies were randomized controlled trials (RCTs) and one study (Schroder 2010) was a quasi-randomized controlled trial (quasi-RCT).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The duration of the intervention in weight loss studies ranged from 10 weeks to 12 months.

    “The duration of the intervention ranged from 10 weeks to 12 months (see Appendix 4).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    In three of the four included weight maintenance trials, participants met BMI criteria at the beginning of the weight loss segment of the study.

    “In three of the four included weight maintenance trials, participants met BMI criteria at the beginning of the weight loss segment of the study.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Most inclusion criteria were based on body mass index (BMI).

    “Most inclusion criteria were based on body mass index (BMI).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Two of the studies comparing an interactive computer-based intervention with a minimal or no treatment control condition were three-arm trials, and both reported no significant difference between the two computer intervention arms.

    “Two of the studies comparing an interactive computer-based intervention with a minimal or no treatment control condition (Schroder 2010; Wylie-Rosett 2001) were three-arm trials, in which a third treatment arm supplemented the computer-based intervention with an in-person treatment component. Both studies reported that there was not a significant difference between the two computer intervention ar”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Schroder 2010 source

      Not checked in the free run.

    • cites Wylie-Rosett 2001 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Two trials included solely women and two trials included solely men; the remaining 14 studies contained both men and women.

    “Two trials (Cussler 2008; Webber 2008) included solely women and two trials (Morgan 2009; Morgan 2011) included solely men. The remaining 14 studies contained both men and women.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    One study was excluded because the focus was diabetes management, and another because the focus was treatment of binge eating disorder.

    “and in one case because the focus was diabetes management (Kalten 2000), and in another because the focus was treatment of binge eating disorder (Carrard 2011).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Kalten 2000

      Not checked in the free run.

    • cites Carrard 2011 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    All studies included weight outcomes in kilograms or pounds of body weight.

    “All studies included weight outcomes in kilograms or pounds of body weight.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Weight, height (if assessed for purposes of calculating BMI) and waist circumference (if assessed) were measured by study personnel.

    “Weight, height (if assessed for purposes of calculating BMI) and waist circumference (if assessed) were measured by study personnel.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Four studies had interventions designed to promote physical activity rather than specifically to increase weight loss, and one study compared two interactive computer-based interventions.

    “Four studies had interventions which were designed to promote physical activity rather than specifically to increase weight loss (Bischoff 2010; Carr 2009; Smith 2009; Steele 2007) and one study compared two interactive computer-based interventions (Webber 2010).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Two potential studies were identified but are awaiting classification: one ongoing study and one conference abstract with insufficient information to determine eligibility.

    “Two potential studies were identified but are awaiting classification. One is an ongoing study (Harvey-Berino NCT01232699) and one is a conference abstract which does not give sufficient information to determine eligibility and whose author could not yet be contacted for further information (Magnusdottir 2010).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    When the sole quasi-randomized trial (Schroder 2010) was omitted, results were similar to the initial analysis (MD -2.8 kg, 95% CI -3.7 to -1.9, P < 0.00001; 339 participants; four trials), although heterogeneity remained moderate (I2 = 31%).

    “When we omitted the sole quasi-randomized trial (Schroder 2010), which was also the only trial that included an ongoing in-support arm as one component of the computer intervention, results were again similar to the initial analysis (MD −2.8 kg (95% CI −3.7 to −1.9), P < 0.00001; 339 participants; four trials; Analysis 1.1: sensitivity analysis 1.1.2), although heterogeneity remained moderate (I2”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Schroder 2010 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    When physical activity was measured, it was by means of physical activity questionnaires completed by the participants, with the exception of Morgan 2009, in which physical activity was measured using pedometers, and Svetkey 2008, in which physical activity was measured by accelerometry.

    “When physical activity was measured, it was by means of physical activity questionnaires completed by the participants, with the exception of Morgan 2009, in which physical activity was measured using pedometers, and Svetkey 2008, in which physical activity was measured by accelerometry.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    When dietary intake was measured, it was always by means of dietary questionnaires completed by the participants.

    “When dietary intake was measured, it was always by means of dietary questionnaires completed by the participants.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The duration of the intervention in weight maintenance studies ranged from 12 months to 30 months.

    “The duration of the intervention ranged from 12 months to 30 months (see Appendix 4).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    One study was excluded because the authors were unable to contact the author to obtain the necessary information for data extraction.

    “Finally one study had to be excluded because we were unable to contact the author to obtain the necessary information for data extraction (Harvey-Berino 2002a).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Harvey-Berino 2002a

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Another study by the same author was excluded because it did not meet the 80% follow-up inclusion criterion at 12 months, there were no extractable data for earlier follow-up points, and the authors were unable to contact the author to obtain data for the earlier follow-up time points.

    “Another study by the same author was excluded from this review because the study did not meet the 80% follow-up inclusion criterion at 12 months, there were no extractable data for earlier follow-up points, and we were unable to contact the author to obtain data for the earlier follow-up time points (Harvey-Berino 2004).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Harvey-Berino 2004 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Sixteen studies were excluded because none or not all participants were overweight or obese.

    “Studies which we excluded for other reasons were either because none or not all participants were overweight or obese (16 in total: Anderson-Bill 2011; Carr 2009; Cook 2007; De Bourdeaudhuij 2007; Dekkers 2011; Gow 2010; Herrick 2009; Kroeze 2008; Kroeze 2008a; Marcus 2007; Smeets 2007; Southard 2003; Vandelanotte 2005; Vandelanotte 2008; Werkman 2010; Winett 2007)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    When only the ongoing in-person support arm from the quasi-randomized trial was omitted, results were similar to the initial comparison (MD -2.5 kg, 95% CI -3.4 to -1.6, P < 0.00001; 399 participants; five trials), and heterogeneity was intermediate (I2 = 39%).

    “When we repeated the analysis omitting only the ongoing in-person support arm from the quasi-randomized trial, results were similar to the initial comparison (MD −2.5 kg (95% CI −3.4 to −1.6), P < 0.00001; 399 participants; five trials; Analysis 1.1: sensitivity analysis 1.1.3), and heterogeneity was intermediate (I2 = 39%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    The fourth weight maintenance study (Wing 2006) recruited participants who had lost at least 10% of their body weight during the last two years, randomly assigned the participants to computer-based or control intervention groups, and followed them for 18 months.

    “The fourth study (Wing 2006) recruited participants who had lost at least 10% of their body weight during the last two years, randomly assigned the participants to computer-based or control intervention groups, and followed them for 18 months.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wing 2006 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    At 12 months the mean difference in BMI was similar to that at six months (MD -0.6 kg/m2, 95% CI -1.1 to -0.1, P = 0.01; 474 participants; one trial), although the difference was smaller and not statistically significant when intervention participants receiving supplementary in-person contact were excluded (MD -0.4 kg/m2, 95% CI -0.9 to 0.1, P = 0.14; 280 participants; one trial).

    “At 12 months the mean difference was similar to that at six months (MD −0.6 kg/m2 (95% CI −1.1 to −0.1); P = 0.01; 474 participants; one trial; Analysis 1.8; primary analysis 1.8.1), although the difference was smaller and not statistically significant when intervention participants receiving supplementary in-person contact were excluded from the analysis (MD −0.4 kg/m2 (95% CI −0.9 to 0.1), P = 0”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Diet-related outcomes were generally expressed as kilocalories (kcal) per day.

    “Diet-related outcomes were generally expressed as kilocalories (kcal) per day.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    No study reported assessing adverse effects of the intervention in the comparison of computer-based intervention versus in-person treatment for weight loss.

    “No study reported assessing adverse effects of the intervention.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the single study reporting percent weight loss at 12 months (Wylie-Rosett 2001), participants in the computer intervention lost a greater percentage of body weight than participants in the control group (MD -2.0%, 95% CI -3.1 to -0.8, P = 0.0008; 474 participants), although this effect was smaller and no longer statistically significant when participants receiving additional in-person cons

    “In the single study reporting percent weight loss at 12 months (Wylie-Rosett 2001), participants in the computer intervention lost a greater percentage of body weight than participants in the control group (MD −2.0% (95% CI −3.1 to −0.8); P = 0.0008; 474 participants; Analysis 1.5; primary analysis 1.5.1), although this effect was smaller and no longer statistically significant when participants”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Wylie-Rosett 2001 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    At six months the computer intervention group had a greater decrease in waist measurement (MD -1.7 cm, 95% CI -2.5 to -0.9, P < 0.00001; 464 participants; two trials) but this difference decreased and was not statistically significant at 12 months (MD -0.9 cm, 95% CI -2.2 to 0.5, P = 0.20; 474 participants; one trial).

    “At six months the computer intervention group had a greater decrease in waist measurement (MD −1.7 cm (95% CI −2.5 to −0.9); P < 0.00001; 464 participants; two trials; Analysis 1.10) but this difference decreased and was not statistically significant at 12 months (MD −0.9 cm (95% CI −2.2 to 0.5); P = 0.20; 474 participants; one trial; Analysis 1.11).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    When the intervention arm with an in-person component was excluded from the 12-month weight loss comparison, the effect was smaller and no longer statistically significant (MD -1.1 kg, 95% CI -2.6 to 0.3, P = 0.12; 280 participants; one trial).

    “This trial also contained an intervention arm with an in-person component, and when that arm was excluded from the comparison, the effect was smaller and no longer statistically significant (MD −1.1 kg (95% CI −2.6 to 0.3); P = 0.12; 280 participants; one trial, Analysis 1.3: sensitivity analysis 1.3.2).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    Morgan 2011 observed that the computer intervention arm had a greater decrease in self-reported intake of cola and other soda drinks than did the control group, but did not report data on overall energy intake.

    “A later study by the same investigators (Morgan 2011) observed that the computer intervention arm had a greater decrease in self reported intake of cola and other soda drinks than did the control group, but did not report data on overall energy intake.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Morgan 2011

      Not checked in the free run.

  • May combine two claims. The quote only partly states this claim.

    Findingcitation

    In Wylie-Rosett 2001, participants in the control arm decreased their caloric intake slightly more than participants in the computer intervention arm at 12 months follow-up, although the difference was small and not significant at P < 0.05 for the analysis including all participants (MD 94 kcal/day, 95% CI -29 to 217, P = 0.14; 474 participants) or for the analysis excluding intervention particip

    “In a third study (Wylie-Rosett 2001), which followed participants to 12 months, participants in the control arm decreased their caloric intake slightly more than participants in the computer intervention arm at 12 months follow-up, although the difference was small and not significant at P < 0.05 for the analysis including all participants (MD 94 kcal/day (95% CI −29 to 217); P = 0.14; 474”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wylie-Rosett 2001 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    No waist circumference outcomes were reported in the comparison of computer-based intervention versus in-person treatment for weight loss.

    “No waist circumference outcomes were reported.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    No study included data on health-related quality of life outcomes in the adjunct to Internet comparison.

    “No study included data on health-related quality of life outcomes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    At six months, the difference for automated feedback was smaller and not statistically significant (MD −1.2, 95% CI −3.1 to 0.7; P = 0.21; 128 participants; one trial).

    “and a smaller difference for automated feedback that was not statistically significant (MD −1.2 (95% CI −3.1 to 0.7); P = 0.21; 128 participants; one trial; Analysis 3.2; subgroup analysis 3.2.3).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Tate 2006 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    There was not any exploration of within-group relationships between adherence and outcomes in DeLucia 1988.

    “There was not any exploration of within-group relationships between adherence and outcomes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites DeLucia 1988 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    At 18 months, participants in computer intervention continued to have regained less weight (−0.7 kg, 95% CI −1.6 to 0.1; P = 0.10; 897 participants; two trials), although the difference was not statistically significant.

    “Participants in the computer intervention continued to have regained less weight at 18 months (−0.7 kg (95% CI −1.6 to 0.1); P = 0.10; 897 participants; two trials; Analysis 5.3), although the difference was not statistically significant.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Svetkey 2008 source

      Not checked in the free run.

    • cites Wing 2006 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In Cussler 2008, at 12 months of follow-up, the difference between intervention groups in BMI was small and not statistically significant (MD −0.4 kg/m2, 95% CI −0.3 to 1.1; P = 0.26; 688 participants).

    “At 12 months of follow-up, the difference between intervention groups was small and not statistically significant (MD −0.4 kg/m2 (95% CI −0.3 to 1.1); P = 0.26; 688 participants; Analysis 5.7).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cussler 2008 source

      Not checked in the free run.

  • The quote only partly states this claim.

    Findingown data

    No other study reported assessing for adverse effects of the intervention in the weight maintenance comparison.

    “No other study reported assessing for adverse effects of the intervention.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingnone given

    DeLucia 1988 did not collect data on waist circumference or health-related quality of life.

    “DeLucia 1988 did not collect data on waist circumference or health-related quality of life.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites DeLucia 1988 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

    Findingown data

    No other study reported assessing adverse effects of the intervention in the adjunct to Internet comparison.

    “No other study reported assessing adverse effects of the intervention.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Assessment of adverse effects was not reported in DeLucia 1988.

    “Assessment of adverse effects was not reported.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites DeLucia 1988 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In Svetkey 2008, at 30 months, the computer intervention group had a smaller increase in energy intake but the difference was not statistically significant (MD −72 kcal/day, 95% CI −168 to 24; P = 0.14; 688 participants).

    “and one study (Svetkey 2008) reported data on energy intake at 30 months (MD −72 kcal/day (95% CI −168 to 24); P = 0.14; 688 participants; Analysis 5.9).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Svetkey 2008 source

      Not checked in the free run.

  • The quote only partly states this claim.

    Findingown data

    None of the studies collected information on costs in the adjunct to Internet comparison.

    “None of the studies collected information on costs.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In Cussler 2008, at 12 months, the computer intervention group had a smaller increase in energy intake but the difference was not statistically significant (MD −48 kcal/day, 95% CI −198 to 102; P = 0.53; 107 participants).

    “One study (Cussler 2008) reported data on energy intake at 12 months (MD −48 kcal/day (95% CI −198 to 102); P = 0.53; 107 participants; Analysis 5.8)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cussler 2008 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    In Cussler 2008, almost one-third of the computer-based group accessed the Internet only once per week during maintenance.

    “For example, almost one-third of the computer-based group accessed the Internet only once per week during maintenance.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cussler 2008 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    At six months, the computer intervention group regained slightly more weight than the face-to-face group, although the difference was not statistically significant (MD 0.5 kg, 95% CI −0.5 to 1.6; P = 0.32; 897 participants; two trials).

    “At six months, the computer intervention group regained slightly more weight than the face-to-face group, although the difference was not statistically significant (MD 0.5 kg (95% CI −0.5 to 1.6); P = 0.32; 897 participants; two trials; Analysis 6.1).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Svetkey 2008 source

      Not checked in the free run.

    • cites Wing 2006 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In Wing 2006, weekly reporting of weight decreased over time, and was consistently higher among participants in the in-person intervention, but the difference between the in-person and computer-based groups was not statistically significant.

    “Weekly reporting of weight also decreased over time, and was consistently higher among participants in the in-person intervention, but the difference between the in-person and computer-based groups was not statistically significant.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wing 2006 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In Svetkey 2008, participants in the personal-contact group completed an average of 91% of monthly intervention contacts, while participants in the computer-based intervention logged onto the Internet at least once per month for 77% of the months of the maintenance intervention.

    “Svetkey 2008 stated that participants in the personal-contact group completed an average of 91% of monthly intervention contacts, while participants in the computer-based intervention logged onto the Internet at least once per month for 77% of the months of the maintenance intervention.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Svetkey 2008 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In Harvey-Berino 2002, attendance at treatment sessions was greater for the intensive in-person condition than the computer condition, and participants in the in-person condition also reported more peer-support contacts.

    “The authors reported that attendance at treatment sessions was greater for the intensive in-person condition than the computer condition, and participants in the in-person condition also reported more peer-support contacts.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Harvey-Berino 2002

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

    Findingown data

    No study included data on change in waist circumference in the minimal in-person control comparison.

    “No study included data on change in waist circumference.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    In Harvey-Berino 2002, the authors did not investigate whether there were any within-group relationships between dose of intervention and amount of weight lost.

    “The authors did not investigate whether there were any within-group relationships between dose of intervention and amount of weight lost.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Harvey-Berino 2002

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In Wing 2006, while attendance at both the in-person and the Internet chat-room sessions decreased over time, the percentage of sessions attended was significantly higher in the in-person group throughout the trial.

    “Wing 2006 reported that while attendance at both the in-person and the Internet chat-room sessions decreased over time, the percentage of sessions attended was significantly higher in the in-person group throughout the trial.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wing 2006 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    At 12 months, the computer group regained more weight than the face-to-face group, and the difference was near to statistical significance (MD 1.6 kg, 95% CI −0.1 to 3.2; P = 0.07; 955 participants; three trials).

    “At 12 months, the computer group regained more weight than the face-to-face group, and the difference was near to statistical significance (MD 1.6 kg (95% −0.1 to 3.2); P = 0.07; 955 participants; three trials; Analysis 6.2)”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Harvey-Berino 2002

      Not checked in the free run.

    • cites Svetkey 2008 source

      Not checked in the free run.

    • cites Wing 2006 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    When the two weight-loss trials that included only men (Morgan 2009; Morgan 2011) were analyzed together, the mean weight loss was larger than that of trials conducted in mixed-gender populations (3 kg versus 2 kg) but there was substantial heterogeneity in the analysis of men only (I2 = 60%).

    “When the two weight-loss trials that included only men (Morgan 2009; Morgan 2011) were analyzed together, the mean weight loss was larger than that of trials conducted in mixed-gender populations (3 kg versus 2 kg; Analysis 1.1; subgroup analyses 1.1.4 and 1.1.5) but there was substantial heterogeneity in the analysis of men only (I2 = 60%)”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Morgan 2009 source

      Not checked in the free run.

    • cites Morgan 2011

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    Harvey-Berino 2002 did not present data on change in waist circumference or health-related quality of life outcomes.

    “Harvey-Berino 2002 did not present data on change in waist circumference or health-related quality of life outcomes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Harvey-Berino 2002

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

    Findingown data

    No study included data on change in physical activity outcomes in the minimal in-person control comparison.

    “No study included data on change in physical activity outcomes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In Wing 2006, attendance at the chat-room sessions and the percentage of participants who reported their weight each week both decreased significantly over time (P < 0.001).

    “Wing 2006 measured attendance at the chat-room sessions and the percentage of participants who reported their weight each week, and both measures decreased significantly over time (P < 0.001).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wing 2006 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingcitation

    Information on costs was not collected in Harvey-Berino 2002.

    “Information on costs was not collected.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Harvey-Berino 2002

      Not checked in the free run.

  • The quote only partly states this claim.

    Findingown data

    No other study reported assessing for adverse effects of the intervention in the minimal in-person control comparison.

    “No other study reported assessing for adverse effects of the intervention.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

    Findingown data

    No study included data on health-related quality of life in the minimal in-person control comparison.

    “No study included data on health-related quality of life.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    In Svetkey 2008, participants in the computer-based intervention group had gained approximately one kg more than participants in the in-person intervention group at 30 months, and this difference was statistically significant (MD 1.2 kg, 95% CI 0.3 to 2.1; P = 0.009; 688 participants).

    “(at 30 months, MD 1.2 kg (95% CI 0.3 to 2.1); P = 0.009; 688 participants; Analysis 6.5).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Svetkey 2008 source

      Not checked in the free run.

  • May combine two claims.

    Findingcitation

    In Svetkey 2008, at 30 months, the computer intervention group took in slightly more calories than the in-person intervention group but this was not statistically significant (MD 39 kcal/day, 95% CI −45 to 123; P = 0.36; 688 participants).

    “At 30 months, the computer intervention group took in slightly more calories than the in-person intervention group but this was not statistically significant (MD 39 kcal/day (95% CI −45 to 123); P = 0.36; 688 participants; Analysis 6.7).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Svetkey 2008 source

      Not checked in the free run.

  • May combine two claims.

    Findingnone given

    The number of trials available for analysis was small for all outcomes, and subgroup analyses by age group and overweight versus obesity could not be performed.

    “The number of trials available for analysis was small for all outcomes, and subgroup analyses by age group and overweight versus obesity could not be performed.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    When sensitivity analyses omitting the sole quasi-randomized trial (Schroder 2010) or the oldest randomized and the sole non-published trial (Threlfall 1984), or both, heterogeneity decreased but the results were consistent with the original analyses.

    “When we conducted sensitivity analyses omitting the sole quasi-randomized trial (Schroder 2010) or the oldest randomized and the sole non-published trial (Threlfall 1984), or both, heterogeneity decreased but the results were consistent with the original analyses.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Schroder 2010 source

      Not checked in the free run.

    • cites Threlfall 1984

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    For maintenance of weight loss, both minimal (once per month or less) and intensive (more often than once per month) in-person interventions outperformed computer-based interventions.

    “For maintenance of weight loss, both minimal (once per month or less) and intensive (more often than once per month) in-person interventions outperformed computer-based interventions.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In this review, the studies that examined cost-effectiveness observed relatively high levels of cost effectiveness, and the single study comparing the cost-effectiveness of an in-person and a computer-based intervention found the computer-based intervention more cost-effective.

    “In the present review, however, the studies that examined cost-effectiveness observed relatively high levels of cost effectiveness, and the single study comparing the cost-effectiveness of an in-person and a computer-based intervention found that the computer-based intervention was more cost-effective.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    When the cluster-randomized studies (Cussler 2008; Morgan 2011) were omitted from analyses, there were not large differences in the estimate of effect or the statistical significance of those analyses, with two exceptions.

    “When we omitted the cluster-randomized studies (Cussler 2008; Morgan 2011) from analyses, there were not large differences in the estimate of effect or the statistical significance of those analyses, with two exceptions.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Cussler 2008 source

      Not checked in the free run.

    • cites Morgan 2011

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    While the review had hoped to conduct sensitivity analyses on additional factors (e.g. language of publication), included studies possessed insufficient variability in those factors to allow performance of sensitivity analyses.

    “Also, while we had hoped to conduct sensitivity analyses on additional factors (e.g. language of publication), included studies possessed insufficient variability in those factors to allow performance of sensitivity analyses.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In the analysis of change in weight maintenance at 12 months, the omission of Cussler 2008 did not change the pooled effect estimate of 0.8 kg, but altered the statistical significance from P = 0.01 to P = 0.08.

    “In the analysis of change in weight maintenance at 12 months (Analysis 5.2), the omission of Cussler 2008 from the analysis did not change the pooled effect estimate of 0.8 kg, but altered the statistical significance from P = 0.01 to P = 0.08.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cussler 2008 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Omitting the one very large trial (Wing 2006) from weight maintenance analyses did not make large differences to the estimate of effect or the statistical significance of those analyses.

    “Likewise, omitting the one very large trial (Wing 2006) from weight maintenance analyses did not make large differences to the estimate of effect or the statistical significance of those analyses.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wing 2006 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Computer-based interventions have a positive effect on short-term weight loss and short-term weight loss maintenance.

    “The findings of this review demonstrate that computer-based interventions have a positive effect on short-term weight loss and short-term weight loss maintenance.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingreasoning

    With the exception of one study examining a computer-based group chat intervention and a non-directive counseling arm in a second study, interactive computer-based interventions were consistently more effective than minimal interventions and less effective than in-person contacts for weight loss and weight maintenance.

    “With the exception of one study examining a computer-based group chat intervention, and a non-directive counseling arm in a second study, interactive computer-based interventions were consistently more effective than minimal interventions and less effective than in-person contacts for weight loss and weight maintenance.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In the analysis of change in waist circumference at six months, the omission of Morgan 2011 reduced the pooled effect size although the difference between intervention groups remained near statistical significance (P = 0.08 versus P = 0.07).

    “In the analysis of change in waist circumference at six months, the omission of Morgan 2011 from the analysis (Analysis 1.9: sensitivity analysis 1.9.2) reduced the pooled effect size although the difference between intervention groups remained near statistical significance (P = 0.08 versus P = 0.07).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Morgan 2011

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Interactive computer-based interventions are more effective than a minimal or no treatment control but are not more effective than in-person treatments, even when the in-person contacts are infrequent.

    “While interactive computer-based interventions appear to be more effective than a minimal or no treatment control, they do not appear to be more effective than in-person treatments, even in cases where the in-person contacts are infrequent.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Few studies included cost information, making conclusions about cost-effectiveness difficult.

    “Few studies included cost information, making conclusions about cost-effectiveness difficult.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Tate and colleagues observed an average monthly login of greater than 20 in months one to three and fewer than 10 in months 10 to 12.

    “For example, Tate and colleagues observed an average monthly login of greater than 20 in months one to three and fewer than 10 in months 10 to 12 (Tate 2003).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Tate 2003 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    For weight maintenance, computer-based interventions are more effective than no treatment but less effective than face-to-face interventions.

    “Similarly, while there is less available evidence on the effects of interactive computer-based interventions for weight maintenance, this review suggests that here too, computer-based interventions are more effective than no treatment but less effective than face-to-face interventions.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingnone given

    Only one study (Wylie-Rosett 2001) examined 12-month outcomes versus minimal treatment and only one study (Tate 2003) examined 12-month outcomes as an adjunct to an Internet intervention.

    “Only one study (Wylie-Rosett 2001) examined 12-month outcomes versus minimal treatment and only one study (Tate 2003) examined 12-month outcomes as an adjunct to an Internet intervention.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Wylie-Rosett 2001 source

      Not checked in the free run.

    • cites Tate 2003 source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    Interactive computer-based programs are effective weight loss interventions, and e-mailed or automated counseling increase the effectiveness of computer-based interventions, although the value of online group chats is unclear.

    “This review indicates that interactive computer-based programs are effective weight loss interventions, and that e-mailed or automated counseling increase the effectiveness of computer-based interventions, although the value of online group chats is unclear.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Two authors independently scanned abstracts/titles for study selection.

    “two authors (KJT and LF for the original search results, and LF and LSW for the updated search results) independently scanned the abstract, title or both sections of every record retrieved.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Two review authors independently abstracted relevant population and intervention characteristics.

    “Two review authors (LSW, SBF) independently abstracted relevant population and intervention characteristics using standard data extraction templates”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Compared to no intervention or minimal interventions (pamphlets, usual care), interactive computer-based interventions are an effective intervention for weight loss and weight maintenance.

    “Compared to no intervention or minimal interventions (pamphlets, usual care), interactive computer-based interventions are an effective intervention for weight loss and weight maintenance.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The review assessed risk of bias using the Cochrane Collaboration's tool.

    “We assessed risk of bias using the Cochrane Collaboration’s tool (Higgins 2009)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Higgins 2009

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The amount of additional weight loss from interactive computer-based interventions is relatively small and of brief duration.

    “The amount of additional weight loss, however, is relatively small and of brief duration”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    Two authors independently extracted study data and assessed risk of bias.

    “Two authors independently extracted study data and assessed risk of bias.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Compared to in-person interventions, interactive computer-based interventions result in smaller weight losses and lower levels of weight maintenance.

    “Compared to in-person interventions, interactive computer-based interventions result in smaller weight losses and lower levels of weight maintenance.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The review measured interrater agreement for study selection using the kappa statistic.

    “We measured interrater agreement for study selection using the kappa statistic (Cohen 1960).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cohen 1960 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Two authors assessed each trial independently for risk of bias.

    “Two authors (KJT, LF) assessed each trial independently.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    A Cochrane systematic review concluded that in people with chronic diseases, interactive health communication applications can help increase knowledge and social support and result in improved behavioral and clinical outcomes.

    “A Cochrane systematic review concluded that in people with chronic diseases, interactive health communication applications can help increase knowledge and social support and result in improved behavioral and clinical outcomes (Murray 2005).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Murray 2005 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Rates of weight loss are rapid in the initial six months, after which point a significantly slower process of weight regain typically occurs.

    “Rates of weight loss are rapid in the initial six months, after which point a significantly slower process of weight regain typically occurs (Franz 2007).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Franz 2007 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Overweight and obesity increase the risks for many chronic medical conditions, including diabetes, heart disease, hypertension and stroke.

    “Overweight and obesity increase the risks for many chronic medical conditions, including diabetes, heart disease, hypertension and stroke (National Institutes of Health 2000)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites National Institutes of Health 2000

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Obesity accounts for 2% to 6% of total healthcare costs in several developed countries; some estimates put the figure as high as 7%.

    “Obesity accounts for 2% to 6% of total healthcare costs in several developed countries; some estimates put the figure as high as 7% (Withrow 2011).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Withrow 2011 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    What was learned in studies that used interactive computer-tailored messages stored locally is important for understanding what types of interactive interventions are effective.

    “For that reason, what was learned in studies that used interactive computer-tailored messages stored locally is important for understanding what types of interactive interventions are effective.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Modest reductions in weight can lead to important health benefits.

    “though modest reductions in weight can lead to important health benefits (Pi-Sunyer 2007; Stevens 2001).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Pi-Sunyer 2007 source

      Not checked in the free run.

    • cites Stevens 2001 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The results of the National Weight Control Registry indicate four types of behavior common to the National Weight Control Registry participants: eating a low-fat, high-carbohydrate diet; eating breakfast almost every day; frequent self monitoring of weight; and participation in a high level of physical activity.

    “The results of the National Weight Control Registry (Wing 2005) indicate four types of behavior common to the National Weight Control Registry participants:”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wing 2005 source

      Not checked in the free run.

  • May combine two claims.

    Premisereasoning

    Although the practices that contribute to weight loss and weight loss maintenance are hypothesized to be the same, the rates of weight change are very different in weight loss versus weight loss maintenance studies, making them difficult to combine statistically.

    “The rationale for this was that, although the practices that contribute to weight loss and weight loss maintenance are hypothesized to be the same (Rothman 2000; Rothman 2009), the rates of weight change are very different in weight loss versus weight loss maintenance studies, making them difficult to combine statistically.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Rothman 2000 source

      Not checked in the free run.

    • cites Rothman 2009 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The review analyzed the e-mail counseling and automated feedback both combined and separately.

    “We analyzed the e-mail counseling and automated feedback both combined and separately.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Most of the studies that have utilized the Internet could have been performed using computer-tailored messages stored on the computer's hard drive, rather than on a server at some distant location.

    “This distinction is important as most of the studies that have utilized the Internet could have been performed using computer-tailored messages stored on the computer’s hard drive, rather than on a server at some distant location.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Websites that attract enough users can be provided at no cost to those users and remain profitable when supported by advertising.

    “Websites that attract enough users can be provided at no cost to those users and remain profitable when supported by advertising (Meenan 2009; Miller 2008; Mitchell 2008).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Meenan 2009

      Not checked in the free run.

    • cites Miller 2008

      Not checked in the free run.

    • cites Mitchell 2008

      Not checked in the free run.

  • May combine two claims.

    Premisereasoning

    Most studies that focus on weight loss maintenance enroll people after the period of most rapid weight regain (months six to 12), so that the rate of regain in those studies is, on average, even slower.

    “Most studies that focus on weight loss maintenance enroll people after the period of most rapid weight regain (months six to 12), so that the rate of regain in those studies is, on average, even slower.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductreasoning

    The review combined the two computer intervention arms for main analyses and conducted sensitivity analyses omitting the arms with the in-person treatment component.

    “We therefore combined the two computer intervention arms for our main analyses, and conducted sensitivity analyses omitting the arms with the in-person treatment component.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The World Health Organization estimates that the number of overweight and obese individuals worldwide will increase from 1 billion in 2010 to 1.5 billion in 2015.

    “The World Health Organization estimates that, without action, the number of overweight and obese individuals worldwide will increase from 1 billion in 2010 to 1.5 billion in 2015 (World Health Organization 2011).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites World Health Organization 2011

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    The review analyzed directive and non-directive e-mail coaching separately because they were based upon different theoretical approaches to counseling and the trial found important differences in the efficacy of the two conditions.

    “We analyzed the directive and non-directive e-mail coaching separately because they were based upon different theoretical approaches to counseling and the trial found important differences in the efficacy of the two conditions.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationreasoning

    Most of what is available in interactive interventions has been a computerization of what is available face-to-face.

    “Most of what is available, therefore, in interactive interventions has been a computerization of what is available face-to-face.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The review analyzed the e-mail counseling trials and the group chats trial separately.

    “We analyzed the e-mail counseling trials (Gabriele 2011; Tate 2001; Tate 2003; Tate 2006) and the group chats trial (Webber 2008) separately.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Computer and web-based interventions have the potential to be cost-effective or even free to the end-user, supported by advertising.

    “As computer and web-based interventions have the potential to be cost-effective or even free to the end-user, supported by advertising, they have the potential for a significant public health impact (Mitchell 2008; Tate 2009).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Mitchell 2008

      Not checked in the free run.

    • cites Tate 2009 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The kappa statistic for trial selection was 0.61 (95% CI 0.42 to 0.80).

    “The kappa statistic for trial selection was 0.61 (95% confidence interval (CI) is 0.42 to 0.80).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Computer and/or Internet-based interventions are associated with improved knowledge and/or behavioral outcomes.

    “Consequently, computer and/or Internet-based interventions are associated with improved knowledge and/ or behavioral outcomes (Wantland 2004).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Wantland 2004 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The review calculated interrater agreement for key bias indicators using the kappa statistic.

    “We calculated interrater agreement for key bias indicators (e.g. allocation concealment, incomplete outcome data) using the kappa statistic (Cohen 1960).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cohen 1960 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In Foster behavioral treatment, weight loss is approximately 10 kg during the first six months of treatment, yet a recent weight loss maintenance study by Perri and colleagues observed a weight regain of only 3.7 kg in the control group over 12 months.

    “For example, in Foster behavioral treatment produces weight loss of approximately 10 kg during the first six months of treatment (Foster 2005), yet a recent weight loss maintenance study by Perri and colleagues observed a weight regain of only 3.7 kg in the control group over 12 months (Perri 2008).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Foster 2005 source

      Not checked in the free run.

    • cites Perri 2008 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Svetkey 2008 used multiple imputation to replace missing end-of-study weights, missing interim weights and other measures (apart from weights missing due to participant death).

    “Svetkey 2008 used multiple imputation to replace missing end-of-study weights, missing interim weights and other measures (apart from weights missing due to participant death).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Svetkey 2008 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    Tate 2006 also used last observation carried forward, expectation maximization and regression to impute missing values, and stated that the pattern of statistical significance using observed data and imputed data was identical with all methods.

    “Tate 2006 also used last observation carried forward, expectation maximization and regression to impute missing values, and stated that the pattern of statistical significance using observed data and imputed data was identical with all methods.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Tate 2006 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Research team members were blind to the type of intervention assignments in the Schroder 2010 study.

    “Research team members were blind to the type of intervention assignments in the Schroder 2010 study.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Schroder 2010 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given

    Participants were aware of randomization assignment, but their knowledge of the other interventions is unclear.

    “Participants were aware of randomization assignment, but their knowledge of the other interventions is unclear.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    Bennett 2010; Cussler 2008; Gabriele 2011; Harvey-Berino 2002; Harvey-Berino 2010; Hunter 2008; Morgan 2011; Tate 2001; Tate 2003 and Tate 2006 all used a baseline observation carried forward approach (BOCF).

    “Bennett 2010; Cussler 2008; Gabriele 2011; Harvey-Berino 2002; Harvey-Berino 2010; Hunter 2008; Morgan 2011; Tate 2001; Tate 2003 and Tate 2006 all used a baseline observation carried forward approach (BOCF).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    Morgan 2011 stated that participants and assessors were blind to treatment allocation at baseline, but did not report whether they were still blinded at follow-up.

    “Morgan 2011 stated that participants and assessors were blind to treatment allocation at baseline, but did not report whether they were still blinded at follow-up.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Morgan 2011

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    Wylie-Rosett 2001 reported that the study completers did not differ significantly from the dropouts with respect to baseline characteristics, but did not otherwise state how missing data were handled.

    “Wylie-Rosett 2001 reported that the study completers did not differ significantly from the dropouts with respect to baseline characteristics, but did not otherwise state how missing data were handled.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wylie-Rosett 2001 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Interrater agreement for risk of bias assessment was measured as 0.51 using the kappa statistic.

    “Interrater agreement for risk of bias assessment was measured as 0.51 using the kappa statistic (Cohen 1960).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cohen 1960 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The Tate 2006 study reported that non-intervention staff weighed participants at baseline and at three and six months, but there is no specific statement of whether or not they were blinded.

    “The Tate 2006 study reported that non-intervention staff weighed participants at baseline and at three and six months, but there is no specific statement of whether or not they were blinded.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Tate 2006 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    DeLucia 1988 and Threlfall 1984 presented data for completers only and did not use any methods to handle missing data.

    “DeLucia 1988 and Threlfall 1984 presented data for completers only and did not use any methods to handle missing data.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites DeLucia 1988 source

      Not checked in the free run.

    • cites Threlfall 1984

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    It was stated that human e-counselors were blinded to the algorithms used to program the automated feedback counselor, but it is unclear whether they were aware of assignment of participants across all three groups.

    “It was stated that human e-counselors were blinded to the algorithms used to program the automated feedback counselor, but it is unclear whether they were aware of assignment of participants across all three groups.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Morgan 2009 used linear mixed models to assess the primary analysis of effects of losses to follow-up.

    “Morgan 2009 used linear mixed models to assess the primary analysis of effects of losses to follow-up.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Morgan 2009 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    The Morgan 2009 trial reported that participants were blind to group allocation at baseline assessment and that assessors were blinded to treatment allocation at all points.

    “The Morgan 2009 trial reported that participants were blind to group allocation at baseline assessment and that assessors were blinded to treatment allocation at all points.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Morgan 2009 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Hunter 2008 stated that the study could not be blinded.

    “Hunter 2008 stated that the study could not be blinded.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hunter 2008 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    One trial (Schroder 2010) was a quasi-randomized controlled trial which assigned every third participant, hence investigators and participants could potentially have foreseen assignments and the review judged that allocation was not adequately concealed.

    “One trial (Schroder 2010) was a quasi-randomized controlled trial which assigned every third participant, hence investigators and participants could potentially have foreseen assignments and we judged that allocation was not adequately concealed.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Schroder 2010 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Bennett 2010 stated that research staff collecting evaluation data were blinded to randomization status.

    “Bennett 2010 stated that research staff collecting evaluation data were blinded to randomization status.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bennett 2010 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    One trial (Bennett 2010) did not describe the method of randomization, but did state that assignments were enclosed in nontransparent envelopes, and the review judged that allocation was adequately concealed.

    “One trial (Bennett 2010) did not describe the method of randomization, but did state that assignments were enclosed in nontransparent envelopes, and we therefore judged that allocation was adequately concealed.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Bennett 2010 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Schroder 2010 replaced missing data points with pre-intervention scores.

    “Schroder 2010 replaced missing data points with pre-intervention scores.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Schroder 2010 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Six of the included studies had protocols; the primary outcome in the protocol was the same as the primary outcome in the methods section for each of these studies, and based on the available information all the trials appear to be free of selective reporting.

    “Six of the included studies had protocols: Harvey-Berino 2010; Morgan 2009; Morgan 2011; Svetkey 2008; Tate 2006; Wing 2006. The primary outcome in the protocol was the same as the primary outcome in the methods section for each of these studies. Based on the available information all the trials appear to be free of selective reporting.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    In Gabriele 2011 participants were reported to be blinded to treatment condition.

    “In Gabriele 2011 participants were reported to be blinded to treatment condition.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Gabriele 2011 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All other studies used an intention-to-treat analysis.

    “All other studies used an intention-to treat analysis.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The interrater agreement measure relates only to the 15 included studies retrieved from the original search results; the measure was not recalculated to incorporate the three studies from the updated search in 2011.

    “This measure relates only to the 15 included studies retrieved from the original search results; the measure was not recalculated to incorporate the three studies from the updated search in 2011.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The in-person intervention in Harvey-Berino 2010 cost EUR 549 to deliver and led to an average weight loss of 8.2%.

    “The Internet intervention cost EUR 288 per participant and led to a loss of 5.6% of body weight, while the in-person intervention in the same trial cost EUR 549 to deliver and led to an average weight loss of 8.2% (Harvey-Berino 2010; Krukowski 2010).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Harvey-Berino 2010 source

      Not checked in the free run.

    • cites Krukowski 2010

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    There were no outcomes examined at the same time point in more than one study, therefore the review performed no meta-analyses for dietary outcomes.

    “There were no outcomes examined at the same time point in more than one study, therefore we performed no meta-analyses.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The intervention from Threlfall cost EUR 55.6 per participant and led to an average participant loss of 4.8% of body weight (based on 2010 Euros).

    “Based on 2010 Euros, the intervention from Threlfall cost EUR 55.6 per participant and led to an average participant loss of 4.8% of body weight.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Threlfall 1984

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The Internet intervention in Harvey-Berino 2010 cost EUR 288 per participant and led to a loss of 5.6% of body weight.

    “The Internet intervention cost EUR 288 per participant and led to a loss of 5.6% of body weight, while the in-person intervention in the same trial cost EUR 549 to deliver and led to an average weight loss of 8.2% (Harvey-Berino 2010; Krukowski 2010).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Harvey-Berino 2010 source

      Not checked in the free run.

    • cites Krukowski 2010

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The intervention from Wylie-Rosett and colleagues cost EUR 38.6 per participant and led to an average participant loss of 4.0% of body weight.

    “The intervention from Wylie-Rosett and colleagues cost EUR 38.6 per participant and led to an average participant loss of 4.0% of body weight.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wylie-Rosett 2001 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Because follow-up in Tate 2001 was above 80% at three months and less than 80% at six months, only the data from the three-month follow-up were eligible for inclusion in this review.

    “Because follow-up in Tate 2001 was above 80% at three months follow-up and less than 80% at six months follow-up, only the data from the three-month follow-up were eligible for inclusion in this review.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Tate 2001 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The effects in individual trials, while small and varying in size and statistical significance, were consistently in favor of the face-to-face intervention.

    “However, the effects in individual trials, while small and varying in size and statistical significance, were consistently in favor of the face-to-face intervention.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The McMaster University Online Rating of Evidence uses 80% follow-up of a randomized controlled trial as a criterion for scientific merit, and the DynaMed Level of Evidence scheme uses 80% follow-up of trial participants as a criterion for Level 1 (likely reliable) evidence.

    “The McMaster University Mc-Master Online Rating of Evidence (Health Information Research Unit) uses 80% follow-up of a randomized controlled trial as a criterion for scientific merit (CITE) and the DynaMed Level of Evidence scheme uses 80% follow-up of trial participants as a criterion for Level 1 (likely reliable) evidence (DynaMed).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites CITE

      Not checked in the free run.

    • cites DynaMed

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    Because it is common for behavioral intervention trials to experience large losses to follow-up, the 80% follow-up exclusion lowered the number of trials in this review, reduced the total amount of information available for review outcomes, and decreased the power of reported meta-analyses.

    “However, because it is common for behavioral intervention trials to experience large losses to follow-up, the effect of this exclusion was to lower the number of trials in this review, reduce the total amount of information available for review outcomes, and decrease the power of reported meta-analyses.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: It is common for behavioral intervention trials to experience large losses to follow-up.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The criterion of 80% follow-up has been used as a quality criterion by some organizations assessing evidence from randomized controlled trials.

    “The criterion of 80% follow-up has been used as a quality criterion by some organizations assessing evidence from randomized controlled trials.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Cost-effectiveness analyses are often done from the perspective of the employer or the managed care organization, who pay for a large percentage of care in the U.S., and such organizations pay very little for the direct care of overweight and obesity, other than for surgery.

    “In addition, while these analyses are often done from the perspective of the employer or the managed care organization, who pay for a large percentage of care in the U.S., such organizations pay very little for the direct care of overweight and obesity, other than for surgery (Wylie-Rosett 2001).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wylie-Rosett 2001 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Most randomized trials did not give details about the methods of randomization, and the review was uncertain about the concealment of allocation to treatment and the blinding of outcome assessors in many of the included trials.

    “Most randomized trials did not give details about the methods of randomization, and we were uncertain about the concealment of allocation to treatment and the blinding of outcome assessors in many of the included trials.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Over the past decade, end-users are being provided more and more services for free online and in mobile applications, their costs being offset by revenue from advertising.

    “Over the past decade, end-users are being provided more and more services for free online and in mobile applications, their costs being offset by revenue from advertising (Miller 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Miller 2008

      Not checked in the free run.

  • May combine two claims.

    Study design and conductnone given

    Incomplete outcome reporting was considered a risk in only one trial, and selective reporting and other sources of potential bias were not observed.

    “Incomplete outcome reporting was only considered to be a risk in one trial, and selective reporting and other sources of potential bias were not observed.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In 2010 Arem and Irwin published a systematic review that included nine studies.

    “In 2010 Arem and Irwin published a systematic review that included nine studies (Arem 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Arem 2010

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    The review's inclusion criterion of 80% or greater follow-up was intended to ensure that included trials were of good quality.

    “Our inclusion criterion of 80% or greater follow-up was intended to ensure that included trials were of good quality.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    Because interactive technologies change quickly, it is quite likely that what is reviewed here will be quite different from the trials reviewed 10 years from now.

    “Finally, interactive technologies change quickly, so it is quite likely that what is reviewed here will be quite different from the trials reviewed 10 years from now.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    When there are fewer than 10 studies in a comparison, it is difficult to assess asymmetry by visual examination, and the power of the funnel plot test is too low to distinguish chance from real asymmetry.

    “When there are fewer than 10 studies in a comparison, it is difficult to assess asymmetry by visual examination, and the power of the funnel plot test is too low to distinguish chance from real asymmetry (Higgins 2009, Chapter 10).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Higgins 2009

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    Given the small number of studies (18 total) and the many permutations of intervention goal, intervention components, control condition and timing, firm conclusions were hard to make and were typically based on a relatively small number of studies.

    “Given the small number of studies (18 total) and the many permutations of intervention goal, intervention components, control condition and timing, firm conclusions were hard to make and were typically based on a relatively small number of studies.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The results of this review are similar to those of other recent reviews.

    “These results are similar to those of other recent reviews (Neve 2010; Reed 2012).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Neve 2010 source

      Not checked in the free run.

    • cites Reed 2012 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Because there were five or fewer studies in all meta-analyses, the review did not construct funnel plots to examine for publication and small study bias.

    “Because there were five or fewer studies in all meta-analyses, we did not construct funnel plots to examine for publication and small study bias.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    Due to the complexities of costs and the shifting epidemiology and treatment options for obesity, conclusions from cost-effectiveness studies in obesity treatment, even well-done ones, can be challenging to make.

    “Due to these complexities, conclusions from cost-effectiveness studies in obesity treatment, even well-done ones, can be challenging to make in the ever-shifting landscape of the epidemiology and treatment options for obesity.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    To date, two systematic reviews have been published that examine the impact of web-based weight control programs among adults.

    “To date, two systematic reviews have been published that examine the impact of web-based weight control programs among adults (Arem 2010; Neve 2010).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Arem 2010

      Not checked in the free run.

    • cites Neve 2010 source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The amount of additional weight loss from in-person versus computer-based interventions is relatively small and of brief duration, making the clinical significance of these differences unclear.

    “The amount of additional weight loss, however, is relatively small and of brief duration, making the clinical significance of these differences unclear.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In 2011, the U.S. Food and Drug Administration lowered the body mass index threshold for use of laparoscopic band procedures for those with obesity-related conditions, from a previous BMI of 35 kg/m2 to 30 kg/m2.

    “Furthermore, in 2011, the U.S. Food and Drug Administration (FDA) lowered the body mass index (BMI) threshold for use of laparoscopic band procedures for those with obesity-related conditions, from a previous BMI of 35 kg/m2 to 30 kg/m2 (Corbett Dooren 2011)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Corbett Dooren 2011

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The rates of surgical treatment of obesity can be expected to increase.

    “so the rates of surgical treatment of obesity can be expected to increase”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Neve and colleagues observed that login frequency was associated with impact, consistent with what has been observed in a number of the individual trials in this review.

    “Neve and colleagues observed that login frequency was associated with impact, consistent with what has been observed in a number of the individual trials in this review (Cussler 2008; Harvey-Berino 2004; Tate 2001; Tate 2003; Womble 2004).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Cussler 2008 source

      Not checked in the free run.

    • cites Harvey-Berino 2004 source

      Not checked in the free run.

    • cites Tate 2001 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    The review confirmed with the author of Morgan 2011 that the means in Table 5 were adjusted for clustering and used those statistics and sample sizes without further adjustment.

    “We contacted the author to confirm that data presented in the publication were adjusted for clustering. On 4 September 2011 we received an e-mail stating that “[T]he means in Table 5 are adjusted for clustering.” We therefore used the statistics and sample sizes in Table 5 for our analyses without further adjustment”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Harvey-Berino 2002 was at unclear risk of performance and detection bias from blinding because it was not reported.

    “Blinding (performance bias and detection bias)All outcomes | Unclear risk | Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Harvey-Berino 2010 was at low risk of selection bias from random sequence generation because participants were randomized using a biased coin approach.

    “Participants were randomized using a biased coin approach”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Harvey-Berino 2010 was at unclear risk of selection bias from allocation concealment because it was not reported.

    “Allocation concealment (selection bias) | Unclear risk | Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Gabriele 2011 was at unclear risk of selection bias from allocation concealment because it was not reported.

    “Allocation concealment (selection bias) | Unclear risk | Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The review authors contacted the author of Gabriele 2011 to obtain the sample size for each intervention group and received this information on 2 April 2010.

    “We contacted the author to obtain the sample size for each intervention group and received a reply with this information on 2 April 2010”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Arem and Irwin observed a wide range of weight losses and made few conclusions, in part because the interventions differed so greatly and treatment adherence rates were low.

    “The authors observed a wide range of weight losses and made few conclusions, in part because the interventions differed so greatly and treatment adherence rates were low (Arem 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Arem 2010

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Harvey-Berino 2010 was at unclear risk of performance and detection bias from blinding because it was not reported.

    “Blinding (performance bias and detection bias)All outcomes | Unclear risk | Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The review calculated the correlation coefficient from the weight loss study Hunter 2008 and used it to impute the missing standard deviation for the change from baseline.

    “We calculated the correlation coefficient from a weight loss study in this review (Hunter 2008) reporting standard deviations for baseline, endpoint and change values of weight, and used the calculated correlation coefficient to impute the missing standard deviation for the change from baseline”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Hunter 2008 source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Harvey-Berino 2002 was at low risk of attrition bias; 100 of 122 participants completed at 6 months, 92 of 122 at 18 months, 90 of 122 had complete data, and both intention-to-treat and complete-case analyses were used.

    “100 out of 122 participants completed the study at 6 months92 out of 122 participants completed the study at 18 months90 out of 122 participants had complete data for all measuresData were examined using both an intention- to-treat analysis and with those having complete data for all measures (90)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The review observed heterogeneity across studies in how adherence to the intervention is expressed, allowing general observations about patterns but making specific conclusions about intervention usage over time difficult.

    “We observed heterogeneity across studies in how adherence to the intervention is expressed, allowing us to make general observations about patterns but making specific conclusions about intervention usage over time difficult.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Gabriele 2011 was at unclear risk of selection bias from random sequence generation because participants were stated to be stratified on sex and weight and randomly assigned, but the method of randomization was not stated.

    “States participants were stratified on sex and weight and randomly assigned, but details of method of randomization not stated”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Hunter 2008 was at low risk of selection bias from random sequence generation because randomization was conducted using a random-numbers table.

    “Randomization was conducted using a random-numbers table”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Harvey-Berino 2002 was at low risk of reporting bias because all of the outcomes listed in the methods section were reported as results.

    “All of the outcomes listed in the methods section were reported as results”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    It is not clear whether these interventions would have the same level of impact if integrated into routine primary care settings.

    “so it is not clear whether these interventions would have the same level of impact if integrated into routine primary care settings.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Gabriele 2011 was at low risk of attrition bias; one participant in each of the 3 treatment groups was lost due to reported work or scheduling conflicts.

    “One participant in each of the 3 treatment groups due to reported work or scheduling conflicts”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Gabriele 2011 was at unclear risk of performance and detection bias from blinding because it was not reported.

    “Blinding (performance bias and detection bias)All outcomes | Unclear risk | Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Harvey-Berino 2002 was at unclear risk of selection bias from random sequence generation because it was randomized but the method was not stated.

    “randomized, but method not stated”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In 2010, Neve and colleagues published a review that included 20 studies.

    “In 2010, Neve and colleagues published a review that included 20 studies (Neve 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Neve 2010 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In Neve and colleagues' review, the heterogeneity of the research questions posed and study designs, coupled with the small number of studies, made conclusions difficult.

    “Although this review compared a greater number of studies, the heterogeneity of the research questions posed and study designs, coupled with the small number of studies made conclusions difficult (Neve 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Neve 2010 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    For Harvey-Berino 2002, the review was unable to obtain author response on 12-month weight maintenance outcomes and therefore extracted data for overall change between the start of the 6-month weight loss segment and the end of the 12-month weight loss segment.

    “In August 2010 we e-mailed the author for information on weight maintenance outcomes at 12 months of maintenance. We were unable to obtain any response and therefore extracted data for overall change between the start of the 6-month weight loss segment of the trial and the end of the 12-month weight loss segment of the trial”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    The weight loss observed in the analyses comparing computer-based interventions to minimal or no treatment controls is likely clinically significant on an individual and public health level, though weight regain will limit the impact of this benefit.

    “It is likely, therefore, that the weight loss observed in the analyses comparing computer-based interventions to minimal or no treatment controls is clinically significant on an individual and public health level, though weight regain will limit the impact of this benefit.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The review authors contacted the author of Schroder 2010 to obtain the sample size for each intervention group and received this information on 2 April 2010.

    “We contacted the author to obtain the sample size for each intervention group and received a reply with this information on 2 April 2010”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The review obtained the confidence interval for weight loss in the control group of Morgan 2011 from the author (95% CI -1.017 to 1.7) on 25 August 2011.

    “We e-mailed the author for information about the confidence interval for weight loss in the control group of the trial, and received a reply with the requested information (95% CI-1.017 to 1.7) on 25 August 2011”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    For weight outcomes, the review calculated the change from baseline following the procedures in Chapter 16 of the Cochrane Handbook for Systematic Reviews of Interventions.

    “For weight outcomes, we calculated the change from baseline following procedures in Chapter 16 of the Cochrane Handbook for Systematic Reviews of Interventions (Higgins 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Higgins 2009

      Not checked in the free run.

  • May combine two claims.

    Study design and conductown data

    Harvey-Berino 2010 was at low risk of attrition bias; 150 of 158 in the In-Person group, 153 of 162 in the Hybrid group, and 159 of 161 in the Internet group completed the study at 6 months.

    “150 out of 158 participants randomized to the In-Person group completed the study at 6 months153 out of 162 participants randomized to the Hybrid group completed the study at 6 months159 out of 161 participants randomized to the Internet group completed the study at 6 months”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Harvey-Berino 2002 was at unclear risk of selection bias from allocation concealment because it was not reported.

    “Allocation concealment (selection bias) | Unclear risk | Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Hunter 2008 was at unclear risk of selection bias from allocation concealment because it was not reported.

    “Allocation concealment (selection bias) | Unclear risk | Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Gabriele 2011 was at low risk of reporting bias because all of the outcomes listed in the methods section were reported as results.

    “All of the outcomes listed in the methods section were reported as results”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The included study was judged at low risk of reporting bias because all outcomes mentioned in the methods section were reported as results.

    “Selective reporting (reporting bias) | Low risk | All outcomes mentioned in the methods section were reported as results”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Morgan 2011 was at low risk of selection bias from allocation concealment because randomization and participant study arm assignment were completed by a researcher not involved in participant assessment and the allocation sequence was concealed when enrolling participants.

    “Randomization and participant study arm assignment completed by a researcher not involved in participant assessment, and allocation sequence concealed when enrolling participants”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Webber 2008, selective reporting was judged at low risk of reporting bias because all outcomes mentioned in the methods section were reported as results.

    “All outcomes mentioned in the methods section were reported as results”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In the first included study, selective reporting was judged at low risk of reporting bias because all outcomes mentioned in the methods section were reported as results.

    “All outcomes mentioned in the methods section were reported as results”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Wing 2006, random sequence generation was judged at unclear risk of selection bias because the method of randomization was not stated.

    “randomized, but method not stated”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The included study was judged at low risk of other bias.

    “Other bias | Low risk |”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Tate 2001, random sequence generation was judged at unclear risk of selection bias because the method of randomization was not stated.

    “randomized, but method not stated”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In Svetkey 2008, incomplete outcome data was judged at low risk of attrition bias; 320/342 self-directed, 323/348 interactive technology, and 321/342 personal-contact participants completed 30-month follow-up, and multiple imputation was used for missing data.

    “320 out of 342 randomized to the self directed weight loss maintenance arm completed the study at 30-month follow-up323 out of 348 randomized to the interactive technology arm completed the study at 30-month follow-up321 out of 342 randomized to the personal-contact arm completed the study at 30-month follow-up”
    • Also stated in: § Characteristics of included studies [ordered by study ID] · plain
      “Multiple imputation used to replace missing end-of-study weights, missing interim weights and other measures (apart from weights missing due to participant death). All randomized surviving participants included in primary outcome analysis”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Webber 2008, random sequence generation was judged at unclear risk of selection bias because it was not reported.

    “Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Threlfall 1984, incomplete outcome data was judged at unclear risk of attrition bias because reasons for attrition were not explored and it was unclear whether attrition was related to outcome.

    “Reasons for attrition were not explored, with exception of one participant who became pregnant. It is unclear whether the reasons for attrition could be related to outcome”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Threlfall 1984, allocation concealment was judged at unclear risk of selection bias because it was not reported.

    “Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Morgan 2011 was at unclear risk of other bias specific to cluster-randomized trials, chiefly because the report did not provide details of the cluster-randomization procedure so prior knowledge of cluster assignment could not be absolutely ruled out.

    “Risks of bias specific to cluster-randomized trials were assessed as follows:Recruitment bias: report did not provide details of the cluster-randomization procedure, therefore prior knowledge of cluster assignment cannot be absolutely ruled outBaseline differences: no statistically significant differences between randomized groupsMissing clusters: not presentIncorrect statistical analysis: not”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Threlfall 1984, random sequence generation was judged at unclear risk of selection bias because the method of randomization was not stated.

    “randomized, but method not stated”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Tate 2003, blinding was judged at unclear risk because it was not reported.

    “Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In the included study, study completers did not differ significantly from dropouts with respect to baseline characteristics, but the method of handling missing data was not stated.

    “It was reported that the study completers did not differ significantly from the dropouts with respect to baseline characteristics, but method of handling missing data not stated”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    In Tate 2006, incomplete outcome data was judged at low risk of attrition bias; 55/67 and 59, 47/61 and 44, and 56/64 and 52 participants in the three groups completed 3- and 6-month follow-up, and all participants were included in the intention-to-treat analysis.

    “55 out of 67 randomized to the Website + No Counselling group completed the study at 3 months and 59 completed at 6 months47 out of 61 randomized to the Website + Automated Feedback group completed the study at 3 months and 44 completed at 6 months56 out of 64 randomized to the Website + Human Counselling group completed the study at 3 months and 52 completed at 6 months”
    • Also stated in: § Characteristics of included studies [ordered by study ID] · plain
      “All participants were included in the intention-to-treat analysis”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Webber 2008, blinding was judged at low risk because trained research assistants blinded to group assignment took participant measurements.

    “Trained research assistants who were blinded to group assignment took participant measurements”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Morgan 2011 was at high risk of performance and detection bias from blinding because participants and assessors were blind to group allocation at baseline assessment but it is not stated that assessors were still blind at 14-week follow-up.

    “States that participants and assessors were blind to group allocation at baseline assessment, but it is not stated that assessors were still blind at 14-week follow-up”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Morgan 2011 was at low risk of reporting bias because all outcomes mentioned in the methods section were reported as results.

    “All outcomes mentioned in the methods section were reported as results”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Morgan 2009 was at low risk of selection bias from random sequence generation because randomization was generated by a computer-based random number-producing algorithm.

    “Randomization was generated by computer-based random number-producing algorithm”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Morgan 2009 was at low risk of selection bias from allocation concealment because it was reported that the allocation sequence was concealed.

    “Reported that allocation sequence was concealed”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Tate 2006, allocation concealment was judged at unclear risk of selection bias because it was not reported.

    “Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In the included study, 97 of 116 participants randomized to the workbook-only group, 183 of 236 randomized to the workbook plus computer group, and 194 of 236 randomized to the workbook plus computer plus staff group completed the study.

    “97 out of the 116 participants randomized to the Workbook only intervention group completed the study183 out of the 236 participants randomized to the Workbook + computer intervention group completed the study194 out of the 236 participants randomized to the Workbook + computer + staff intervention group completed the study”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    In Tate 2003, incomplete outcome data was judged at low risk of attrition bias; 39/46 Basic Internet and 38/46 Basic Internet Plus Counselling participants completed the study, and intention-to-treat analysis was used.

    “39 out of 46 randomized to the Basic Internet group completed the study38 out of 46 randomized to the Basic Internet Plus Counselling group completed the studyReasons for loss of follow-up were medical reasons, unknown or lack of interestIntention-to-treat analysis used including all randomized participants and assuming no change from baseline for those with missing data”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Wing 2006, allocation concealment was judged at unclear risk of selection bias because it was not reported.

    “Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Tate 2001, blinding was judged at unclear risk because it was not reported.

    “Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Svetkey 2008, allocation concealment was judged at low risk of selection bias because allocation assignments were accessible only to authorized unblinded personnel.

    “The allocation assignments were accessible only to authorized unblinded personnel”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In Tate 2006, selective reporting was judged at low risk of reporting bias because all outcomes mentioned in the methods section were reported as results.

    “All outcomes mentioned in the methods section were reported as results”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Tate 2001, allocation concealment was judged at unclear risk of selection bias because it was not reported.

    “Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Tate 2003, allocation concealment was judged at unclear risk of selection bias because it was not reported.

    “Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Wing 2006, blinding was judged at unclear risk because it was not reported.

    “Not reported”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Morgan 2011 was at low risk of attrition bias; 54 of 65 in the intervention group and 36 of 45 in the control group completed the study at 14 weeks, and intention-to-treat analysis was used.

    “54 out of 65 participants randomized to the intervention group completed the study at 14 weeks36 out of 45 participants randomized to the control group completed the study at 14 weeksIntention-to-treat analysis used”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Tate 2001, selective reporting was judged at low risk of reporting bias because all outcomes mentioned in the methods section were reported as results.

    “All outcomes mentioned in the methods section were reported as results”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In the first included study, incomplete outcome data was judged at low risk of attrition bias; 24/30 CAD, 26/31 CAD+G, and 26/30 wait-list participants completed 3-month follow-up, intention-to-treat analysis was used, and missing data points were replaced with pre-intervention scores.

    “24 out of 30 assigned to the CAD group completed the 3-month follow-up26 out of 31 assigned to the CAD+G group completed 3-month follow-up26 out of 30 assigned to the wait list control group completed 3 month-follow-upNo details given for patient dropoutIntention-to-treat analysis used. Missing data points replaced with pre-intervention scores”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Tate 2006, random sequence generation was judged at low risk of selection bias because computerized random numbers were used to assign participants to one of three groups.

    “Computerized random numbers were used to assign participants to 1 of 3 groups”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Tate 2003, selective reporting was judged at low risk of reporting bias because all outcomes mentioned in the methods section were reported as results.

    “All outcomes mentioned in the methods section were reported as results”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Morgan 2009 was at low risk of reporting bias because all outcomes mentioned in the methods section were reported as results.

    “All outcomes mentioned in the methods section were reported as results”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Svetkey 2008, selective reporting was judged at low risk of reporting bias because all outcomes mentioned in the methods section were reported as results.

    “All outcomes mentioned in the methods section were reported as results”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Svetkey 2008, blinding was judged at low risk because measurements were taken by staff members masked to treatment assignment.

    “States that measurements were taken by staff members masked to treatment assignment”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In Tate 2006, blinding was judged at unclear risk because it was unclear whether non-intervention staff weighing participants were blinded and whether e-counselors were aware of participants' group assignment.

    “Non-intervention staff weighed participants at baseline and at 3 and 6 months, but no statement of whether or not they were blinded. Participants were aware of randomization assignment, but knowledge of other interventions is unclear.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Svetkey 2008, random sequence generation was judged at low risk of selection bias because randomization was stratified by clinic, race and amount of weight loss and allocated in blocks using a password-restricted web-based application.

    “Randomization assignments were stratified by clinic, race and amount of weight loss during phase 1 and were allocated in blocks. Allocation was generated using a password-restricted, web-based application”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In Tate 2001, incomplete outcome data was judged at low risk of attrition bias; 32/45 and 35/45 Internet Education and 33/46 and 36/46 Internet Behavior Therapy participants completed follow-up, and an intention-to-treat analysis was performed.

    “32 out of 45 participants randomized to the Internet Education group completed baseline, 3 and 6-month follow-up35 out of 45 participants randomized to the Internet Education group completed baseline and 6-month follow-up33 out of 46 participants randomized to the Internet Behavior Therapy group completed baseline,3 and 6-month follow-up36 out of 46 participants randomized to the Internet Behavior”
    • Also stated in: § Characteristics of included studies [ordered by study ID] · plain
      “An intention-to-treat analysis was performed”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The included study was judged at unclear risk of selection bias for allocation concealment because allocation concealment was not reported.

    “Allocation concealment (selection bias) | Unclear risk | Not reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In Webber 2008, incomplete outcome data was judged at low risk of attrition bias; all 33 Enhanced Intervention and 32/33 Minimal Intervention participants completed the final measurement and questionnaires.

    “All 33 participants randomized to the Enhanced Intervention group completed the final weight measurement and questionnaires32 of the 33 participants randomized to the Minimal Intervention completed the final measurement and questionnaires”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Threlfall 1984, selective reporting was judged at low risk of reporting bias because all outcomes specified in the research hypotheses were reported.

    “All outcomes specified in the research hypotheses were reported”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Morgan 2009 was at low risk of performance and detection bias from blinding because participants were blind to group allocation at baseline assessment and assessors were blinded to treatment allocation at all time points.

    “Participants blind to group allocation at baseline assessmentAssessors blinded to treatment allocation at all time points”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Tate 2003, random sequence generation was judged at low risk of selection bias because participants were randomized using a computerized random numbers sequence.

    “Participants were randomized using a computerized random numbers sequence”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    In Wing 2006, incomplete outcome data was judged at low risk of attrition bias; 98/105 Control, 101/104 Internet, and 92/105 Face-to-face participants completed 18-month follow-up, and authors assumed all dropouts regained 2.3 kg or more.

    “98 out of the 105 participants randomized to the Control group completed 18-month follow-up101 out of the 104 participants randomized to the Internet group completed 18-month follow-up92 out of the 105 participants randomized to the Face-to-face group completed 18-month follow-upReasons for loss to follow-up were death, declined and had cancerAuthors assumed all dropouts regained 2.3 kg or more”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Wing 2006, selective reporting was judged at low risk of reporting bias because all outcomes mentioned in the methods section were reported as results.

    “All outcomes mentioned in the methods section were reported as results”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In Webber 2008, allocation concealment was judged at unclear risk of selection bias because it was not reported.

    “Not reported”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Hunter 2008 was at low risk of attrition bias; 206 of 224 in usual care and 193 of 227 in the behavioral Internet-based program completed the study, and intention-to-treat analysis using baseline observation carried forward was used.

    “206 of the 224 participants randomized to usual care completed the study193 of the 227 participants randomized to the behavioral Internet-based program completed the studyIn both cases reasons given were: leaving the local area, medical reasons and the wish to withdrawIntention-to-treat analysis used using the baseline observation carried forward approach”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    In Threlfall 1984, blinding was judged at high risk because there was no report of whether the nurse measuring participants was blinded, the investigator offered counseling to the intervention group, and the investigator carried out the analyses.

    “At baseline participants were measured by a student nurse, but there is no report of whether the nurse was blinded to the treatment assignmentThe investigator had no contact with either group but offered counseling during the trial to the intervention group. The investigator carried out the analyses”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The included study was judged at unclear risk of selection bias for random sequence generation because it was randomized but the method was not stated.

    “Random sequence generation (selection bias) | Unclear risk | randomized, but method not stated”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    In the first included study, blinding was judged at high risk of performance and detection bias because the first author was aware of assignments and participants were informed of their group assignment, although research team members were blind to intervention assignment.

    “First author was aware of assignations, participants were informed about their group assignment, but research team members were blind to the type of intervention assignments”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    In the first included study (CAD vs CAD+G vs wait-list control), allocation concealment was judged at high risk of selection bias because no randomization sequence was generated to conceal allocation.

    “No randomization sequence generated to conceal”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The included study was judged at unclear risk of performance and detection bias for blinding of all outcomes because blinding was not reported.

    “Blinding (performance bias and detection bias)All outcomes | Unclear risk | Not reported”
    Quote in the paperNot a substantial claim
259 of 259

  • The authors state this as an assumption.

    The comparison condition for the Internet intervention cost-effectiveness analysis is a no treatment, no costs, no weight loss condition.

    “versus a hypothesized no treatment, no costs, no weight loss condition”

  • The authors state this as an assumption.

    A 50% weight regain occurs at one year post-treatment.

    “Assuming a 50% weight regain at one year post-treatment”

  • The paper relies on this without support.

    A major advantage of computer-based interventions is their ability to reach large numbers of people at a relatively low cost.

    “A major advantage of computer-based interventions is their ability to reach large numbers of people at a relatively low cost.”

  • The paper relies on this without support.

    It is common for behavioral intervention trials to experience large losses to follow-up.

    “However, because it is common for behavioral intervention trials to experience large losses to follow-up, the effect of this exclusion was to lower the number of trials in this review, reduce the total amount of information available for review outcomes, and decrease the power of reported meta-analyses.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conflicting BMI eligibility ranges for Svetkey 2008

    Minor

    The narrative gives an upper BMI limit of 40 kg/m2 at the beginning of weight loss, while the study-characteristics table gives 45.

  • Cussler BMI estimate falls outside its confidence interval

    Minor

    The reported mean difference of −0.4 kg/m2 is below its stated 95% CI lower bound of −0.3. The interval's midpoint is +0.4, suggesting an erroneous sign or interval.

    Reported -0.4 · recomputed 0.4

  • Abstract says there were no adverse-event data despite a reported result

    Minor

    The abstract says no adverse-event data were identified, whereas the results report that Tate 2006 recorded no serious adverse events.

  • Search-flow counts leave 87 titles unaccounted for

    Minor

    Excluding 184 of 376 potentially eligible titles leaves 192, not the 105 reported as retrieved in full text. The text does not account for the other 87 titles.

    Reported 105 · recomputed 192

  • Cussler BMI analysis lists more participants than the entire trial

    Minor

    The BMI result attributes 688 participants to Cussler 2008, but its study-characteristics table lists 66 and 69 randomized participants, totaling 135.

    Reported 688 · recomputed 135

  • A study included despite less than 80% follow-up

    Minor

    Harvey-Berino 2002 had 92 of 122 participants complete the 18-month assessment, or about 75%, despite the statement that every included study had follow-up data from at least 80% of participants.

  • Summary table overlooks a significant physical-activity result

    Minor

    The summary table says no individual study found a statistically significant physical-activity effect, but the results report one at three months with P = 0.03.

7 of 7

Cites

Flagged first, then by citations

Research works printed but not linked: 26

  1. Krukowski, 2010, Comparative cost-effectiveness for in-person versus online behavioral weight loss programs, Obesity Reviews, 11 Suppl 1, 249
  2. Rasu, 2010, Economic evaluation of an Internet-based weight management program, American Journal of Managed Care, 16, e98
  3. Bischoff SA The effects of goal setting on increasing physical activity behavior through a 16-week internet-delivered intervention ProQuest Dissertation Dissertations 2010
  4. Brantley, 2008, Design considerations and rationale of a multi-center trial to sustain weight loss: the Weight Loss Maintenance Trial, Clinical Trials, 5, 546, 10.1177/1740774508096315 · DOI
  5. Burnett, 1984, Ambulatory computer-assisted therapy in the behavioral treatment of obesity [Dissertation]
  6. Cange, 2008, Improving adherence to an exercise program: a personalized virtual coach, Telemedicine and e-Health, 14, 39
  7. Carr, 2009, Short and long-term efficacy of an internet-delivered physical activity behavior change program on physical activity and cardiometabolic disease risk factors in sedentary, overweight adults, Dissertation Abstracts International: Section B: The Sciences and Engineering, 69, 7454
  8. Herrick, 2009, Characterization of time and order of internet lessons in Project WebHealth [Dissertation]
  9. Jacobs, 2010, Effect of a tailored behaviour change programme on a composite lifestyle change score: a randomised controlled trial, European Journal of Cardiovascular Prevention and Rehabilitation, 17, S106
  10. Jones, 1997, A comparison of instructional methods for weight loss and curriculum comprehension in women [Dissertation]
  11. Lohof Christy, 2007, Self-efficacy and physical activity: the effect of a theory-driven, Internet-based intervention [Dissertation]
  12. Magnusdottir, 2010, One year weight reduction in young overweight adults: two months controlled modest energy restriction and/or 12 months program with internet based education and visits to the clinic, Obesity Reviews, 11, 247
  13. McHugh, 2008, The effectiveness of web-based tailored messaging on employee health [Dissertation]
  14. Mobley, 2006, Evaluation of behavioral theory and integrated Internet/telephone technologies to support military obesity and weight management programs [Dissertation]
  15. Nieto, 2010, A comparison of weight loss outcome across three distinct weight-loss program delivery venues [Dissertation], TUI University
  16. Sartor MR The use of computer technology in teaching weight loss Dissertation Abstracts International 1991 446
  17. Thurston, 1991, Development and formative evaluation of a decision-management health promotion program on healthy weights for women [Dissertation]
  18. Brownell, 2000, The Learn Program for Weight Management 2000
  19. Corbett Dooren J FDA approves wider use of Allergan's lap band for obesity The Wall Street Journal 2011
  20. Finkelstein, 2003, National medical spending attributable to overweight and obesity: how much, and who's paying?, Health Affairs (Project Hope), Suppl Web Exclu, W3
  21. Guyatt, 2001, Therapy
  22. Krukowski, 2010, Comparative cost-effectiveness for in-person versus online behavioral weight loss programs, Obesity Reviews, 11 Suppl 1, 249
  23. Meenan, 2009, Development and implementation cost analysis of telephone- and Internet-based interventions for the maintenance of weight loss, International Journal of Technology Assessment in Health Care, 25, 400, 10.1017/S0266462309990018 · DOI
  24. Meenan, 2010, PS2-34: Implementation cost analysis of telephone and Internet-based interventions for the maintenance of weight loss, Clinical Medicine and Research, 8, 52
  25. Rasu, 2010, Economic evaluation of an Internet-based weight management program, American Journal of Managed Care, 16, e98
  26. Stevens, 2008, Design and implementation of an interactive website to support long-term maintenance of weight loss, Journal of Medical Internet Research, 10, e1, 10.2196/jmir.931 · DOI

Cited by

Sorted by citations

Related

Authors
Wieland, L. S., Falzon, L., Sciamanna, C. N., Trudeau, K. J., Brodney Folse, S., Schwartz, J. E., & Davidson, K. W.
Affiliations
  • University of Maryland, Baltimore (US)
  • Columbia University Irving Medical Center (US)
  • Penn State College of Medicine; Chief, Division of General Internal Medicine; Hershey USA PA 17033
  • Inflexxion (United States) (US)
  • The Health & Wellness Institute; 291 Promenade St. Providence Rhode Island USA 02908
  • Stony Brook University (US)
  • Columbia University (US)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2012-08-15
Volume
2012
Issue
8
Pages
CD007675-CD007675
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd007675.pub2
PMC
PMC3996838
OpenAlex
W2150562633
Cited by
195
References
153
Citations by year
2025: 3 · 2024: 5 · 2023: 5 · 2022: 7 · 2021: 11 · 2020: 11 · 2019: 16 · 2018: 14 · 2017: 26 · 2016: 29 · 2015: 29 · 2014: 27 · 2013: 8 · 2012: 3
FWCI
3.26
Type
journal article
Language
en
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • Columbia Academic Commons (Columbia University)
Funders
National Heart, Lung, and Blood Institute (R24HL076857, P01HL088117)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
computer-based intervention, weight loss, weight maintenance, obesity, overweight, weight regain, dietary behavior, physical activity, cost-effectiveness, chronic disease prevention
MeSH terms
Adult, Female, Humans, Male, Obesity, Therapy, Computer-Assisted, Weight Loss, Randomized Controlled Trials as Topic, Overweight

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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