This paper was originally commissioned research initiated by the Swedish Council of Technology Assessment (SBU) and the SWedish Nursing Society (SSF). The objective was to review nursing methods, more specifically computer based education programme. However, as the review produced insufficient evidence of effectiveness, the publication was withheld due to a previous incident were such evidence was misunderstood by Swedish policy and healthcare decision makers. The aim with this paper is therefore to highlight the concept of evidence with regards to the consequences when insufficient evidence of effectiveness is mistaken for evidence of no effectiveness. The aim is also to present a systematic review evaluating a computerbased education program for patients suffering from severe mental illness. Systematic database searches in MedLine, CINAHL, PsycINFO and the Cochrane Library identified a total of 131 potentially relevant references. Thereafter, 27 references were retrieved as full-textdocuments of which 5 were finally included and co-reviewed by two independent researchers. The review found no decisive evidence of effectiveness regarding computer based education programmes designed to assist persons suffering from severe mental illness. Failing to see the difference between insufficient evidence and evidence of no effectiveness may have unexpected consequences. As a result, practice may be misguided and treatments withheld which as its worst may have harmful consequences for patients. In the end, it is of outmost importance to patients that researchers do good research by ensuring statistical power, quality of outcome measurements and strive for overall excellence. For example, this review of computer based education programmes could have revealed effective ways of dealing with severe mental illness if the studies included had been more sophistically designed.
En systematisk litteraturöversikt rörande utbildning med hjälp av dator för personer med svår mental ohälsa visade otillräckliga evidens för effekt. SBU valde då att inte publisera resultatet med risk att det skulle kunna missförstås. Vi argumenterar här för att det är en form av publikationsbias och att otillräckliga evidens inte betyder att evidens saknas.