This article reports on commissioned research funded by the Swedish Council of Technology Assessment in Health Care (SBU) and the Swedish Society of Nursing (SSF). The objective was to review computer-based education programs. However, as the review produced insufficient evidence of effectiveness, the publication was withheld due to previous incident where such evidence was misunderstood by Swedish policy and health care decision makers. This article highlights the concept of evidence with regard to the consequences of insufficient evidence of effectiveness being mistaken for evidence of no effectiveness. The aim is also to present a systematic review evaluating a computer-based education program for patients suffering from severe menatl 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 fulltext documents, 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 programs designed to assisst 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 at worse may have harmful consequences for patients. In the end, it is of utmost importance that researchers do good quality research by ensuring statistical power and quality of outcome measurement. For example, this review of computer-based education programs could have revealed effective ways of dealing with severe mental illness if the studies included had been conducted using more sophisticated designs.

I denna artikel rapporteras en studie som initierades av Svensk sjuksköterskeförening och utfördes inom SBU-Alerts ram. Målsättningen var att granska dator-baserade utbildningsprogram för patienter. eftersom den systematiska granskningen inte visade tillräckligt starka evidens valde man att inte publicera resultatet. I denna artikel diskuterar vi begreppet evidens med hänvisning till att otillräckliga evidens inte är detsamma som ingen evidens. Syftet är också att presentera resultatet av den systematiska litteraturgranskningen av dator-baserade utbildningsprogram för patienter med svår psykisk ohälsa. Systematiska sökningar genomfördes i databaserna Medline, CINAHL, PsycINFO och Cochrane biblioteket. Totalt identifierades 131 relevanta referenser och av dessa granskades 27 som fulltext dokument av två oberoende granskare och slutligen inkluderades 5 i sammanställningen. det fanns inga övertygande evidens för dessa programs effekt. men att missförstå otillräckliga evidens som inga evidens alls kan vara missvisande, i värsta fall kan patienter bli utan behandling.