Data Cash Quick Report Delphi 2010 EXCLUSIVE Full Version 5

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Study selection was done in two phases. In the first phase, two reviewers (LM and JA) independently screened the reports identified by the searches by title and abstract for eligibility. In the second phase, both reviewers (LM and JA) examined the full-text of articles obtained from the first phase against the inclusion and exclusion criteria. Disagreements were resolved through consensus in discussions involving three reviewers (LM, JA and EC). We extracted data relevant for analysis using a pretested data extraction tool designed by the reviewers using guidelines from the PRISMA checklist. Extracted data included author details, study setting, study population, participant characteristics, the type of healthcare services sought, and barriers hindering access or utilization of the services by children with NI or disability. We assessed the quality of each study using the Joanna Briggs Institute (JBI) critical appraisal tools, which are distinct for case-control, cohort, and qualitative studies ( Munn et al., 2014).

However, there are a number of limitations to the methods of the review which limit its comprehensiveness. This does not necessarily invalidate the findings concerning types of barriers, though others of relevance may have been missed. However, it does create bias in some of the authors' statements concerning how frequently different types of conditions or disorders would be represented in the literature, and such references should be rewritten (e.g. the first sentence of the Discussion, and the second sentence of the Conclusion). Of limitations, first, the authors considered only papers published in English, in only four databases, and did not include grey literature or searches by key author surnames. Second, the search terms for neurodisability were limited mostly to 'impairment', i.e. apart from epilepsy. In the span of time searched (1990-2019), before the publication of the ICF in 2001, a range of etiological and disability terms would have been used. For example, a search on 'cerebral palsy' (not just 'motor impairment') would have yielded a number of additional papers examining barriers to service use in LMICs. It is not clear that the authors did a preliminary check that key expected papers were found by their search strategy, and the resulting focus on epilepsy studies in their results is not surprising. Third, two reviewers independently screened papers on title and abstract for eligibility, but there is no statement as to whether there was any check on agreement at this crucial stage. Fourth, the authors state they examined the quality of studies but how this information was used is not reported. Fifth, there is inadequate description of how the seven themes to classify barriers were derived. Was this drafted in advance, or from the data extracted? Was there any check on the validity/reliability of the classification? What type of evidence was used - were single quotes from a paper sufficient, or was the paper itself required to have presented categories? Thus not enough information is presented so that the systematic review could be repeated by others. Obviously, the authors cannot redo the review at this stage, but a fuller acknowledgement of limitations in the Discussion is necessary. 2b1af7f3a8