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Abstract
PURPOSE To review the existing literature on the effects of postural management on hip migration in children with cerebral palsy. METHODS A systematic literature search was performed using 5 databases. Quality of articles was assessed and study designs were appraised according to the American Academy of Cerebral Palsy and Developmental Medicine Systematic Review Method. RESULTS Eight of 655 identified studies were included, reporting postural management in children with cerebral palsy. Seven of 8 studies reported positive effects on hip migration after postural management interventions. However, level of evidence and quality of the articles were low. CONCLUSION The evidence for postural management to prevent or reduce hip migration in children with cerebral palsy is limited by the lack of high-quality studies. Strong recommendations for clinical practice are not possible. Future high-quality research is crucial to improve our understanding of the effects of postural management to prevent hip migration in children with cerebral palsy.
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Gilissen J, Pivodic L, Gastmans C, Vander Stichele R, Deliens L, Breuer E, Van den Block L. How to achieve the desired outcomes of advance care planning in nursing homes: a theory of change. BMC Geriatr 2018; 18:47. [PMID: 29444645 PMCID: PMC5813418 DOI: 10.1186/s12877-018-0723-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 01/23/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Advance care planning (ACP) has been identified as particularly relevant for nursing home residents, but it remains unclear how or under what circumstances ACP works and can best be implemented in such settings. We aimed to develop a theory that outlines the hypothetical causal pathway of ACP in nursing homes, i.e. what changes are expected, by means of which processes and under what circumstances. METHODS The Theory of Change approach is a participatory method of programme design and evaluation whose underlying intention is to improve understanding of how and why a programme works. It results in a Theory of Change map that visually represents how, why and under what circumstances ACP is expected to work in nursing home settings in Belgium. Using this approach, we integrated the results of two workshops with stakeholders (n = 27) with the results of a contextual analysis and a systematic literature review. RESULTS We identified two long-term outcomes that ACP can achieve: to improve the correspondence between residents’ wishes and the care/treatment they receive and to make sure residents and their family feel involved in planning their future care and are confident their care will be according to their wishes. Besides willingness on the part of nursing home management to implement ACP and act accordingly, other necessary preconditions are identified and put in chronological order. These preconditions serve as precursors to, or requirements for, accomplishing successful ACP. Nine original key intervention components with specific rationales are identified at several levels (resident/family, staff or nursing home) to target the preconditions: selection of a trainer, ensuring engagement by management, training ACP reference persons, in-service education for healthcare staff, information for staff, general practitioners, residents and their family, ACP conversations and documentation, regular reflection sessions, multidisciplinary meetings, and formal monitoring. ONCLUSIONS The Theory of Change map presented here illustrates a theory of how ACP is expected to work in order to achieve its desired long-term outcomes while highlighting organisational factors that potentially facilitate the implementation and sustainability of ACP. We provide the first comprehensive rationale of how ACP is expected to work in nursing homes, something that has been called for repeatedly.
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Affiliation(s)
- J. Gilissen
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - L. Pivodic
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - C. Gastmans
- Centre for Biomedical Ethics and Law, KU Leuven, Kapucijnenvoer 35, Box 7001, 3000 Leuven, Belgium
| | - R. Vander Stichele
- Department of Pharmacology, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
| | - L. Deliens
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Medical Oncology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
| | - E. Breuer
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - L. Van den Block
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Laarbeeklaan 103, 1090 Brussels, Belgium
- Department of Family Medicine and Chronic Care, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
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153
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Abstract
High quality up-to-date systematic reviews are essential in order to help healthcare practitioners and researchers keep up-to-date with a large and rapidly growing body of evidence. Systematic reviews answer pre-defined research questions using explicit, reproducible methods to identify, critically appraise and combine results of primary research studies. Key stages in the production of systematic reviews include clarification of aims and methods in a protocol, finding relevant research, collecting data, assessing study quality, synthesizing evidence, and interpreting findings. Systematic reviews may address different types of questions, such as questions about effectiveness of interventions, diagnostic test accuracy, prognosis, prevalence or incidence of disease, accuracy of measurement instruments, or qualitative data. For all reviews, it is important to define criteria such as the population, intervention, comparison and outcomes, and to identify potential risks of bias. Reviews of the effect of rehabilitation interventions or reviews of data from observational studies, diagnostic test accuracy, or qualitative data may be more methodologically challenging than reviews of effectiveness of drugs for the prevention or treatment of stroke. Challenges in reviews of stroke rehabilitation can include poor definition of complex interventions, use of outcome measures that have not been validated, and poor generalizability of results. There may also be challenges with bias because the effects are dependent on the persons delivering the intervention, and because masking of participants and investigators may not be possible. There are a wide range of resources which can support the planning and completion of systematic reviews, and these should be considered when planning a systematic review relating to stroke.
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Affiliation(s)
- Alex Pollock
- 1 Nursing Midwifery and Allied Health Professions (NMAHP) Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Eivind Berge
- 2 Department of Internal Medicine and Cardiology, Oslo University Hospital, Oslo, Norway
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Albarqouni L, Glasziou P, Hoffmann T. Completeness of the reporting of evidence-based practice educational interventions: a review. MEDICAL EDUCATION 2018; 52:161-170. [PMID: 29098706 DOI: 10.1111/medu.13410] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/07/2017] [Accepted: 07/04/2017] [Indexed: 05/25/2023]
Abstract
CONTEXT Complete reporting of intervention details in trials of evidence-based practice (EBP) educational interventions is essential to enable clinical educators to translate research evidence about interventions that have been shown to be effective into practice. In turn, this will improve the quality of EBP education. OBJECTIVES This study was designed to examine the completeness of reporting of EBP educational interventions in published studies and to assess whether missing details of educational interventions could be retrieved by searching additional sources and contacting study authors. METHODS A systematic review of controlled trials that had evaluated EBP educational interventions was conducted using a citation analysis technique. Forward and backward citations of the index articles were tracked until March 2016. The TIDieR (template for intervention description and replication) checklist was used to assess the completeness of intervention reporting. Missing details were sought from: (i) the original publication; (ii) additional publicly available sources, and (iii) the study authors. RESULTS Eighty-three articles were included; 45 (54%) were randomised controlled trials (RCTs) and 38 (46%) were non-RCTs. The majority of trials (n = 62, 75%) involved medical professionals. None of the studies completely reported all of the main items of the educational intervention within the original publication or in additional sources. However, details became complete for 17 (20%) interventions after contact with the respective authors. The item most frequently missing was 'intervention materials', which was missing in 80 (96%) of the original publications, in additional sources for 77 (93%) interventions, and in 59 (71%) studies after contact with the authors. Authors of 69 studies were contacted; 33 provided the details requested. CONCLUSIONS The reporting of EBP educational interventions is incomplete and remained so for the majority of studies, even after study authors had been contacted for missing information. Collaborative efforts involving authors and editors are required to improve the completeness of reporting of EBP educational interventions.
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Affiliation(s)
- Loai Albarqouni
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Paul Glasziou
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Tammy Hoffmann
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
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155
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Incomplete descriptions of oral nutritional supplement interventions in reports of randomised controlled trials. Clin Nutr 2018; 37:61-71. [DOI: 10.1016/j.clnu.2017.03.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/06/2017] [Accepted: 03/21/2017] [Indexed: 11/21/2022]
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156
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Demmelmaier I, Iversen MD. How Are Behavioral Theories Used in Interventions to Promote Physical Activity in Rheumatoid Arthritis? A Systematic Review. Arthritis Care Res (Hoboken) 2018; 70:185-196. [DOI: 10.1002/acr.23265] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 04/18/2017] [Indexed: 01/05/2023]
Affiliation(s)
| | - Maura D. Iversen
- Northeastern University and Harvard Medical School, Boston, Massachusetts and Karolinska Institutet Stockholm Sweden
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157
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Franco JVA, Turk T, Jung JH, Xiao Y, Iakhno S, Garrote V, Vietto V. Non-pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome. Cochrane Database Syst Rev 2018; 1:CD012551. [PMID: 29372565 PMCID: PMC6491290 DOI: 10.1002/14651858.cd012551.pub2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common disorder in which the two main clinical features are pelvic pain and lower urinary tract symptoms. There are currently many approaches for its management, using both pharmacological and non-pharmacological interventions. The National Institute of Health - Chronic Prostatitis Symptom Index (NIH-CPSI) score is a validated measure commonly used to measure CP/CPPS symptoms. OBJECTIVES To assess the effects of non-pharmacological therapies for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). SEARCH METHODS We performed a comprehensive search using multiple databases, trial registries, grey literature and conference proceedings with no restrictions on the language of publication or publication status. The date of the latest search of all databases was August 2017. SELECTION CRITERIA We included randomised controlled trials. Inclusion criteria were men with a diagnosis of CP/CPPS. We included all available non-pharmacological interventions. DATA COLLECTION AND ANALYSIS Two review authors independently classified studies and abstracted data from the included studies, performed statistical analyses and rated quality of evidence (QoE) according to the GRADE methods. MAIN RESULTS We included 38 unique studies with 3290 men with CP/CPPS across 23 comparisons.1. Acupuncture: (three studies, 204 participants) based on short-term follow-up, acupuncture reduces prostatitis symptoms in an appreciable number of participants compared with sham procedure (mean difference (MD) in total NIH-CPSI score -5.79, 95% confidence interval (CI) -7.32 to -4.26, high QoE). Acupuncture likely results in little to no difference in adverse events (moderate QoE). It probably also decreases prostatitis symptoms compared with standard medical therapy in an appreciable number of participants (MD -6.05, 95% CI -7.87 to -4.24, two studies, 78 participants, moderate QoE).2. Circumcision: (one study, 713 participants) based on short-term follow-up, early circumcision probably decreases prostatitis symptoms slightly (NIH-CPSI score MD -3.00, 95% CI -3.82 to -2.18, moderate QoE) and may not be associated with a greater incidence of adverse events compared with control (a waiting list to be circumcised, low QoE).3. Electromagnetic chair: (two studies, 57 participants) based on short-term follow-up, we are uncertain of the effects of the use of an electromagnetic chair on prostatitis symptoms. It may be associated with a greater incidence of adverse events compared with sham procedure (low to very low QoE).4. Lifestyle modifications: (one study, 100 participants) based on short-term follow-up, lifestyle modifications may be associated with a greater improvement in prostatitis symptoms in an appreciable number of participants compared with control (risk ratio (RR) for improvement in NIH-CPSI scores 3.90, 95% CI 2.20 to 6.92, very low QoE). We found no information regarding adverse events.5. Physical activity: (one study, 85 participants) based on short-term follow-up, a physical activity programme may cause a small reduction in prostatitis symptoms compared with control (NIH-CPSI score MD -2.50, 95% CI -4.69 to -0.31, low QoE). We found no information regarding adverse events.6. Prostatic massage: (two studies, 115 participants) based on short-term follow-up, we are uncertain whether the prostatic massage reduces or increases prostatitis symptoms compared with control (very low QoE). We found no information regarding adverse events.7. Extracorporeal shockwave therapy: (three studies, 157 participants) based on short-term follow-up, extracorporeal shockwave therapy reduces prostatitis symptoms compared with control (NIH-CPSI score MD -6.18, 95% CI -7.46 to -4.89, high QoE). These results may not be sustained at medium-term follow-up (low QoE). This treatment may not be associated with a greater incidence of adverse events (low QoE).8. Transrectal thermotherapy compared to medical therapy: (two studies, 237 participants) based on short-term follow-up, transrectal thermotherapy alone or in combination with medical therapy may decrease prostatitis symptoms slightly when compared with medical therapy alone (NIH-CPSI score MD -2.50, 95% CI -3.82 to -1.18, low QoE). One included study reported that participants may experience transient adverse events.9. Other interventions: there is uncertainty about the effects of other interventions included in this review. We found no information regarding psychological support or prostatic surgery. AUTHORS' CONCLUSIONS Some of the interventions can decrease prostatitis symptoms in an appreciable number without a greater incidence of adverse events. The QoE was mostly low. Future clinical trials should include a full report of their methods including adequate masking, consistent assessment of all patient-important outcomes including potential treatment-related adverse events and appropriate sample sizes.
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Affiliation(s)
| | - Tarek Turk
- Damascus UniversityFaculty of MedicineMazzeh StreetDamascusSyrian Arab Republic
| | | | - Yu‐Tian Xiao
- Changhai Hospital, Second Military Medical UniversityDepartment of Urology168 Changhai RoadShanghaiChina
| | - Stanislav Iakhno
- Norwegian University of Life SciencesFood Safety and Infection Biology (Matinf)OsloNorway
| | - Virginia Garrote
- Instituto Universitario Hospital ItalianoBiblioteca CentralJ.D. Perón 4190Buenos AiresArgentinaC1199ABB
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Cotterill S, Knowles S, Martindale AM, Elvey R, Howard S, Coupe N, Wilson P, Spence M. Getting messier with TIDieR: embracing context and complexity in intervention reporting. BMC Med Res Methodol 2018; 18:12. [PMID: 29347910 PMCID: PMC5774137 DOI: 10.1186/s12874-017-0461-y] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 12/15/2017] [Indexed: 01/22/2023] Open
Abstract
Background The Template for Intervention Description and Replication (TIDieR) checklist and guide was developed by an international team of experts to promote full and accurate description of trial interventions. It is now widely used in health research. The aim of this paper is to describe the experience of using TIDieR outside of trials, in a range of applied health research contexts, and make recommendations on its usefulness in such settings. Main body We used the TIDieR template for intervention description in six applied health research projects. The six cases comprise a diverse sample in terms of clinical problems, population, settings, stage of intervention development and whether the intervention was led by researchers or the service deliverers. There was also variation in how the TIDieR description was produced in terms of contributors and time point in the project. Researchers involved in the six cases met in two workshops to identify issues and themes arising from their experience of using TIDieR. We identified four themes which capture the difficulties or complexities of using TIDieR in applied health research: (i) fidelity and adaptation: all aspects of an intervention can change over time; (ii) voice: the importance of clarity on whose voice the TIDieR description represents; (iii) communication beyond the immediate context: the usefulness of TIDieR for wider dissemination and sharing; (iv) the use of TIDieR as a research tool. Conclusion We found TIDieR to be a useful tool for applied research outside the context of clinical trials and we suggest four revisions or additions to the original TIDieR which would enable it to better capture these complexities in applied health research:An additional item, ‘voice’ conveys who was involved in preparing the TIDieR template, such as researchers, service users or service deliverers. An additional item, ‘stage of implementation’ conveys what stage the intervention has reached, using a continuum of implementation research suggested by the World Health Organisation. A new column, ‘modification’ reminds authors to describe modifications to any item in the checklist. An extension of the ‘how well’ item encourages researchers to describe how contextual factors affected intervention delivery.
Electronic supplementary material The online version of this article (10.1186/s12874-017-0461-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sarah Cotterill
- Centre for Biostatistics, School of Health Sciences, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
| | - Sarah Knowles
- Alliance Manchester Business School, University of Manchester, Manchester, UK
| | | | - Rebecca Elvey
- Centre for Primary Care, University of Manchester, Manchester, UK
| | | | - Nia Coupe
- Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK
| | - Paul Wilson
- Alliance Manchester Business School, University of Manchester, Manchester, UK
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159
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The effectiveness of online pain resources for health professionals: a systematic review with subset meta-analysis of educational intervention studies. Pain 2018; 159:631-643. [DOI: 10.1097/j.pain.0000000000001146] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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160
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C. Ashe M, Merali K, Edwards N, Schiller C, M. Hanson H, Fleig L, M. Khan K, L. Cook W, A. McKay H. Integrating research into clinical practice for hip fracture rehabilitation: Implementation of a pragmatic RCT. AIMS MEDICAL SCIENCE 2018. [DOI: 10.3934/medsci.2018.2.102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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161
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Gspörer I, Schrems BM. [Transparency and replicability of nursing intervention studies in long-term care: A selective literature review]. ZEITSCHRIFT FUR EVIDENZ FORTBILDUNG UND QUALITAET IM GESUNDHEITSWESEN 2017; 133:1-8. [PMID: 29269170 DOI: 10.1016/j.zefq.2017.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 11/23/2017] [Accepted: 11/27/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVE The development and evaluation of interventions in long-term care is time-consuming and expensive due to their complexity. To ensure reproducibility and successful implementation, these interventions must be described and published in a comprehensible and qualitative manner. The aim of this study is to analyze intervention studies from the inpatient long-term care setting with regard to their completeness, reporting quality, transparency and thus reproducibility. METHOD The completeness and the reporting quality of the interventions described in the publications were examined in the context of a selective literature review by means of intervention studies from the long-term care setting (n=22). To this end, the Template for Intervention Description and Replication (TIDieR) checklist and the Criteria for Reporting the Development and Evaluation of Complex Interventions in Healthcare 2 (CReDECI2-DE) list were used. Transparency criteria included study registration and access to study protocols. RESULTS The TIDieR checklist examination revealed that only three studies contained all the information necessary; the CReDECI2 test provided a complete description for only one study. Frequent shortcomings were observed concerning the information on modifications and titrations for the study participants and the location. Protocols were available for eight studies, 14 studies were registered. CONCLUSIONS In terms of science, this means that the reproducibility of scientific findings is limited, which is why they cannot provide secure knowledge. As a result, the practical benefit to be derived from published studies that are accessible to decision-makers is limited as well. As far as publishers are concerned they should pay more attention to the completeness, registration and availability of materials.
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Affiliation(s)
- Irene Gspörer
- Universität Wien, Institut für Pflegewissenschaft, Wien, Österreich.
| | - Berta M Schrems
- Universität Wien, Institut für Pflegewissenschaft, Wien, Österreich
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Walker MF, Hoffmann TC, Brady MC, Dean CM, Eng JJ, Farrin AJ, Felix C, Forster A, Langhorne P, Lynch EA, Radford KA, Sunnerhagen KS, Watkins CL. Improving the Development, Monitoring and Reporting of Stroke Rehabilitation Research: Consensus-Based Core Recommendations from the Stroke Recovery and Rehabilitation Roundtable. Neurorehabil Neural Repair 2017; 31:877-884. [DOI: 10.1177/1545968317732686] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Recent reviews have demonstrated that the quality of stroke rehabilitation research has continued to improve over the last four decades but despite this progress, there are still many barriers in moving the field forward. Rigorous development, monitoring and complete reporting of interventions in stroke trials are essential in providing rehabilitation evidence that is robust, meaningful and implementable. An international partnership of stroke rehabilitation experts committed to develop consensus-based core recommendations with a remit of addressing the issues identified as limiting stroke rehabilitation research in the areas of developing, monitoring and reporting stroke rehabilitation interventions. Work exploring each of the three areas took place via multiple teleconferences and a two-day meeting in Philadelphia in May 2016. A total of 15 recommendations were made. To validate the need for the recommendations, the group reviewed all stroke rehabilitation trials published in 2015 (n=182 papers). Our review highlighted that the majority of publications did not clearly describe how interventions were developed or monitored during the trial. In particular, under-reporting of the theoretical rationale for the intervention and the components of the intervention call into question many interventions that have been evaluated for efficacy. More trials were found to have addressed the reporting of interventions recommendations than those related to development or monitoring. Nonetheless, the majority of reporting recommendations were still not adequately described. To progress the field of stroke rehabilitation research and to ensure stroke patients receive optimal evidence-based clinical care, we urge the research community to endorse and adopt our recommendations.
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Affiliation(s)
| | - Tammy C. Hoffmann
- Centre for Research in Evidence-Based Practice, Bond University, Queensland, Australia
| | - Marian C. Brady
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Catherine M. Dean
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Janice J. Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada
| | - Amanda J. Farrin
- Clinical Trials Research Unit at the Leeds Institute for Clinical Trials Research, University of Leeds, Leeds, UK
| | - Cynthia Felix
- The George Institute for Global Health, Hyderabad, India
| | - Anne Forster
- Clinical Trials Research Unit at the Leeds Institute for Clinical Trials Research, University of Leeds, Leeds, UK
| | - Peter Langhorne
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Elizabeth A. Lynch
- NHMRC Centre of Research Excellence, Florey Institute of Neuroscience and Mental Health, Parkville, Australia and University of Adelaide, Adelaide, Australia
| | | | - Katharina S. Sunnerhagen
- Department of Clinical Neuroscience at the Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Caroline L. Watkins
- University of Central Lancashire, Preston, UK and Australian Catholic University, Sydney, Australia
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163
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Warner MM, Kelly JT, Reidlinger DP, Hoffmann TC, Campbell KL. Reporting of Telehealth-Delivered Dietary Intervention Trials in Chronic Disease: Systematic Review. J Med Internet Res 2017; 19:e410. [PMID: 29229588 PMCID: PMC5742660 DOI: 10.2196/jmir.8193] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 10/26/2017] [Accepted: 11/04/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Telehealth-delivered dietary interventions are effective for chronic disease management and are an emerging area of clinical practice. However, to apply interventions from the research setting in clinical practice, health professionals need details of each intervention component. OBJECTIVE The aim of this study was to evaluate the completeness of intervention reporting in published dietary chronic disease management trials that used telehealth delivery methods. METHODS Eligible randomized controlled trial publications were identified through a systematic review. The completeness of reporting of experimental and comparison interventions was assessed by two independent assessors using the Template for Intervention Description and Replication (TIDieR) checklist that consists of 12 items including intervention rationale, materials used, procedures, providers, delivery mode, location, when and how much intervention delivered, intervention tailoring, intervention modifications, and fidelity. Where reporting was incomplete, further information was sought from additional published material and through email correspondence with trial authors. RESULTS Within the 37 eligible trials, there were 49 experimental interventions and 37 comparison interventions. One trial reported every TIDieR item for their experimental intervention. No publications reported every item for the comparison intervention. For the experimental interventions, the most commonly reported items were location (96%), mode of delivery (98%), and rationale for the essential intervention elements (96%). Least reported items for experimental interventions were modifications (2%) and intervention material descriptions (39%) and where to access them (20%). Of the 37 authors, 14 responded with further information, and 8 could not be contacted. CONCLUSIONS Many details of the experimental and comparison interventions in telehealth-delivered dietary chronic disease management trials are incompletely reported. This prevents accurate interpretation of trial results and implementation of effective interventions in clinical practice.
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Affiliation(s)
- Molly M Warner
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Jaimon T Kelly
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | | | - Tammy C Hoffmann
- Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
| | - Katrina L Campbell
- Faculty of Health Sciences and Medicine, Bond University, Robina, Australia
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Glasbey JC, Magill EL, Brock K, Bach SP. Recommendations for Randomised Trials in Surgical Oncology. Clin Oncol (R Coll Radiol) 2017; 29:799-810. [PMID: 29097072 DOI: 10.1016/j.clon.2017.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 09/20/2017] [Indexed: 01/06/2023]
Abstract
Trials of surgical procedures in the treatment of malignant disease face a unique set of challenges. This review aimed to describe recommendations for the design, delivery and reporting of randomised trials in surgical oncology. A literature search was carried out without date limits to identify articles related to trial methodology research in surgery and surgical oncology. A narrative review was framed around two open National Institute of Health Research portfolio trials in colon and rectal cancer: the STAR-TREC trial (ISRCTN14240288) and the ROCCS trial (ISRCTN46330337). Twelve specific challenges were highlighted: standardisation of technique; pilot and feasibility studies; balancing treatments; the recruitment pathway; outcome measures; patient and public representation; trainee-led networks; randomisation; novel techniques and training; learning curves; blinding; follow-up. Evidence-based recommendations were made for the future design and conduct of surgical oncology trials. Better understanding of the challenges facing trials in the surgical treatment of cancer will accelerate high-quality evaluation and rapid adoption of innovation for the benefit of patient care.
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Affiliation(s)
- J C Glasbey
- Academic Department of Surgery, University of Birmingham, Birmingham, UK; Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - E L Magill
- Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - K Brock
- Devices, Drugs, Diagnostics and Biomarkers (D3B), Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK
| | - S P Bach
- Academic Department of Surgery, University of Birmingham, Birmingham, UK; Birmingham Clinical Trials Unit, University of Birmingham, Birmingham, UK; Devices, Drugs, Diagnostics and Biomarkers (D3B), Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK.
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165
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How can we implement exercise therapy for patellofemoral pain if we don’t know what was prescribed? A systematic review. Br J Sports Med 2017; 52:385. [DOI: 10.1136/bjsports-2017-097547] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2017] [Indexed: 12/21/2022]
Abstract
ObjectiveTo evaluate the completeness of exercise prescription in randomised controlled trials (RCTs) for patellofemoral pain (PFP), identify which elements are most frequently missing and supplement recommendations based on additional data from authors.DesignSystematic review.Data sourcesAll studies included in the most recent Cochrane review were evaluated. Additionally, the Cochrane search was updated in June 2016 in Cochrane, MEDLINE, EMBASE, PEDro, CINAHL and AMED databases. Two raters independently assessed completeness of reporting using the Toigo and Boutellier mechanobiological exercise descriptors, and Template for Intervention Description and Replication (TIDieR) checklist. Authors were also contacted to provide additional information.Eligibility criteria for selecting studiesRCTs of exercise interventions for PFP.ResultsWe included 38 RCTs. The level of exercise prescription detail was low, with no study providing complete information. The most commonly reported exercise descriptors were the ’duration of the experimental period' (n=38/38) and ’number of exercise interventions' (n=35). From TIDieR, the most commonly reported items were the ’intervention name' (n=38) and ’rationale' (n=36).The least reported items from the exercise descriptors were ’volitional muscular failure', ’temporal distribution of contraction modes', ’time under tension' and ’recovery between exercise sessions' (all n=2/38). From TIDieR, the least reported item was ‘How well (fidelity and adherence)’ (n=3/38).36 authors were contacted, with 22 replies and 13 providing additional exercise prescription details .ConclusionExercise prescriptions in RCTs with proven efficacy for PFP are poorly reported, impairing their implementation in clinical practice.PROSPERO registration numberCRD42016039138.
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Johnston M, Johnston D, Wood CE, Hardeman W, Francis J, Michie S. Communication of behaviour change interventions: Can they be recognised from written descriptions? Psychol Health 2017; 33:713-723. [DOI: 10.1080/08870446.2017.1385784] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Marie Johnston
- Institute of Applied Health Sciences, College of Life Science and Medicine, University of Aberdeen , Aberdeen, UK
| | - Derek Johnston
- Institute of Applied Health Sciences, College of Life Science and Medicine, University of Aberdeen , Aberdeen, UK
| | - Caroline E. Wood
- Centre for Behaviour Change, Department of Clinical Educational and Health Psychology, University College London , London, UK
| | - Wendy Hardeman
- Behavioural Science Group, Primary Care Unit, Institute of Public Health, School of Clinical Medicine, University of Cambridge , Cambridge, UK
| | - Jill Francis
- School of Health Sciences, City University of London , London, UK
| | - Susan Michie
- Centre for Behaviour Change, Department of Clinical Educational and Health Psychology, University College London , London, UK
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167
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Mhizha-Murira JR, Drummond A, Klein OA, dasNair R. Reporting interventions in trials evaluating cognitive rehabilitation in people with multiple sclerosis: a systematic review. Clin Rehabil 2017; 32:243-254. [PMID: 28828902 DOI: 10.1177/0269215517722583] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the quantity and quality of description of cognitive rehabilitation for cognitive deficits in people with multiple sclerosis, using a variety of published checklists, and suggest ways of improving the reporting of these interventions. DATA SOURCES A total of 10 electronic databases were searched, including MEDLINE, EMBASE, CINAHL and PsycINFO, from inception to May 2017. Grey literature databases, trial registers, reference lists and author citations were also searched. REVIEW METHODS Papers were included if participants were people with multiple sclerosis aged 18 years and over and if the effectiveness of cognitive rehabilitation in improving functional ability for memory, attention or executive dysfunction, with or without a control group, was being evaluated. RESULTS A total of 54 studies were included in this review. The reporting of a number of key aspects of cognitive rehabilitation was poor. This was particularly in relation to content of interventions (reported completely in 26 of the 54 studies), intervention procedures (reported completely in 16 of the 54 studies), delivery mode (reported completely in 24 of the 54 studies) and intervention mechanism of action (reported completely in 21 of the 54 studies). CONCLUSION The quality of reporting of cognitive rehabilitation for memory, attention and executive function for multiple sclerosis, across a range of study designs, is poor. Existing reporting checklists do not adequately cover aspects relevant to cognitive rehabilitation, such as the approaches used to address cognitive deficits. Future checklists could consider these aspects we have identified in this review.
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Affiliation(s)
| | - Avril Drummond
- 1 School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Olga A Klein
- 1 School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Roshan dasNair
- 2 Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
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168
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Gordon M. Where is the risk of bias? Considering intervention reporting quality. MEDICAL EDUCATION 2017; 51:874-875. [PMID: 28378914 DOI: 10.1111/medu.13277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Morris Gordon
- School of Medicine, University of Central Lancashire, Preston, UK
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169
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Ndounga Diakou LA, Ntoumi F, Ravaud P, Boutron I. Avoidable waste related to inadequate methods and incomplete reporting of interventions: a systematic review of randomized trials performed in Sub-Saharan Africa. Trials 2017; 18:291. [PMID: 28676066 PMCID: PMC5497345 DOI: 10.1186/s13063-017-2034-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 05/17/2017] [Indexed: 11/26/2022] Open
Abstract
Background Randomized controlled trials (RCTs) are needed to improve health care in Sub-Saharan Africa (SSA). However, inadequate methods and incomplete reporting of interventions can prevent the transposition of research in practice which leads waste of research. The aim of this systematic review was to assess the avoidable waste in research related to inadequate methods and incomplete reporting of interventions in RCTs performed in SSA. Methods We performed a methodological systematic review of RCTs performed in SSA and published between 1 January 2014 and 31 March 2015. We searched PubMed, the Cochrane library and the African Index Medicus to identify reports. We assessed the risk of bias using the Cochrane Risk of Bias tool, and for each risk of bias item, determined whether easy adjustments with no or minor cost could change the domain to low risk of bias. The reporting of interventions was assessed by using standardized checklists based on the Consolidated Standards for Reporting Trials, and core items of the Template for Intervention Description and Replication. Corresponding authors of reports with incomplete reporting of interventions were contacted to obtain additional information. Data were descriptively analyzed. Results Among 121 RCTs selected, 74 (61%) evaluated pharmacological treatments (PTs), including drugs and nutritional supplements; and 47 (39%) nonpharmacological treatments (NPTs) (40 participative interventions, 1 surgical procedure, 3 medical devices and 3 therapeutic strategies). Overall, the randomization sequence was adequately generated in 76 reports (62%) and the intervention allocation concealed in 48 (39%). The primary outcome was described as blinded in 46 reports (38%), and incomplete outcome data were adequately addressed in 78 (64%). Applying easy methodological adjustments with no or minor additional cost to trials with at least one domain at high risk of bias could have reduced the number of domains at high risk for 24 RCTs (19%). Interventions were completely reported for 73/121 (60%) RCTs: 51/74 (68%) of PTs and 22/47 (46%) of NPTs. Additional information was obtained from corresponding authors for 11/48 reports (22%). Conclusion Inadequate methods and incomplete reporting of published SSA RCTs could be improved by easy and inexpensive methodological adjustments and adherence to reporting guidelines. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2034-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lee Aymar Ndounga Diakou
- Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo. .,INSERM, UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS Team, Paris, France. .,Paris Descartes University, Paris, France.
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale (FCRM), Brazzaville, Congo.,Marien Ngouabi University, Brazzaville, Democratic Republic of the Congo.,Institute for Tropical Medicine, University of Tubingen, Tubingen, Germany
| | - Philippe Ravaud
- INSERM, UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS Team, Paris, France.,Paris Descartes University, Paris, France.,Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Isabelle Boutron
- INSERM, UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS Team, Paris, France.,Paris Descartes University, Paris, France.,Centre d'Épidémiologie Clinique, Hôpital Hôtel Dieu, Assistance Publique des Hôpitaux de Paris, Paris, France
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170
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Lewis KB, Wood B, Sepucha KR, Thomson RG, Stacey D. Quality of reporting of patient decision aids in recent randomized controlled trials: A descriptive synthesis and comparative analysis. PATIENT EDUCATION AND COUNSELING 2017; 100:1387-1393. [PMID: 28256281 DOI: 10.1016/j.pec.2017.02.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 01/18/2017] [Accepted: 02/22/2017] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Variable reporting of patient decision aids (PDAs) in published articles raises uncertainty about whether the intervention meets the definition of a PDA. We appraised the quality of reporting of PDA characteristics in randomized controlled trials (RCTs). METHODS RCTs eligible for the Cochrane review of PDAs and published June 2012 to April 2015 were included. Quality of PDA reporting was appraised using the International Patient Decision Aid Standards Instrument (v4.0). We descriptively synthesized and comparatively analysed qualifying and certification criteria reported in each publication against their presence in actual PDAs. RESULTS Seventeen RCTs evaluating sixteen PDAs were included. Ten PDAs (58.8%) were reported using all qualifying criteria. Two (11.8%) were reported using all certification criteria. The median score for reporting qualifying criteria was 6 of 6 (range 4-6). The median score for reporting certification criteria was 2 of 10 (range 2-3) for screening and 1 of 6 (range 0-6) for treatment decisions. CONCLUSION Reporting of PDAs in RCTs is suboptimal. Incomplete reporting poses challenges for clinicians and researchers needing to identify PDA content for clinical practice and/or future research. PRACTICE IMPLICATIONS Authors should report IPDASi (v4.0) criteria in published articles. Reporting guidelines for PDA evaluation studies are in development to improve reporting within the scientific literature.
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Affiliation(s)
| | - Brianne Wood
- School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada
| | - Karen R Sepucha
- Division of General Internal Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | - Richard G Thomson
- Institute of Health and Society, Newcastle University, Newcastle, UK
| | - Dawn Stacey
- School of Nursing, University of Ottawa, Ottawa, Canada; Ottawa Hospital Research Institute, Ottawa, Canada.
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Fernández Bustos P, Muriel García A. En enfermos ingresados en cuidados intensivos, ¿es efectiva la rehabilitación y la movilización activa en la mortalidad y capacidad funcional? ENFERMERIA INTENSIVA 2017. [DOI: 10.1016/j.enfi.2017.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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172
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Abell B, Glasziou P, Hoffmann T. Exploration of the methodological quality and clinical usefulness of a cross-sectional sample of published guidance about exercise training and physical activity for the secondary prevention of coronary heart disease. BMC Cardiovasc Disord 2017; 17:153. [PMID: 28610621 PMCID: PMC5470313 DOI: 10.1186/s12872-017-0589-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 06/05/2017] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Clinicians are encouraged to use guidelines to assist in providing evidence-based secondary prevention to patients with coronary heart disease. However, the expanding number of publications providing guidance about exercise training may confuse cardiac rehabilitation clinicians. We therefore sought to explore the number, scope, publication characteristics, methodological quality, and clinical usefulness of published exercise-based cardiac rehabilitation guidance. METHODS We included publications recommending physical activity, exercise or cardiac rehabilitation for patients with coronary heart disease. These included systematically developed clinical practice guidelines, as well as other publications intended to support clinician decision making, such as position papers or consensus statements. Publications were obtained via electronic searches of preventive cardiology societies, guideline databases and PubMed, to November 2016. Publication characteristics were extracted, and two independent assessors evaluated quality using the 23-item Appraisal of Guidelines Research and Evaluation II (AGREE) tool. RESULTS Fifty-four international publications from 1994 to 2016 were identified. Most were found on preventive cardiology association websites (n = 35; 65%) and were freely accessible (n = 50; 93%). Thirty (56%) publications contained only broad recommendations for physical activity and cardiac rehabilitation referral, while 24 (44%) contained the necessary detailed exercise training recommendations. Many were labelled as "guidelines", however publications with other titles (e.g. scientific statements) were common (n = 24; 44%). This latter group of publications contained a significantly greater proportion of detailed exercise training recommendations than clinical guidelines (p = 0.017). Wide variation in quality also existed, with 'applicability' the worst scoring AGREE II domain for clinical guidelines (mean score 53%) and 'rigour of development' rated lowest for other guidance types (mean score 33%). CONCLUSIONS While a large number of guidance documents provide recommendations for exercise-based cardiac rehabilitation, most have limitations in either methodological quality or clinical usefulness. The lack of rigorously developed guidelines which also contain necessary detail about exercise training remains a substantial problem for clinicians.
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Affiliation(s)
- Bridget Abell
- Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, QLD, Gold Coast, 4229 Australia
| | - Paul Glasziou
- Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, QLD, Gold Coast, 4229 Australia
| | - Tammy Hoffmann
- Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, QLD, Gold Coast, 4229 Australia
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Hariohm K, Jeyanthi S, Kumar JS, Prakash V. Description of interventions is under-reported in physical therapy clinical trials. Braz J Phys Ther 2017; 21:281-286. [PMID: 28579012 PMCID: PMC5537478 DOI: 10.1016/j.bjpt.2017.05.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/14/2016] [Accepted: 09/27/2016] [Indexed: 11/20/2022] Open
Abstract
A clear definition and description of the interventions in randomized controlled trials are pre-requisites for implementation in clinical practice. There is a trend among investigators to describe control group interventions poorly compared to the experimental group. The readers would not be able to apply the findings of the trial to their clinical practice if the interventions are poorly described.
Background Amongst several barriers to the application of quality clinical evidence and clinical guidelines into routine daily practice, poor description of interventions reported in clinical trials has received less attention. Although some studies have investigated the completeness of descriptions of non-pharmacological interventions in randomized trials, studies that exclusively analyzed physical therapy interventions reported in published trials are scarce. Objectives To evaluate the quality of descriptions of interventions in both experimental and control groups in randomized controlled trials published in four core physical therapy journals. Methods We included all randomized controlled trials published from the Physical Therapy Journal, Journal of Physiotherapy, Clinical Rehabilitation, and Archives of Physical Medicine and Rehabilitation between June 2012 and December 2013. Each randomized controlled trial (RCT) was analyzed and coded for description of interventions using the checklist developed by Schroter et al. Results Out of 100 RCTs selected, only 35 RCTs (35%) fully described the interventions in both the intervention and control groups. Control group interventions were poorly described in the remaining RCTs (65%). Conclusions Interventions, especially in the control group, are poorly described in the clinical trials published in leading physical therapy journals. A complete description of the intervention in a published report is crucial for physical therapists to be able to use the intervention in clinical practice.
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Affiliation(s)
- K Hariohm
- The Centre for Evidence Based Neuro-Rehabilitation (CEBNR), Chennai, Tamilnadu, India.
| | - S Jeyanthi
- The Centre for Evidence Based Neuro-Rehabilitation (CEBNR), Chennai, Tamilnadu, India
| | - J Saravan Kumar
- The Centre for Evidence Based Neuro-Rehabilitation (CEBNR), Chennai, Tamilnadu, India
| | - V Prakash
- Ashok & Rita Patel Institute of Physiotherapy, Charotar University of Science and Technology, Changa, Gujarat, India
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Ludemann A, Power E, Hoffmann TC. Investigating the Adequacy of Intervention Descriptions in Recent Speech-Language Pathology Literature: Is Evidence From Randomized Trials Useable? AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2017; 26:443-455. [PMID: 28475801 DOI: 10.1044/2016_ajslp-16-0035] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 12/01/2016] [Indexed: 06/07/2023]
Abstract
PURPOSE To evaluate the completeness of intervention descriptions in recent randomized controlled trials of speech-language pathology treatments. METHOD A consecutive sample of entries on the speechBITE database yielded 129 articles and 162 interventions. Interventions were rated using the Template for Intervention Description and Replication (TIDieR) checklist. Rating occurred at 3 stages: interventions as published in the primary article, secondary locations referred to by the article (e.g., protocol papers, websites), and contact with corresponding authors. RESULTS No interventions were completely described in primary publications or after analyzing information from secondary locations. After information was added from correspondence with authors, a total of 28% of interventions was rated as complete. The intervention elements with the most information missing in the primary publications were tailoring and modification of interventions (in 25% and 13% of articles, respectively) and intervention materials and where they could be accessed (18%). Elements that were adequately described in most articles were intervention names (in 100% of articles); rationale (96%); and details of the frequency, session duration, and length of interventions (69%). CONCLUSIONS Clinicians and researchers are restricted in the usability of evidence from speech-language pathology randomized trials because of poor reporting of elements essential to the replication of interventions.
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Affiliation(s)
| | - Emma Power
- Speech Pathology, University of Sydney, New South Wales
| | - Tammy C Hoffmann
- Centre for Research in Evidence-Based Practice, Bond University, Queensland, Australia
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175
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Hanlon P, Daines L, Campbell C, McKinstry B, Weller D, Pinnock H. Telehealth Interventions to Support Self-Management of Long-Term Conditions: A Systematic Metareview of Diabetes, Heart Failure, Asthma, Chronic Obstructive Pulmonary Disease, and Cancer. J Med Internet Res 2017; 19:e172. [PMID: 28526671 PMCID: PMC5451641 DOI: 10.2196/jmir.6688] [Citation(s) in RCA: 312] [Impact Index Per Article: 44.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 02/22/2017] [Accepted: 03/09/2017] [Indexed: 12/28/2022] Open
Abstract
Background Self-management support is one mechanism by which telehealth interventions have been proposed to facilitate management of long-term conditions. Objective The objectives of this metareview were to (1) assess the impact of telehealth interventions to support self-management on disease control and health care utilization, and (2) identify components of telehealth support and their impact on disease control and the process of self-management. Our goal was to synthesise evidence for telehealth-supported self-management of diabetes (types 1 and 2), heart failure, asthma, chronic obstructive pulmonary disease (COPD) and cancer to identify components of effective self-management support. Methods We performed a metareview (a systematic review of systematic reviews) of randomized controlled trials (RCTs) of telehealth interventions to support self-management in 6 exemplar long-term conditions. We searched 7 databases for reviews published from January 2000 to May 2016 and screened identified studies against eligibility criteria. We weighted reviews by quality (revised A Measurement Tool to Assess Systematic Reviews), size, and relevance. We then combined our results in a narrative synthesis and using harvest plots. Results We included 53 systematic reviews, comprising 232 unique RCTs. Reviews concerned diabetes (type 1: n=6; type 2, n=11; mixed, n=19), heart failure (n=9), asthma (n=8), COPD (n=8), and cancer (n=3). Findings varied between and within disease areas. The highest-weighted reviews showed that blood glucose telemonitoring with feedback and some educational and lifestyle interventions improved glycemic control in type 2, but not type 1, diabetes, and that telemonitoring and telephone interventions reduced mortality and hospital admissions in heart failure, but these findings were not consistent in all reviews. Results for the other conditions were mixed, although no reviews showed evidence of harm. Analysis of the mediating role of self-management, and of components of successful interventions, was limited and inconclusive. More intensive and multifaceted interventions were associated with greater improvements in diabetes, heart failure, and asthma. Conclusions While telehealth-mediated self-management was not consistently superior to usual care, none of the reviews reported any negative effects, suggesting that telehealth is a safe option for delivery of self-management support, particularly in conditions such as heart failure and type 2 diabetes, where the evidence base is more developed. Larger-scale trials of telehealth-supported self-management, based on explicit self-management theory, are needed before the extent to which telehealth technologies may be harnessed to support self-management can be established.
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Affiliation(s)
- Peter Hanlon
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Luke Daines
- Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Christine Campbell
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Brian McKinstry
- E-Health Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - David Weller
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Hilary Pinnock
- Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
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Gallois M, Davergne T, Ledinot P, Ravaud P, Regnaux JP. Dosage of Preventive or Therapeutic Exercise Interventions: Review of Published Randomized Controlled Trials and Survey of Authors. Arch Phys Med Rehabil 2017; 98:2558-2565.e10. [PMID: 28465221 DOI: 10.1016/j.apmr.2017.03.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 03/20/2017] [Accepted: 03/22/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To describe the dose components and choice justifications in exercise interventions in a convenient sample of randomized controlled trials (RCTs). DATA SOURCES We searched the following databases: PubMed and Cochrane Central Register of Controlled Trials in 2014. STUDY SELECTION We included published RCTs evaluating preventive or therapeutic interventions in people with clinical conditions or at risk to develop health problems. DATA EXTRACTION Two reviewers independently extracted data and evaluated the adequacy of the justifications. We contacted and invited the trials authors to complete an online survey to ask for additional information on dose justifications and dose-effect relation. DATA SYNTHESIS We included 187 published RCTs. Of these, 68 (36%) reported a justification for the dose choice, and 135 (72%) reported 3 doses components. Most reported components were duration (96%) and frequency (93%). Sixty-six survey responders (response rate, 35%) provided additional information. When combining the publications and survey responses, 104 (56%) trials had a justification for the dose choice. We judged justifications adequate in 45 (43%) articles. From the survey responders, 39% indicated that intensity was the dose component that can have the greatest effect on their study results. CONCLUSIONS Most of the published RCTs adequately reported the dose components of their exercise interventions but only a small number provided sufficient justifications for dosage choices. Further studies are recommended to justify the exercise intervention dose choices.
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Affiliation(s)
- Marion Gallois
- Center of Research in Epidemiology and Statistics Sorbonne Cité U1153, Inserm, METHODS team, Paris, France; Sorbonne Paris Cité, faculté de médecine, Paris Descartes University, Paris, France
| | - Thomas Davergne
- Center of Research in Epidemiology and Statistics Sorbonne Cité U1153, Inserm, METHODS team, Paris, France; Sorbonne Paris Cité, faculté de médecine, Paris Descartes University, Paris, France
| | - Pauline Ledinot
- Center of Research in Epidemiology and Statistics Sorbonne Cité U1153, Inserm, METHODS team, Paris, France; Sorbonne Paris Cité, faculté de médecine, Paris Descartes University, Paris, France
| | - Philippe Ravaud
- Center of Research in Epidemiology and Statistics Sorbonne Cité U1153, Inserm, METHODS team, Paris, France; Sorbonne Paris Cité, faculté de médecine, Paris Descartes University, Paris, France; Assistance Publique des Hôpitaux de Paris, hôpital Hôtel Dieu, centre d'épidémiologie clinique, Paris, France
| | - Jean-Philippe Regnaux
- Center of Research in Epidemiology and Statistics Sorbonne Cité U1153, Inserm, METHODS team, Paris, France; Sorbonne Paris Cité, faculté de médecine, Paris Descartes University, Paris, France; French School of Public Health, Department of Social Human Science, Sorbonne Paris Cité, Paris, France.
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Välimäki M, Yang M, Normand SL, Lorig KR, Anttila M, Lantta T, Pekurinen V, Adams CE. Study protocol for a cluster randomised controlled trial to assess the effectiveness of user-driven intervention to prevent aggressive events in psychiatric services. BMC Psychiatry 2017; 17:123. [PMID: 28372555 PMCID: PMC5379524 DOI: 10.1186/s12888-017-1266-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/11/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND People admitted to psychiatric hospitals with a diagnosis of schizophrenia may display behavioural problems. These may require management approaches such as use of coercive practices, which impact the well-being of staff members, visiting families and friends, peers, as well as patients themselves. Studies have proposed that not only patients' conditions, but also treatment environment and ward culture may affect patients' behaviour. Seclusion and restraint could possibly be prevented with staff education about user-centred, more humane approaches. Staff education could also increase collaboration between patients, family members and staff, which may further positively affect treatment culture and lower the need for using coercive treatment methods. METHODS This is a single-blind, two-arm cluster randomised controlled trial involving 28 psychiatric hospital wards across Finland. Units will be randomised to receive either a staff educational programme delivered by the team of researchers, or standard care. The primary outcome is the incidence of use of patient seclusion rooms, assessed from the local/national health registers. Secondary outcomes include use of other coercive methods (limb restraint, forced injection, and physical restraint), service use, treatment satisfaction, general functioning among patients, and team climate and employee turn-over (nursing staff). DISCUSSION The study, designed in close collaboration with staff members, patients and their relatives, will provide evidence for a co-operative and user-centred educational intervention aiming to decrease the prevalence of coercive methods and service use in the units, increase the functional status of patients and improve team climate in the units. We have identified no similar trials. TRIAL REGISTRATION ClinicalTrials.gov NCT02724748 . Registered on 25th of April 2016.
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Affiliation(s)
- Maritta Välimäki
- Department of Nursing Science, Faculty of Medicine, University of Turku , Turku, Finland
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
- Turku University Hospital, Turku, Finland
| | - Min Yang
- West China Research Center for Rural Health Development, Sichuan University Huaxi Medical Center, Sichuan University of China, Administration Building, No 17,Section 3,Ren Ming Nan Lu, Chengdu, Sichuan China
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115-5899 USA
| | - Sharon-Lise Normand
- Department of Health Care Policy, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115-5899 USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard Medical School, 180 Longwood Avenue, Boston, MA 02115-5899 USA
| | - Kate R. Lorig
- Department of Medicine - Med/Immunology & Rheumatology, Stanford University, 1000 WELCH RD. #204, Stanford, CA 94305-5755 USA
| | - Minna Anttila
- Department of Nursing Science, Faculty of Medicine, University of Turku , Turku, Finland
| | - Tella Lantta
- Department of Nursing Science, Faculty of Medicine, University of Turku , Turku, Finland
| | - Virve Pekurinen
- Department of Nursing Science, Faculty of Medicine, University of Turku , Turku, Finland
| | - Clive E. Adams
- Institute of Mental Health, Division of Psychiatry, University of Nottingham, Jubilee Campus, Wollaton Road, Nottingham, NG8 1BB UK
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Pinnock H, Barwick M, Carpenter CR, Eldridge S, Grandes G, Griffiths CJ, Rycroft-Malone J, Meissner P, Murray E, Patel A, Sheikh A, Taylor SJC. Standards for Reporting Implementation Studies (StaRI): explanation and elaboration document. BMJ Open 2017; 7:e013318. [PMID: 28373250 PMCID: PMC5387970 DOI: 10.1136/bmjopen-2016-013318] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 01/09/2017] [Accepted: 01/11/2017] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Implementation studies are often poorly reported and indexed, reducing their potential to inform the provision of healthcare services. The Standards for Reporting Implementation Studies (StaRI) initiative aims to develop guidelines for transparent and accurate reporting of implementation studies. METHODS An international working group developed the StaRI guideline informed by a systematic literature review and e-Delphi prioritisation exercise. Following a face-to-face meeting, the checklist was developed iteratively by email discussion and critical review by international experts. RESULTS The 27 items of the checklist are applicable to the broad range of study designs employed in implementation science. A key concept is the dual strands, represented as 2 columns in the checklist, describing, on the one hand, the implementation strategy and, on the other, the clinical, healthcare or public health intervention being implemented. This explanation and elaboration document details each of the items, explains the rationale and provides examples of good reporting practice. CONCLUSIONS Previously published reporting statements have been instrumental in improving reporting standards; adoption by journals and authors may achieve a similar improvement in the reporting of implementation strategies that will facilitate translation of effective interventions into routine practice.
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Affiliation(s)
- Hilary Pinnock
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Melanie Barwick
- Research Institute, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Christopher R Carpenter
- Division of Emergency Medicine, Washington University School of Medicine in St Louis, St Louis, USA
| | - Sandra Eldridge
- Pragmatic Clinical Trials Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Basque Health Service, Bilbao, Spain
| | - Chris J Griffiths
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jo Rycroft-Malone
- Bangor Institute for Health and Medical Research, Bangor University, Bangor, UK
| | - Paul Meissner
- Montefiore Medical Center, The University Hospital for Albert Einstein College of Medicine, New York, USA
| | - Elizabeth Murray
- Department of Primary Care and Population Health, University College London, London, UK
| | - Anita Patel
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aziz Sheikh
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - Stephanie J C Taylor
- Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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Page P, Hoogenboom B, Voight M. IMPROVING THE REPORTING OF THERAPEUTIC EXERCISE INTERVENTIONS IN REHABILITATION RESEARCH. Int J Sports Phys Ther 2017; 12:297-304. [PMID: 28515984 PMCID: PMC5380872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
UNLABELLED The foundation of evidence-based practice lies in clinical research, which is based on the utilization of the scientific method. The scientific method requires that all details of the experiment be provided in publications to support replication of the study in order to evaluate and validate the results. More importantly, clinical research can only be translated into practice when researchers provide explicit details of the study. Too often, rehabilitation exercise intervention studies lack the appropriate detail to allow clinicians to replicate the exercise protocol in their patient populations. Therefore, the purpose of this clinical commentary is to provide guidelines for optimal reporting of therapeutic exercise interventions in rehabilitation research. LEVEL OF EVIDENCE 5.
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Burchett HED, Leurent B, Baiden F, Baltzell K, Björkman A, Bruxvoort K, Clarke S, DiLiberto D, Elfving K, Goodman C, Hopkins H, Lal S, Liverani M, Magnussen P, Mårtensson A, Mbacham W, Mbonye A, Onwujekwe O, Roth Allen D, Shakely D, Staedke S, Vestergaard LS, Whitty CJM, Wiseman V, Chandler CIR. Improving prescribing practices with rapid diagnostic tests (RDTs): synthesis of 10 studies to explore reasons for variation in malaria RDT uptake and adherence. BMJ Open 2017; 7:e012973. [PMID: 28274962 PMCID: PMC5353269 DOI: 10.1136/bmjopen-2016-012973] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES The overuse of antimalarial drugs is widespread. Effective methods to improve prescribing practice remain unclear. We evaluated the impact of 10 interventions that introduced rapid diagnostic tests for malaria (mRDTs) on the use of tests and adherence to results in different contexts. DESIGN A comparative case study approach, analysing variation in outcomes across different settings. SETTING Studies from the ACT Consortium evaluating mRDTs with a range of supporting interventions in 6 malaria endemic countries. Providers were governmental or non-governmental healthcare workers, private retail sector workers or community volunteers. Each study arm in a distinct setting was considered a case. PARTICIPANTS 28 cases from 10 studies were included, representing 148 461 patients seeking care for suspected malaria. INTERVENTIONS The interventions included different mRDT training packages, supervision, supplies and community sensitisation. OUTCOME MEASURES Analysis explored variation in: (1) uptake of mRDTs (% febrile patients tested); (2) provider adherence to positive mRDTs (% Plasmodium falciparum positive prescribed/given Artemisinin Combination Treatment); (3) provider adherence to negative mRDTs (% P. falciparum negative not prescribed/given antimalarial). RESULTS Outcomes varied widely across cases: 12-100% mRDT uptake; 44-98% adherence to positive mRDTs; 27-100% adherence to negative mRDTs. Providers appeared more motivated to perform well when mRDTs and intervention characteristics fitted with their own priorities. Goodness of fit of mRDTs with existing consultation and diagnostic practices appeared crucial to maximising the impact of mRDTs on care, as did prior familiarity with malaria testing; adequate human resources and supplies; possible alternative treatments for mRDT-negative patients; a more directive intervention approach and local preferences for ACTs. CONCLUSIONS Basic training and resources are essential but insufficient to maximise the potential of mRDTs in many contexts. Programme design should respond to assessments of provider priorities, expectations and capacities. As mRDTs become established, the intensity of supporting interventions required seems likely to reduce.
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Affiliation(s)
- Helen E D Burchett
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Baptiste Leurent
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Frank Baiden
- Epidemiology Unit, Ensign College of Public Health, Kpong, Ghana
| | - Kimberly Baltzell
- Department of Family Health Care Nursing, and Global Health Science, University of California, Berkeley, California, USA
| | - Anders Björkman
- Department of Microbiology, Tumour and Cell Biology, Karolinska Institute, Stockholm, Sweden
| | - Katia Bruxvoort
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Siân Clarke
- Disease Control Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Deborah DiLiberto
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Kristina Elfving
- Department of Infectious Diseases, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Department of Paediatrics, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
- Department of Microbiology, Tumour and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Catherine Goodman
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Heidi Hopkins
- Disease Control Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Sham Lal
- Disease Control Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Marco Liverani
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Pascal Magnussen
- Faculty of Health and Medical Sciences, Centre for Medical Parasitology, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Mårtensson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Wilfred Mbacham
- Laboratory for Public Health Research Biotechnologies, The Biotechnology Center, University of Yaoundé, Yaoundé, Cameroon
| | - Anthony Mbonye
- School of Public Health- Makerere University and Commissioner Health Services, Ministry of Health, Uganda
| | - Obinna Onwujekwe
- Department of Pharmacology and Therapeutics, University of Nigeria Enugu-Campus, Nigeria
| | | | - Delér Shakely
- Department of Microbiology, Tumour and Cell Biology, Karolinska Institute, Stockholm, Sweden
- Department of Medicine, Kungälv Hospital, Sweden
| | - Sarah Staedke
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Lasse S Vestergaard
- Centre for Medical Parasitology, University of Copenhagen and Copenhagen University Hospital Rigshospitalet, Denmark
- Department of Infectious Disease Epidemiology, Statens Serum Institut, Denmark
| | - Christopher J M Whitty
- Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Virginia Wiseman
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
- School of Public Health and Community Medicine, Australia
| | - Clare I R Chandler
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
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Barkun J, Fisher W, Davidson G, Wakabayashi G, Besselink M, Pitt H, Holt J, Strasberg S, Vollmer C, Kooby D. Research considerations in the evaluation of minimally invasive pancreatic resection (MIPR). HPB (Oxford) 2017; 19:246-253. [PMID: 28274661 DOI: 10.1016/j.hpb.2017.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 01/06/2017] [Indexed: 12/12/2022]
Abstract
The IHPBA/AHPBA-sponsored 2016 minimally invasive pancreatic resection (MIPR) conference held on April 20th, 2016 included a session designed to evaluate what would be the most appropriate scientific contribution to help define the increasing role of MIPR internationally. Participants in the conference reviewed the assessment of numerous pertinent scientific designs including randomized controlled trial (RCT), pragmatic international RCT, registry-RCT, non-RCT with propensity matching, and various types of clinical registries including those aiming to create a quality improvement data system or a learning health care system. The strengths and weaknesses of each of these designs, the status of trials which are currently recruiting patients, and pragmatic considerations were evaluated. A recommendation was made to establish a clinical registry to collect data prospectively from around the world to assess current practices and provide a framework for future studies in MIPR.
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Affiliation(s)
- Jeffrey Barkun
- McGill University Heath Center, McGill University, Montreal, Canada.
| | - William Fisher
- Department of Surgery, General Surgery, Baylor College of Medicine, Houston, USA
| | - Giana Davidson
- University of Washington Department of Surgery, Department of Health Services, Surgical Outcomes Research Center, Seattle, USA
| | | | - Marc Besselink
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Henry Pitt
- Temple University Health System, Inc., Temple University - Lewis Katz School of Medicine, Philadelphia Academy of Surgery, Philadelphia, USA
| | | | - Steve Strasberg
- Surgery Division of General Surgery, Barnes-Jewish Hospital, VA Medical Center - St. Louis - John Cochran Division, St. Louis, USA
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Ferrante di Ruffano L, Dinnes J, Taylor-Phillips S, Davenport C, Hyde C, Deeks JJ. Research waste in diagnostic trials: a methods review evaluating the reporting of test-treatment interventions. BMC Med Res Methodol 2017; 17:32. [PMID: 28231757 PMCID: PMC5324286 DOI: 10.1186/s12874-016-0286-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 12/22/2016] [Indexed: 11/05/2023] Open
Abstract
BACKGROUND The most rigorous method for evaluating the effectiveness of diagnostic tests is through randomised trials that compare test-treatment interventions: complex interventions comprising episodes of testing, decision-making and treatment. The multi-staged nature of these interventions, combined with the need to relay diagnostic decision-making and treatment planning, has led researchers to hypothesise that test-treatment strategies may be very challenging to document. However, no reviews have yet examined the reporting quality of interventions used in test-treatment RCTs. In this study we evaluate the completeness of intervention descriptions in a systematically identified cohort of test-treatment RCTs. METHODS We ascertained all test-treatment RCTs published 2004-2007, indexed in CENTRAL. Included trials randomized patients to diagnostic tests and measured patient outcomes after treatment. Two raters examined the completeness of test-treatment intervention descriptions in four components: 1) the test, 2) diagnostic decision-making, 3) management decision-making, 4) treatments. RESULTS One hundred and three trials compared 105 control with 119 experimental interventions, most commonly in cardiovascular medicine (35, 34%), obstetrics and gynecology (17%), gastroenterology (14%) or orthopedics (10%). A broad range of tests were evaluated, including imaging (50, 42%), biochemical assays (21%) and clinical assessment (12%). Only five (5%) trials detailed all four components of experimental and control interventions, none of which also provided a complete care pathway diagram. Experimental arms were missing descriptions of tests, diagnostic-decision making, management planning and treatments (36%, 51%, 55% and 79% of trials respectively); control arms were missing the same details in 61%, 66%, 67% and 84% of trials. CONCLUSION Reporting of test-treatment interventions is very poor, inadequate for understanding the results of these trials, and for comparing or translating results into clinical practice. Reporting needs to improve, with greater emphasis on describing the decision-making components of care pathways in both pragmatic and explanatory trials. Please see the companion paper to this article: http://bmcmedresmethodol.biomedcentral.com/articles/10.1186/s12874-016-0287-z .
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Affiliation(s)
- Lavinia Ferrante di Ruffano
- Biostatistics, Evidence Synthesis and Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT UK
| | - Jacqueline Dinnes
- Biostatistics, Evidence Synthesis and Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT UK
| | - Sian Taylor-Phillips
- Biostatistics, Evidence Synthesis and Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT UK
- Warwick Medical School, The University of Warwick, Coventry, CV4 7AL UK
| | - Clare Davenport
- Biostatistics, Evidence Synthesis and Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT UK
| | - Chris Hyde
- PenTAG, The Institute of Health Reseach, University of Exeter Medical School, Exeter, EX1 2LU UK
| | - Jonathan J. Deeks
- Biostatistics, Evidence Synthesis and Test Evaluation Research Group, Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT UK
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Le Roux E, Mellerio H, Guilmin-Crépon S, Gottot S, Jacquin P, Boulkedid R, Alberti C. Methodology used in comparative studies assessing programmes of transition from paediatrics to adult care programmes: a systematic review. BMJ Open 2017; 7:e012338. [PMID: 28131998 PMCID: PMC5278245 DOI: 10.1136/bmjopen-2016-012338] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To explore the methodologies employed in studies assessing transition of care interventions, with the aim of defining goals for the improvement of future studies. DESIGN Systematic review of comparative studies assessing transition to adult care interventions for young people with chronic conditions. DATA SOURCES MEDLINE, EMBASE, ClinicalTrial.gov. ELIGIBILITY CRITERIA FOR SELECTING STUDIES 2 reviewers screened comparative studies with experimental and quasi-experimental designs, published or registered before July 2015. Eligible studies evaluate transition interventions at least in part after transfer to adult care of young people with chronic conditions with at least one outcome assessed quantitatively. RESULTS 39 studies were reviewed, 26/39 (67%) published their final results and 13/39 (33%) were in progress. In 9 studies (9/39, 23%) comparisons were made between preintervention and postintervention in a single group. Randomised control groups were used in 9/39 (23%) studies. 2 (2/39, 5%) reported blinding strategies. Use of validated questionnaires was reported in 28% (11/39) of studies. In terms of reporting in published studies 15/26 (58%) did not report age at transfer, and 6/26 (23%) did not report the time of collection of each outcome. CONCLUSIONS Few evaluative studies exist and their level of methodological quality is variable. The complexity of interventions, multiplicity of outcomes, difficulty of blinding and the small groups of patients have consequences on concluding on the effectiveness of interventions. The evaluation of the transition interventions requires an appropriate and common methodology which will provide access to a better level of evidence. We identified areas for improvement in terms of randomisation, recruitment and external validity, blinding, measurement validity, standardised assessment and reporting. Improvements will increase our capacity to determine effective interventions for transition care.
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Affiliation(s)
- E Le Roux
- UFR de Médecine Paris Diderot—Site Villemin, Unité INSERM ECEVE, UMRS 1123, Paris, France
| | - H Mellerio
- UFR de Médecine Paris Diderot—Site Villemin, Unité INSERM ECEVE, UMRS 1123, Paris, France
| | - S Guilmin-Crépon
- UFR de Médecine Paris Diderot—Site Villemin, Unité INSERM ECEVE, UMRS 1123, Paris, France
| | - S Gottot
- UFR de Médecine Paris Diderot—Site Villemin, Unité INSERM ECEVE, UMRS 1123, Paris, France
| | - P Jacquin
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, CIC-EC, Unité INSERM CIC 1426, Paris, France
| | - R Boulkedid
- UFR de Médecine Paris Diderot—Site Villemin, Unité INSERM ECEVE, UMRS 1123, Paris, France
| | - C Alberti
- UFR de Médecine Paris Diderot—Site Villemin, Unité INSERM ECEVE, UMRS 1123, Paris, France
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Fairman CM, Hyde PN, Focht BC. Resistance training interventions across the cancer control continuum: a systematic review of the implementation of resistance training principles. Br J Sports Med 2016; 51:677-685. [DOI: 10.1136/bjsports-2016-096537] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2016] [Indexed: 11/03/2022]
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Howarth E, Moore THM, Welton NJ, Lewis N, Stanley N, MacMillan H, Shaw A, Hester M, Bryden P, Feder G. IMPRoving Outcomes for children exposed to domestic ViolencE (IMPROVE): an evidence synthesis. PUBLIC HEALTH RESEARCH 2016. [DOI: 10.3310/phr04100] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
BackgroundExposure to domestic violence and abuse (DVA) during childhood and adolescence increases the risk of negative outcomes across the lifespan.ObjectivesTo synthesise evidence on the clinical effectiveness, cost-effectiveness and acceptability of interventions for children exposed to DVA, with the aim of making recommendations for further research.Design(1) A systematic review of controlled trials of interventions; (2) a systematic review of qualitative studies of participant and professional experience of interventions; (3) a network meta-analysis (NMA) of controlled trials and cost-effectiveness analysis; (4) an overview of current UK provision of interventions; and (5) consultations with young people, parents, service providers and commissioners.SettingsNorth America (11), the Netherlands (1) and Israel (1) for the systematic review of controlled trials of interventions; the USA (4) and the UK (1) for the systematic review of qualitative studies of participant and professional experience of interventions; and the UK for the overview of current UK provision of interventions and consultations with young people, parents, service providers and commissioners.ParticipantsA total of 1345 children for the systematic review of controlled trials of interventions; 100 children, 202 parents and 39 professionals for the systematic review of qualitative studies of participant and professional experience of interventions; and 16 young people, six parents and 20 service providers and commissioners for the consultation with young people, parents, service providers and commissioners.InterventionsPsychotherapeutic, advocacy, parenting skills and advocacy, psychoeducation, psychoeducation and advocacy, guided self-help.Main outcome measuresInternalising symptoms and externalising behaviour, mood, depression symptoms and diagnosis, post-traumatic stress disorder symptoms and self-esteem for the systematic review of controlled trials of interventions and NMA; views about and experience of interventions for the systematic review of qualitative studies of participant and professional experience of interventions and consultations.Data sourcesMEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, EMBASE, Cochrane Central Register of Controlled Trials, Science Citation Index, Applied Social Sciences Index and Abstracts, International Bibliography of the Social Sciences, Social Services Abstracts, Social Care Online, Sociological Abstracts, Social Science Citation Index, World Health Organization trials portal and clinicaltrials.gov.Review methodsA narrative review; a NMA and incremental cost-effectiveness analysis; and a qualitative synthesis.ResultsThe evidence base on targeted interventions was small, with limited settings and types of interventions; children were mostly < 14 years of age, and there was an absence of comparative studies. The interventions evaluated in trials were mostly psychotherapeutic and psychoeducational interventions delivered to the non-abusive parent and child, usually based on the child’s exposure to DVA (not specific clinical or broader social needs). Qualitative studies largely focused on psychoeducational interventions, some of which included the abusive parent. The evidence for clinical effectiveness was as follows: 11 trials reported improvements in behavioural or mental health outcomes, with modest effect sizes but significant heterogeneity and high or unclear risk of bias. Psychoeducational group-based interventions delivered to the child were found to be more effective for improving mental health outcomes than other types of intervention. Interventions delivered to (non-abusive) parents and to children were most likely to be effective for improving behavioural outcomes. However, there is a large degree of uncertainty around comparisons, particularly with regard to mental health outcomes. In terms of evidence of cost-effectiveness, there were no economic studies of interventions. Cost-effectiveness was modelled on the basis of the NMA, estimating differences between types of interventions. The outcomes measured in trials were largely confined to children’s mental health and behavioural symptoms and disorders, although stakeholders’ concepts of success were broader, suggesting that a broader range of outcomes should be measured in trials. Group-based psychoeducational interventions delivered to children and non-abusive parents in parallel were largely acceptable to all stakeholders. There is limited evidence for the acceptability of other types of intervention. In terms of the UK evidence base and service delivery landscape, there were no UK-based trials, few qualitative studies and little widespread service evaluation. Most programmes are group-based psychoeducational interventions. However, the funding crisis in the DVA sector is significantly undermining programme delivery.ConclusionsThe evidence base regarding the acceptability, clinical effectiveness and cost-effectiveness of interventions to improve outcomes for children exposed to DVA is underdeveloped. There is an urgent need for more high-quality studies, particularly trials, that are designed to produce actionable, generalisable findings that can be implemented in real-world settings and that can inform decisions about which interventions to commission and scale. We suggest that there is a need to pause the development of new interventions and to focus on the systematic evaluation of existing programmes. With regard to the UK, we have identified three types of programme that could be justifiably prioritised for further study: psycho-education delivered to mothers and children, or children alone; parent skills training in combination with advocacy: and interventions involving the abusive parent/caregiver. We also suggest that there is need for key stakeholders to come together to explicitly identify and address the structural, practical and cultural barriers that may have hampered the development of the UK evidence base to date.Future work recommendationsThere is a need for well-designed, well-conducted and well-reported UK-based randomised controlled trials with cost-effectiveness analyses and nested qualitative studies. Development of consensus in the field about core outcome data sets is required. There is a need for further exploration of the acceptability and effectiveness of interventions for specific groups of children and young people (i.e. based on ethnicity, age, trauma exposure and clinical profile). There is also a need for an investigation of the context in which interventions are delivered, including organisational setting and the broader community context, and the evaluation of qualities, qualifications and disciplines of personnel delivering interventions. We recommend prioritisation of psychoeducational interventions and parent skills training delivered in combination with advocacy in the next phase of trials, and exploratory trials of interventions that engage both the abusive and the non-abusive parent.Study registrationThis study is registered as PROSPERO CRD42013004348 and PROSPERO CRD420130043489.FundingThe National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Emma Howarth
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of England (NIHR CLAHRC EoE), Cambridge, UK
- Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Theresa HM Moore
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Nicky J Welton
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Natalia Lewis
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Nicky Stanley
- Connect Centre, School of Social Work, Care and Community, University of Central Lancashire, Preston, UK
| | - Harriet MacMillan
- Psychiatry and Behavioural Neurosciences, and Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Alison Shaw
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Marianne Hester
- School for Policy Studies, University of Bristol, Bristol, UK
| | - Peter Bryden
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Gene Feder
- Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol, Bristol, UK
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Sakzewski L, Reedman S, Hoffmann T. Do we really know what they were testing? Incomplete reporting of interventions in randomised trials of upper limb therapies in unilateral cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 59:417-427. [PMID: 27736712 DOI: 10.1016/j.ridd.2016.09.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 09/14/2016] [Accepted: 09/19/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Incomplete reporting of components of interventions limits uptake of evidence into clinical practice. AIMS To evaluate the completeness of reporting of research and control interventions in randomised trials of upper limb therapies for children with unilateral cerebral palsy. METHODS AND PROCEDURES Sixty randomized trials were included, encompassing 60 research and 68 control interventions. Using the 12-item Template for Intervention Description and Replication (TIDieR) checklist, two reviewers independently rated intervention and control descriptions. OUTCOMES AND RESULTS When using 50% of studies as the benchmark, five of the 12 TIDieR items for the research intervention, eight of the 12 items for the control intervention and 11 of 12 items for "usual care" interventions were inadequately reported. Procedures used to deliver the research intervention were adequately reported for 63% of studies. Materials were used in 94% of research interventions, yet only 27% provided details to access/replicate materials. Training materials for interventionists were used in 38% of trials, 10 (17%) had procedure manuals, yet only 3 reported details to access materials. The location where the research intervention was provided was detailed in 65% of studies. Reporting of all items was poorer for the control intervention. CONCLUSIONS No study adequately reported all elements on the TIDieR checklist. Details crucial for replication of interventions and interpretation of results were missing. Authors, reviewers, and editors all have a responsibility to improve the quality of intervention reporting in published trials. The TIDieR guide is a potential solution, helping to structure accounts of interventions.
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Affiliation(s)
- Leanne Sakzewski
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia.
| | - Sarah Reedman
- Queensland Cerebral Palsy and Rehabilitation Research Centre, Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia
| | - Tammy Hoffmann
- Centre for Research in Evidence-Based Practice, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
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Yamato T, Maher C, Saragiotto B, Moseley A, Hoffmann T, Elkins M, Brooks D. The TIDieR Checklist Will Benefit the Physiotherapy Profession. Physiother Can 2016; 68:311-314. [PMID: 27904230 DOI: 10.3138/ptc.68.4.gee] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Tie Yamato
- Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, N.S.W
| | - Chris Maher
- Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, N.S.W
| | - Bruno Saragiotto
- Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, N.S.W
| | - Anne Moseley
- Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, N.S.W
| | - Tammy Hoffmann
- Centre for Research in Evidence Based Practice, Faculty of Health Sciences and Medicine, Bond University, Robina, Qld., Australia
| | - Mark Elkins
- International Society of Physiotherapy Journal Editor
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Yamato T, Maher C, Saragiotto B, Moseley A, Hoffmann T, Elkins M, Brooks D. La liste de contrôle TIDieR profitera à la profession de physiothérapeute. Physiother Can 2016. [DOI: 10.3138/ptc.68.4.gef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Tie Yamato
- Division musculosquelettique, Institut George pour la santé mondiale, École de médecine de Sydney, Université de Sydney, Sydney, N.S.W
| | - Chris Maher
- Division musculosquelettique, Institut George pour la santé mondiale, École de médecine de Sydney, Université de Sydney, Sydney, N.S.W
| | - Bruno Saragiotto
- Division musculosquelettique, Institut George pour la santé mondiale, École de médecine de Sydney, Université de Sydney, Sydney, N.S.W
| | - Anne Moseley
- Division musculosquelettique, Institut George pour la santé mondiale, École de médecine de Sydney, Université de Sydney, Sydney, N.S.W
| | - Tammy Hoffmann
- Centre de recherche sur la pratique fondée sur les données probantes, Faculté des sciences de la santé et de médecine, Université Bond, Robina, Qld., Australie
| | - Mark Elkins
- Société internationale des rédacteurs en chef de revues de physiothérapie
| | - Dina Brooks
- Directrice scientifique, Physiotherapy Canada
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189
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Sugden E, Baker E, Munro N, Williams AL. Involvement of parents in intervention for childhood speech sound disorders: a review of the evidence. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2016; 51:597-625. [PMID: 27017993 DOI: 10.1111/1460-6984.12247] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 12/15/2015] [Accepted: 01/06/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Internationally, speech and language therapists (SLTs) are involving parents and providing home tasks in intervention for phonology-based speech sound disorder (SSD). To ensure that SLTs' involvement of parents is guided by empirical research, a review of peer-reviewed published evidence is needed. AIMS To provide SLTs and researchers with a comprehensive appraisal and analysis of peer-reviewed published intervention research reporting parent involvement and the provision of home tasks in intervention studies for children with phonology-based SSD. METHODS & PROCEDURES A systematic search and review was conducted. Academic databases were searched for peer-reviewed research papers published between 1979 and 2013 reporting on phonological intervention for SSD. Of the 176 papers that met the criteria, 61 were identified that reported on the involvement of parents and/or home tasks within the intervention. These papers were analysed using a quality appraisal tool. Details regarding the involvement of parents and home tasks were extracted and analysed to provide a summary of these practices within the evidence base. MAIN CONTRIBUTION Parents have been involved in intervention research for phonology-based SSD. However, most of the peer-reviewed published papers reporting this research have provided limited details regarding what this involved. This paucity of information presents challenges for SLTs wishing to integrate external evidence into their clinical services and clinical decision-making. It also raises issues regarding treatment fidelity for researchers wishing to replicate published intervention research. CONCLUSIONS & IMPLICATIONS The range of tasks in which parents were involved, and the limited details reported in the literature, present challenges for SLTs wanting to involve parents in intervention. Further high-quality research reporting more detail regarding the involvement of parents and home tasks in intervention for SSD is needed.
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Affiliation(s)
| | - Elise Baker
- The University of Sydney, Sydney, NSW, Australia
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190
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Graham L, Wright J, Walwyn R, Russell AM, Bryant L, Farrin A, House A. Measurement of adherence in a randomised controlled trial of a complex intervention: supported self-management for adults with learning disability and type 2 diabetes. BMC Med Res Methodol 2016; 16:132. [PMID: 27716063 PMCID: PMC5052902 DOI: 10.1186/s12874-016-0236-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 09/29/2016] [Indexed: 01/18/2023] Open
Abstract
Background Reporting adherence to intervention delivery and uptake is a detailed way of describing what was actually delivered and received, in comparison to what was intended. Measuring and reporting adherence is not routinely done well in complex interventions. The OK Diabetes trial (ISRCTN41897033) aimed to develop and subsequently test the feasibility of implementing a supported self-management intervention in adults with a learning disability and type 2 diabetes. A key study objective was to develop a measure of adherence to the intervention. Methods We conducted a systematic review of published literature, extracting data from included papers using a standardised proforma. We undertook a narrative synthesis of papers to determine the form and content of methods for adherence measurement for self-management interventions in this population that had already been developed. We used the framework and data extraction form developed for the review as the basis for an adherence measurement tool that we applied in the OK Diabetes trial. Results The literature review found variability in the quality and content of adherence measurement and reporting, with no standardised approach. We were able to develop an adherence measure based upon the review, and populate it with data collected during the OK Diabetes trial. The adherence tool proved satisfactory for recording and measuring adherence in the trial. Conclusion There remains a need for a standardised approach to adherence measurement in the field of complex interventions. We have shown that it is possible to produce a simple, feasible measure for assessing adherence in the OK Diabetes trial. Electronic supplementary material The online version of this article (doi:10.1186/s12874-016-0236-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Liz Graham
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK.
| | - Judy Wright
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Rebecca Walwyn
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Amy M Russell
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Louise Bryant
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Amanda Farrin
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Allan House
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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191
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Slade SC, Dionne CE, Underwood M, Buchbinder R. Consensus on Exercise Reporting Template (CERT): Explanation and Elaboration Statement. Br J Sports Med 2016; 50:1428-1437. [DOI: 10.1136/bjsports-2016-096651] [Citation(s) in RCA: 324] [Impact Index Per Article: 40.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2016] [Indexed: 12/31/2022]
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192
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Thomas R, Sims R, Degeling C, Street JM, Carter SM, Rychetnik L, Whitty JA, Wilson A, Ward P, Glasziou P. CJCheck Stage 1: development and testing of a checklist for reporting community juries - Delphi process and analysis of studies published in 1996-2015. Health Expect 2016; 20:626-637. [PMID: 27704684 PMCID: PMC5513001 DOI: 10.1111/hex.12493] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2016] [Indexed: 12/25/2022] Open
Abstract
Background Opportunities for community members to actively participate in policy development are increasing. Community/citizen's juries (CJs) are a deliberative democratic process aimed to illicit informed community perspectives on difficult topics. But how comprehensive these processes are reported in peer‐reviewed literature is unknown. Adequate reporting of methodology enables others to judge process quality, compare outcomes, facilitate critical reflection and potentially repeat a process. We aimed to identify important elements for reporting CJs, to develop an initial checklist and to review published health and health policy CJs to examine reporting standards. Design Using the literature and expertise from CJ researchers and policy advisors, a list of important CJ reporting items was suggested and further refined. We then reviewed published CJs within the health literature and used the checklist to assess the comprehensiveness of reporting. Results CJCheck was developed and examined reporting of CJ planning, juror information, procedures and scheduling. We screened 1711 studies and extracted data from 38. No studies fully reported the checklist items. The item most consistently reported was juror numbers (92%, 35/38), while least reported was the availability of expert presentations (5%, 2/38). Recruitment strategies were described in 66% of studies (25/38); however, the frequency and timing of deliberations was inadequately described (29%, 11/38). Conclusions Currently CJ publications in health and health policy literature are inadequately reported, hampering their use in policy making. We propose broadening the CJCheck by creating a reporting standards template in collaboration with international CJ researchers, policy advisors and consumer representatives to ensure standardized, systematic and transparent reporting.
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Affiliation(s)
- Rae Thomas
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia
| | - Rebecca Sims
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia
| | - Chris Degeling
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW, Australia
| | - Jackie M Street
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - Stacy M Carter
- Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW, Australia
| | - Lucie Rychetnik
- School of Medicine, University of Notre Dame, Sydney, NSW, Australia.,School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Jennifer A Whitty
- Health Economics Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - Andrew Wilson
- Menzies Centre for Health Policy, University of Sydney, Sydney, NSW, Australia
| | - Paul Ward
- Discipline of Public Health, School of Health Sciences, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Paul Glasziou
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Qld, Australia
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193
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Consensus on Exercise Reporting Template (CERT): Modified Delphi Study. Phys Ther 2016; 96:1514-1524. [PMID: 27149962 DOI: 10.2522/ptj.20150668] [Citation(s) in RCA: 269] [Impact Index Per Article: 33.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 04/28/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Exercise interventions are often incompletely described in reports of clinical trials, hampering evaluation of results and replication and implementation into practice. OBJECTIVE The aim of this study was to develop a standardized method for reporting exercise programs in clinical trials: the Consensus on Exercise Reporting Template (CERT). DESIGN AND METHODS Using the EQUATOR Network's methodological framework, 137 exercise experts were invited to participate in a Delphi consensus study. A list of 41 items was identified from a meta-epidemiologic study of 73 systematic reviews of exercise. For each item, participants indicated agreement on an 11-point rating scale. Consensus for item inclusion was defined a priori as greater than 70% agreement of respondents rating an item 7 or above. Three sequential rounds of anonymous online questionnaires and a Delphi workshop were used. RESULTS There were 57 (response rate=42%), 54 (response rate=95%), and 49 (response rate=91%) respondents to rounds 1 through 3, respectively, from 11 countries and a range of disciplines. In round 1, 2 items were excluded; 24 items reached consensus for inclusion (8 items accepted in original format), and 16 items were revised in response to participant suggestions. Of 14 items in round 2, 3 were excluded, 11 reached consensus for inclusion (4 items accepted in original format), and 7 were reworded. Sixteen items were included in round 3, and all items reached greater than 70% consensus for inclusion. LIMITATIONS The views of included Delphi panelists may differ from those of experts who declined participation and may not fully represent the views of all exercise experts. CONCLUSIONS The CERT, a 16-item checklist developed by an international panel of exercise experts, is designed to improve the reporting of exercise programs in all evaluative study designs and contains 7 categories: materials, provider, delivery, location, dosage, tailoring, and compliance. The CERT will encourage transparency, improve trial interpretation and replication, and facilitate implementation of effective exercise interventions into practice.
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194
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Yamato T, Maher C, Saragiotto B, Moseley A, Hoffmann T, Elkins M, Swisher AK. The TIDieR Checklist Will Benefit the Physiotherapy Profession. Cardiopulm Phys Ther J 2016. [DOI: 10.1097/cpt.0000000000000043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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195
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Hetrick SE, Robinson J, Spittal MJ, Carter G. Effective psychological and psychosocial approaches to reduce repetition of self-harm: a systematic review, meta-analysis and meta-regression. BMJ Open 2016; 6:e011024. [PMID: 27660314 PMCID: PMC5051331 DOI: 10.1136/bmjopen-2016-011024] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 08/11/2016] [Accepted: 08/23/2016] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To examine the efficacy of psychological and psychosocial interventions for reductions in repeated self-harm. DESIGN We conducted a systematic review, meta-analysis and meta-regression to examine the efficacy of psychological and psychosocial interventions to reduce repeat self-harm in adults. We included a sensitivity analysis of studies with a low risk of bias for the meta-analysis. For the meta-regression, we examined whether the type, intensity (primary analyses) and other components of intervention or methodology (secondary analyses) modified the overall intervention effect. DATA SOURCES A comprehensive search of MEDLINE, PsycInfo and EMBASE (from 1999 to June 2016) was performed. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials of psychological and psychosocial interventions for adult self-harm patients. RESULTS Forty-five trials were included with data available from 36 (7354 participants) for the primary analysis. Meta-analysis showed a significant benefit of all psychological and psychosocial interventions combined (risk ratio 0.84; 95% CI 0.74 to 0.96; number needed to treat=33); however, sensitivity analyses showed that this benefit was non-significant when restricted to a limited number of high-quality studies. Meta-regression showed that the type of intervention did not modify the treatment effects. CONCLUSIONS Consideration of a psychological or psychosocial intervention over and above treatment as usual is worthwhile; with the public health benefits of ensuring that this practice is widely adopted potentially worth the investment. However, the specific type and nature of the intervention that should be delivered is not yet clear. Cognitive-behavioural therapy or interventions with an interpersonal focus and targeted on the precipitants to self-harm may be the best candidates on the current evidence. Further research is required.
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Affiliation(s)
- Sarah E Hetrick
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jo Robinson
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Greg Carter
- Centre for Translational Neuroscience and Mental Health, The University of Newcastle, Newcastle, New South Wales, Australia
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196
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Yamato T, Maher C, Saragiotto B, Moseley A, Hoffmann T, Elkins M, Petersen S, Riley S, Brismée JM. Improving completeness and transparency of reporting in clinical trials using the template for intervention description and replication (TIDieR) checklist will benefit the physiotherapy profession. J Man Manip Ther 2016; 24:183-4. [PMID: 27582616 DOI: 10.1080/10669817.2016.1210343] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Tiê Yamato
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia
| | - Chris Maher
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia
| | - Bruno Saragiotto
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia
| | - Anne Moseley
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia
| | - Tammy Hoffmann
- Faculty of Health Sciences and Medicine, Centre for Research in Evidence Based Practice, Bond University, Queensland, Australia
| | - Mark Elkins
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia
| | | | - Sean Riley
- Doctor of Physical Therapy Program, Sacred Heart University, Connecticut, USA
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197
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Holmes J, Phillips J, Morris R, Bedekar Y, Tyerman R, Radford K. Development and evaluation of an early specialised traumatic brain injury vocational rehabilitation training package. Br J Occup Ther 2016. [DOI: 10.1177/0308022616651645] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background In a feasibility randomised controlled trial, training was developed to equip occupational therapists to deliver early specialised traumatic brain injury vocational rehabilitation in the English National Health Service (NHS). Method The package was developed by experts in vocational rehabilitation and traumatic brain injury, and included a manual, direct instruction by six trainers and opportunity for mentorship by four therapists. Following training, therapists were interviewed regarding the effectiveness and ease of use of the package. Interviews were analysed using the framework approach. Results Five trained therapists were interviewed regarding the package. Results were organised into six categories: (1) motivation to participate in research; (2) impact of the learning environment; (3) changing confidence levels over time; (4) growing appreciation of complexities about the intervention; (5) acceptability of the training package; and (6) lessons for future implementation. Conclusion The therapists reported acquiring the knowledge necessary to implement the intervention. The data indicate that the training packages require detailed descriptions of the interventions being taught for local implementation in the NHS and for future research. The training materials are valued by therapists but require time for familiarisation, and reminders from mentors help put training into practice. The therapists have concerns about implementing the interventions within a research context, which researchers should address.
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Affiliation(s)
- Jain Holmes
- UKOTRF and University of Nottingham PhD Research Fellow, University of Nottingham, UK
| | - Julie Phillips
- Research Occupational Therapist, University of Nottingham, UK
| | | | - Yashashree Bedekar
- Independent Occupational Therapist, Neurological Rehabilitation Specialist, London, UK
| | - Ruth Tyerman
- Buckinghamshire Healthcare Trust, Programme Manager, UK
| | - Kate Radford
- University of Nottingham, Associate Professor in Rehabilitation Research (Long Term Conditions), UK
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198
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Cunningham P, Turton AJ, Van Wijck F, Van Vliet P. Task-specific reach-to-grasp training after stroke: development and description of a home-based intervention. Clin Rehabil 2016; 30:731-40. [DOI: 10.1177/0269215515603438] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 08/09/2015] [Indexed: 11/16/2022]
Abstract
This series of articles for rehabilitation in practice aims to cover a knowledge element of the rehabilitation medicine curriculum. Nevertheless they are intended to be of interest to a multidisciplinary audience. The competency addressed in this article is to transparently describe the process of developing a complex intervention for people after stroke as part of a feasibility randomised controlled trial. Objective: To describe and justify the development of a home-based, task-specific upper limb training intervention to improve reach-to-grasp after stroke and pilot it for feasibility and acceptability prior to a randomized controlled trial. Intervention description: The intervention is based on intensive practice of whole reach-to-grasp tasks and part-practice of essential reach-to-grasp components. A ‘pilot’ manual of activities covering the domains of self-care, leisure and productivity was developed for the feasibility study. The intervention comprises 14 hours of therapist-delivered sessions over six weeks, with additional self-practice recommended for 42 hours (i.e. one hour every day). As part of a feasibility randomized controlled trial, 24 people with a wide range of upper limb impairment after stroke experienced the intervention to test adherence and acceptability. The median number of repetitions in one-hour therapist-delivered sessions was 157 (interquartile range IQR 96–211). The amount of self-practice was poorly documented. Where recorded, the median amount of practice was 30 minutes (interquartile range 22–45) per day. Findings demonstrated that the majority of participants found the intensity, content and level of difficulty of the intervention acceptable, and the programme to be beneficial. Comments on the content and presentation of the self-practice material were incorporated in a revised ‘final’ intervention manual. Discussion: A comprehensive training intervention to improve reach-to-grasp for people living at home after stroke has been described in accordance with the Template for Intervention Description and Replication (TIDieR) reporting guidelines. The intervention has been piloted, and found to be acceptable and feasible in the home setting. Trial registration: ISRCTN56716589
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Affiliation(s)
- Paul Cunningham
- Department of Allied Health Professions, University of the West of England, Bristol, UK
| | - Ailie J Turton
- Department of Allied Health Professions, University of the West of England, Bristol, UK
| | | | - Paulette Van Vliet
- School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Hunter Medical Research Institute, Australia
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199
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Michie S, Wood CE, Johnston M, Abraham C, Francis JJ, Hardeman W. Behaviour change techniques: the development and evaluation of a taxonomic method for reporting and describing behaviour change interventions (a suite of five studies involving consensus methods, randomised controlled trials and analysis of qualitative data). Health Technol Assess 2016; 19:1-188. [PMID: 26616119 DOI: 10.3310/hta19990] [Citation(s) in RCA: 346] [Impact Index Per Article: 43.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Meeting global health challenges requires effective behaviour change interventions (BCIs). This depends on advancing the science of behaviour change which, in turn, depends on accurate intervention reporting. Current reporting often lacks detail, preventing accurate replication and implementation. Recent developments have specified intervention content into behaviour change techniques (BCTs) - the 'active ingredients', for example goal-setting, self-monitoring of behaviour. BCTs are 'the smallest components compatible with retaining the postulated active ingredients, i.e. the proposed mechanisms of change. They can be used alone or in combination with other BCTs' (Michie S, Johnston M. Theories and techniques of behaviour change: developing a cumulative science of behaviour change. Health Psychol Rev 2012;6:1-6). Domain-specific taxonomies of BCTs have been developed, for example healthy eating and physical activity, smoking cessation and alcohol consumption. We need to build on these to develop an internationally shared language for specifying and developing interventions. This technology can be used for synthesising evidence, implementing effective interventions and testing theory. It has enormous potential added value for science and global health. OBJECTIVE (1) To develop a method of specifying content of BCIs in terms of component BCTs; (2) to lay a foundation for a comprehensive methodology applicable to different types of complex interventions; (3) to develop resources to support application of the taxonomy; and (4) to achieve multidisciplinary and international acceptance for future development. DESIGN AND PARTICIPANTS Four hundred participants (systematic reviewers, researchers, practitioners, policy-makers) from 12 countries engaged in investigating, designing and/or delivering BCIs. Development of the taxonomy involved a Delphi procedure, an iterative process of revisions and consultation with 41 international experts; hierarchical structure of the list was developed using inductive 'bottom-up' and theory-driven 'top-down' open-sort procedures (n = 36); training in use of the taxonomy (1-day workshops and distance group tutorials) (n = 161) was evaluated by changes in intercoder reliability and validity (agreement with expert consensus); evaluating the taxonomy for coding interventions was assessed by reliability (intercoder; test-retest) and validity (n = 40 trained coders); and evaluating the taxonomy for writing descriptions was assessed by reliability (intercoder; test-retest) and by experimentally testing its value (n = 190). RESULTS Ninety-three distinct, non-overlapping BCTs with clear labels and definitions formed Behaviour Change Technique Taxonomy version 1 (BCTTv1). BCTs clustered into 16 groupings using a 'bottom-up' open-sort procedure; there was overlap between these and groupings produced by a theory-driven, 'top-down' procedure. Both training methods improved validity (both p < 0.05), doubled the proportion of coders achieving competence and improved confidence in identifying BCTs in workshops (both p < 0.001) but did not improve intercoder reliability. Good intercoder reliability was observed for 80 of the 93 BCTs. Good within-coder agreement was observed after 1 month (p < 0.001). Validity was good for 14 of 15 BCTs in the descriptions. The usefulness of BCTTv1 to report descriptions of observed interventions had mixed results. CONCLUSIONS The developed taxonomy (BCTTv1) provides a methodology for identifying content of complex BCIs and a foundation for international cross-disciplinary collaboration for developing more effective interventions to improve health. Further work is needed to examine its usefulness for reporting interventions. FUNDING This project was funded by the Medical Research Council Ref: G0901474/1. Funding also came from the Peninsula Collaboration for Leadership in Applied Health Research and Care.
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Affiliation(s)
- Susan Michie
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Caroline E Wood
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Marie Johnston
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Institute of Applied Health Sciences, College of Life Science and Medicine, University of Aberdeen, Health Sciences Building, Aberdeen, UK
| | - Charles Abraham
- University of Exeter Medical School, University of Exeter, St Luke's Campus, Exeter, UK
| | - Jill J Francis
- School of Health Sciences, City University London, London, UK
| | - Wendy Hardeman
- Primary Care Unit, Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
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200
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Eyles H, Jull A, Dobson R, Firestone R, Whittaker R, Te Morenga L, Goodwin D, Mhurchu CN. Co-design of mHealth Delivered Interventions: A Systematic Review to Assess Key Methods and Processes. Curr Nutr Rep 2016. [DOI: 10.1007/s13668-016-0165-7] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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