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Arienti C, Armijo-Olivo S, Ferriero G, Feys P, Hoogeboom T, Kiekens C, Lazzarini SG, Minozzi S, Negrini S, Oral A, Pollini E, Puljak L, Todhunter-Brown A, Walshe M. The influence of bias in randomized controlled trials on rehabilitation intervention effect estimates: what we have learned from meta-epidemiological studies. Eur J Phys Rehabil Med 2024; 60:135-144. [PMID: 38088137 PMCID: PMC10938941 DOI: 10.23736/s1973-9087.23.08310-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/14/2023] [Indexed: 12/20/2023]
Abstract
This study aimed to synthesize evidence from studies that addressed the influence of bias domains in randomized controlled trials on rehabilitation intervention effect estimates and discuss how these findings can maximize the trustworthiness of an RCT in rehabilitation. We screened studies about the influence of bias on rehabilitation intervention effect estimates published until June 2023. The characteristics and results of the included studies were categorized based on methodological characteristics and summarized narratively. We included seven studies with data on 227,806 RCT participants. Our findings showed that rehabilitation intervention effect estimates are likely exaggerated in trials with inadequate/unclear sequence generation and allocation concealment when using continuous outcomes. The influence of blinding was inconsistent and different from the rest of medical science, as meta-epidemiological studies showed overestimation, underestimation, or neutral associations for different types of blinding on rehabilitation treatment effect estimates. Still, it showed a more consistent pattern when looking at patient-reported outcomes. The impact of attrition bias and intention to treat has been analyzed only in two studies with inconsistent results. The risk of reporting bias seems to be associated with overestimation of treatment effects. Bias domains can influence rehabilitation treatment effects in different directions. The evidence is mixed and inconclusive due to the poor methodological quality of RCTs and the limited number and quality of studies looking at the influence of bias and treatment effects in rehabilitation. Further studies about the influence of bias in RCTs on rehabilitation intervention effect estimates are needed.
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Affiliation(s)
| | - Susan Armijo-Olivo
- Faculty of Economics and Social Sciences, University of Applied Sciences of Osnabrück, Osnabrück, Germany
- Faculties of Rehabilitation Medicine and Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Giorgio Ferriero
- Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
- Physical Rehabilitation Medicine Unit, Scientific Institute of Tradate IRCCS, Istituti Clinici Scientifici Maugeri, Tradate, Varese, Italy
| | - Peter Feys
- Uhasselt, Faculty of Rehabilitation Sciences, REVAL Rehabilitation Research Center, Hasselt, Belgium
| | - Thomas Hoogeboom
- IQ Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | | | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
- Laboratory of Methodology of Systematic Reviews and Guidelines Production, Mario Negri Pharmacological Research Institute IRCCS, Milan, Italy
| | - Stefano Negrini
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy
| | - Aydan Oral
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, University of Istanbul, Istanbul, Türkiye
| | | | - Livia Puljak
- Center for Evidence-Based Medicine and Healthcare, Catholic University of Croatia, Zagreb, Croatia
| | | | - Margaret Walshe
- Department of Clinical Speech and Language Studies, Trinity College, Dublin, Ireland
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Novak I, Te Velde A, Hines A, Stanton E, Mc Namara M, Paton MCB, Finch-Edmondson M, Morgan C. Rehabilitation Evidence-Based Decision-Making: The READ Model. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:726410. [PMID: 36188787 PMCID: PMC9397823 DOI: 10.3389/fresc.2021.726410] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 09/08/2021] [Indexed: 12/31/2022]
Abstract
Evidence-based practice is the foundation of rehabilitation for maximizing client outcomes. However, an unacceptably high number of ineffective or outdated interventions are still implemented, leading to sub-optimal outcomes for clients. This paper proposes the Rehabilitation Evidence bAsed Decision-Making (READ) Model, a decision-making algorithm for evidence-based decision-making in rehabilitation settings. The READ Model outlines a step-by-step layered process for healthcare professionals to collaboratively set goals, and to select appropriate interventions. The READ Model acknowledges the important multi-layered contributions of client's preferences and values, family supports available, and external environmental factors such as funding, availability of services and access. Healthcare professionals can apply the READ Model to choose interventions that are evidence-based, with an appropriate mode, dose, and with regular review, in order to achieve client's goals. Two case studies are used to demonstrate application of the READ Model: cerebral palsy and autism spectrum disorder. The READ Model applies the four central principles of evidence-based practice and can be applied across multiple rehabilitation settings.
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Affiliation(s)
- Iona Novak
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.,Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Anna Te Velde
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Ashleigh Hines
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Emma Stanton
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Maria Mc Namara
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Madison C B Paton
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Megan Finch-Edmondson
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Catherine Morgan
- Specialty of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The Cerebral Palsy Alliance Research Institute, University of Sydney, Sydney, NSW, Australia
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Frontera WR, Stucki G, Engkasan JP, Francisco GE, Gutenbrunner C, Hasnan N, Lains J, Yusof YM, Negrini S, Omar Z, Battistella LR, Sowa G, Stam H, Bickenbach J. Advancing Academic Capacity in Physical and Rehabilitation Medicine to Strengthen Rehabilitation in Health Systems Worldwide: A Joint Effort by the European Academy of Rehabilitation Medicine, the Association of Academic Physiatrists, and the International Society of Physical and Rehabilitation Medicine. Am J Phys Med Rehabil 2022; 101:897-904. [PMID: 35777886 PMCID: PMC9377495 DOI: 10.1097/phm.0000000000002067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Trustworthiness and Quality in Research for Clinical Application. REHABILITATION ONCOLOGY 2022. [DOI: 10.1097/01.reo.0000000000000315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Frontera W, Stucki G, Engkasan J, Francisco G, Gutenbrunner C, Hasnan N, Lains J, Yusof Y, Negrini S, Omar Z, Battistella L, Sowa G, Stam H, Bickenbach J. Advancing academic capacity in physical and rehabilitation medicine to strengthen rehabilitation in health systems worldwide: A joint effort by the european academy of rehabilitation medicine, the association of academic physiatrists, and the international society of physical and rehabilitation medicine. THE JOURNAL OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE 2022. [DOI: 10.4103/ijprm.jisprm-000168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Jesus TS, Castellini G, Gianola S. Global health workforce research: Comparative analyses of the scientific publication trends in PubMed. Int J Health Plann Manage 2021; 37:1351-1365. [PMID: 34897803 DOI: 10.1002/hpm.3401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 10/21/2021] [Accepted: 11/30/2021] [Indexed: 12/24/2022] Open
Abstract
AIM To analyse the amount of Human Resources for Health (HRH) research publication trends [1990-2019], compared to the broader health policy, systems, and services research (HPSSR). METHODS PubMed and its indexation system with Medical Subject Headings (MeSH) are used for this time-trend study. Searches combine MeSH terms for research publications and HPSSR or HRH subjects, except education. Sub-group searches are conducted on: funding support, and high- versus low- and middle-income countries (HICs vs. LMICs). Linear regressions are used for the analysis. RESULTS HRH research publications rose exponentially (r2 = 0.94; p < 0.001) from 129 yearly publications in 1990, to 867 in 2018. Yet, HRH research publications had a logarithmic decrease (p < 0.001) in percentage of broader HPSSR publications, from 2.5% to 1.5% [1990-2018]. Funding support increased significantly and linearly (p < 0.001 r2 = 0.88), up to 44% in 2018. The percentage of HRH research publications addressing LMICs grew linearly (p < 0.001; r2 = 0.75), up to 23% in 2018. CONCLUSION HRH research publications in the PubMed database increased especially in the more recent years but did not outpace (in earlier times was outpaced) by the growth of HPSSR publications overall. Yearly, HICs still accounted for more than three-quarters of HRH research. These findings can inform global and health research policies.
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Affiliation(s)
- Tiago S Jesus
- Global Health and Tropical Medicine, Institute of Hygiene and Tropical Medicine - NOVA University of Lisbon, Lisbon, Portugal.,Department of Occupational Therapy, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, Massachusetts, USA
| | - Greta Castellini
- IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Milan, Italy
| | - Silvia Gianola
- IRCCS Istituto Ortopedico Galeazzi, Unit of Clinical Epidemiology, Milan, Italy
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Arabi H. Physical Medicine and Rehabilitation: From the Birth of a Specialty to Its Recognition. Cureus 2021; 13:e17664. [PMID: 34650846 PMCID: PMC8489541 DOI: 10.7759/cureus.17664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 11/05/2022] Open
Abstract
Physical Medicine and Rehabilitation (PMR) was subordinate to different specialties. Currently, it is recognized as essential to improving healthcare. How did it originate and which events impacted it? Different events have impacted the development of PMR including war, epidemic, sport, natural disasters, and the demographic and sociocultural characteristics of each country. At present, PMR is experiencing some difficulties throughout the world; we present proposals to improve its position to bring the specialty up to the specialty podium. Accidentology, sports events, and natural disasters enrich medicine in general and PRM in particular. Indeed, all these events create disability through a participatory and integrative strategy of the patients; PMR always takes up the challenge.
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Affiliation(s)
- Hafid Arabi
- Physical Medicine, Cadi Ayyad University, Marrakesh, MAR
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Wada Y, Kawate N. Publication Trends in Physical Medicine and Rehabilitation in Japan from 2001 to 2019. Prog Rehabil Med 2021; 6:20210026. [PMID: 34179546 PMCID: PMC8214998 DOI: 10.2490/prm.20210026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 06/09/2021] [Indexed: 11/09/2022] Open
Abstract
Objectives The aim of this study was to examine, using PubMed, the number of articles in the field of physical medicine and rehabilitation medicine originating in Japan, especially those containing high-quality scientific evidence (randomized controlled trials [RCTs], systematic reviews, meta-analyses) and those published in high impact factor journals. Methods We searched the PubMed database to identify articles, RCTs, systematic reviews, and meta-analyses from Japan covering physical medicine and rehabilitation published between 2001 and 2019; we then calculated the proportion of articles from Japan. Additionally, using Journal Citation Reports, we selected the top ten highest impact factor journals on "Rehabilitation" each year between 2001 and 2019. For each year, we searched PubMed for the total number of articles in these top ten journals and for articles originating in Japan. The Cochran-Armitage test was used to evaluate the change in the proportion of publications from Japan over time. Results The proportion of articles on physical medicine and rehabilitation originating in Japan increased from 2001 to 2019 (P<0.0001). An increase in the percentages of systematic reviews (P=0.046) and meta-analyses (P=0.0013) originating in Japan and a decrease in the percentage of original articles published in the top ten highest impact factor journals were demonstrated (P=0.002). However, there was no change in the percentage of RCTs from Japan over time (P=0.055). Conclusions Our findings suggest that the proportion of articles from Japan containing high-quality scientific evidence is increasing. However, there is a need to expand the support system for research while considering the quality of research.
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Affiliation(s)
- Yoshitaka Wada
- Department of Rehabilitation Medicine, Showa University Fujigaoka Rehabilitation Hospital, Kanagawa, Japan
| | - Nobuyuki Kawate
- Department of Rehabilitation Medicine, Showa University Fujigaoka Rehabilitation Hospital, Kanagawa, Japan
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Shepherd M, Young J, McDevitt A. A little love for case reports? Tips to enhance acceptance to publication. J Man Manip Ther 2021; 29:133-135. [PMID: 34080957 DOI: 10.1080/10669817.2021.1918955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Mark Shepherd
- Department of Physical Therapy, Bellin College, Green Bay, WI, USA
| | - Jodi Young
- Department of Physical Therapy, Bellin College, Green Bay, WI, USA
| | - Amy McDevitt
- Anschutz Medical Campus, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, CO, USA
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Arienti C, Armijo-Olivo S, Minozzi S, Tjosvold L, Lazzarini SG, Patrini M, Negrini S. Methodological Issues in Rehabilitation Research: A Scoping Review. Arch Phys Med Rehabil 2021; 102:1614-1622.e14. [PMID: 33989598 DOI: 10.1016/j.apmr.2021.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 03/22/2021] [Accepted: 04/22/2021] [Indexed: 01/11/2023]
Abstract
OBJECTIVE To identify, synthesize, and categorize the methodological issues faced by the rehabilitation field. DATA SOURCES A scoping review was conducted using studies identified in MEDLINE, the Cochrane Library, EMBASE, Web of Science, Scopus, Physiotherapy Evidence Database, and Google Scholar up to August 2018. STUDY SELECTION We included all type of publications describing methodological issues in rehabilitation research where rehabilitation is described as a multimodal process. The methodological issues have been categorized and classified. DATA EXTRACTION The synthesis included qualitative and quantitative analysis. To focus the attention on rehabilitation, we post hoc divided in "specific issues" (highly related to, even if not exclusive of, rehabilitation research) and "generic issues" (common in biomedical research). DATA SYNTHESIS Seventy-one publications were included: 68% were narrative reviews, 15% systematic reviews, 7% editorials, 4% meta-epidemiologic studies, and 5% others. Specific methodological issues include the following: problematic application of randomized controlled trials (32%), absent definition of core outcome sets (28%), poor interventions description (22%), weak methodological (conducting) and reporting quality (21%), scarce clinical practice applicability (14%), lack of blinding assessor (10%), inadequate randomization methods or inadequate allocation concealment (8%), and inadequate participants description and recruitment (8%). "Generic" issues included the following: data and statistical description (31%), authors' methodological training (7%), peer review process (6%, n=4), funding declaration (6%), ethical statement (3%), protocol registration (3%), and conflict of interest declaration (1%). CONCLUSIONS Methodological and reporting issues might influence the quality of the evidence produced in rehabilitation research. The next steps to move forward in the field of rehabilitation could be to evaluate the influence of all these issues on the validity of trial results through meta-epidemiologic studies and to develop specific checklists to provide guidance to authors to improve the reporting and conduct of trials in this field.
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Affiliation(s)
| | - Susan Armijo-Olivo
- University of Applied Sciences, Faculty of Business and Social Sciences, Osnabrück, Germany; Faculties of Rehabilitation Medicine and Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Silvia Minozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Lisa Tjosvold
- Institute of Health Economics, Edmonton, Alberta, Canada
| | | | | | - Stefano Negrini
- Department of Biomedical, Surgical, and Dental Sciences, University of Milan "La Statale", Milan, Italy; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Negrini S, Mills JA, Arienti C, Kiekens C, Cieza A. "Rehabilitation Research Framework for Patients With COVID-19" Defined by Cochrane Rehabilitation and the World Health Organization Rehabilitation Programme. Arch Phys Med Rehabil 2021; 102:1424-1430. [PMID: 33716115 PMCID: PMC7948530 DOI: 10.1016/j.apmr.2021.02.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 02/20/2021] [Indexed: 12/13/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic resulted in a surge of research activity. Since its outset, efforts have been made to guide the rapid generation of research in medicine. There are gaps in some areas of rehabilitation research for patients with COVID-19. The development of a specific research framework might serve to help monitor the status of research (mapping), shape and strengthen research by pointing to under-investigated areas, and promote rehabilitation research in this context. This article introduces and discusses the COVID-19 Rehabilitation Research Framework (CRRF) and presents the methodology used for its development. The questions have been developed among the World Health Organization (WHO) Rehabilitation Programme, Cochrane Rehabilitation, and the experts of its Rehabilitation-COVID-19 Evidence-based Response Action International Multiprofessional Steering Committee. The framework is divided into 2 parts and includes 20 questions organized in 4 groups: epidemiology, and evidence at the micro- (individual), meso- (health services), and macro- (health systems) levels. The CRRF offers a comprehensive view of the research areas relevant to COVID-19 and rehabilitation that are necessary to inform best practice and ensure rehabilitation services and health systems can best serve the population with COVID-19. The collaboration between Cochrane Rehabilitation and the WHO Rehabilitation Programme in establishing the CRRF brought together perspectives from the health systems, health management, and clinical evidence. The authors encourage researchers to use the CRRF when planning studies on rehabilitation in the context of COVID-19.
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Affiliation(s)
- Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy; Laboratory of Evidence-based Rehabilitation, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Jody-Anne Mills
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland; John Walsh Centre for Rehabilitation Research, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | | | - Carlotte Kiekens
- Spinal Unit, Montecatone Rehabilitation Institute, Imola (BO), Italy
| | - Alarcos Cieza
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland; Department of Management of Noncommunicable Diseases, Disability, Violence and Injury Prevention, World Health Organization, Geneva, Switzerland
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Does Type of Sponsorship of Randomized Controlled Trials Influence Treatment Effect Size Estimates in Rehabilitation: A Meta-Epidemiological Study. Am J Phys Med Rehabil 2020; 99:909-916. [PMID: 32960528 DOI: 10.1097/phm.0000000000001444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Sponsorship bias could affect research results to inform decision makers when using the results of these trials. The extent to which sponsorship bias affect results in the field of physical therapy has been unexplored in the literature. Therefore, the main aim of this study was to evaluate the influence of sponsorship bias on the treatment effects of randomized controlled trials in physical therapy area. METHODS This was a meta-epidemiological study. A random sample of randomized controlled trials included in meta-analyses of physical therapy area were identified. Data extraction including assessments of appropriate influence of funders was conducted independently by two reviewers. To determine the association between biases related to sponsorship biases and effect sizes, a two-level analysis was conducted using a meta-meta-analytic approach. RESULTS We analyzed 393 trials included in 43 meta-analyses. The most common sources of sponsorship for this sample of physical therapy trials were government (n = 205, 52%), followed by academic (n = 44, 11%) and industry (n = 39, 10%). The funding was not declared in a high percentage of the trials (n = 85, 22%). The influence of the trial sponsor was assessed as being appropriate in 246 trials (63%) and considered inappropriate/unclear in 147 (37%) of them. We have moderate evidence to say that trials with inappropriate/unclear influence of funders tended to have on average a larger effect size than those with appropriate influence of funding (effect size = 0.15; 95% confidence interval = -0.03 to 0.33). CONCLUSIONS Based on our sample of physical therapy trials, it seems that most of the trials are funded by either government and academia and a small percentage are funded by the industry. Treatment effect size estimates were on average 0.15 larger in trials with lack of appropriate influence of funders as compared with trials with appropriate influence of funding. Contrarily to other fields, industry funding was relatively small and their influence perhaps less marked. All these results could be explained by the relative youth of the field and/or the absence of clear industry interests. In front of the call for action by the World Health Organization to strengthen rehabilitation in health systems, these results raise the issue of the need of public funding in the field.
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The Randomized Controlled Trials Rehabilitation Checklist: Methodology of Development of a Reporting Guideline Specific to Rehabilitation. Am J Phys Med Rehabil 2020; 99:210-215. [PMID: 31851008 DOI: 10.1097/phm.0000000000001370] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND One of the goals of Cochrane Rehabilitation is to strengthen methodology relevant to evidence-based clinical practice. Toward this goal, several research activities have been performed in rehabilitation literature: a scoping review listed the methodological issues in research, a study showed the low clinical replicability of randomized controlled trials, two systematic reviews showed the relevant items in reporting guidelines, and a series of articles discussed main methodological issues as a result of the first Cochrane Rehabilitation Methodological Meeting (Paris 2018). The need to improve the quality of conduct and reporting of research studies in rehabilitation emerged as a relevant task. The aim of this article is to present the Randomized Controlled Trial Rehabilitation Checklists (RCTRACK) project to produce a specific reporting guideline in rehabilitation. METHODS The project followed a combination of the CONsolidated Standards of Reporting Trials and EQUATOR Network methodologies. The project includes five phases. The first is kick-off, first consensus meeting and executive and advisory committee identification. The second is literature search and synthesis, where eight working groups will produce knowledge synthesis products (systematic or scoping reviews) to compile items relevant to reporting of randomized controlled trials in rehabilitation. The topics will be as follows: patient selection; blinding; treatment group; control group and co-interventions; attrition, follow-up, and protocol deviation; outcomes; statistical analysis and appropriate randomization; and research questions. The third is guidelines development, which means drafting of a document with the guidelines through a consensus meeting. The fourth is Delphi process consensus, a Delphi study involving all the rehabilitation research and methodological community. The fifth is final consensus meeting and publication. CONCLUSIONS The RCTRACK will be an important contribution to the rehabilitation field and will impact several groups of rehabilitation stakeholders worldwide. The main goal is to improve the quality of the evidence produced in rehabilitation research. The RCTRACK also wants to improve the recognition and understanding of rehabilitation within Cochrane and the scientific and medical community at large.
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Colquhoun HL, Jesus TS, O'Brien KK, Tricco AC, Chui A, Zarin W, Lillie E, Hitzig SL, Seaton S, Engel L, Rotenberg S, Straus SE. Scoping Review on Rehabilitation Scoping Reviews. Arch Phys Med Rehabil 2020; 101:1462-1469. [PMID: 32325163 DOI: 10.1016/j.apmr.2020.03.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/11/2020] [Accepted: 03/19/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To examine the extent, scope, and methodological quality of rehabilitation scoping reviews. DATA SOURCES A comprehensive list of scoping reviews conducted in the broader health field (inception to July 2014), with a further update of that list (up to February 2017) using similar methods, including searching 9 electronic databases. STUDY SELECTION Articles were included if they were scoping reviews within rehabilitation. Established review methods were used including (1) a PubMed filter detecting rehabilitation content and (2) title-and-abstract screening by 2 independent reviewers applied sequentially to articles from the existing list of scoping reviews and to the updated search results. Full-text articles were reviewed by 1 reviewer, with discrepancies resolved by another after pilot screening with > 80% agreement. Remaining discrepancies were resolved by external experts. DATA EXTRACTION Two independent reviewers used piloted and standardized data extraction forms. DATA SYNTHESIS We screened 1823 records, including 992 full texts, to identify 251 rehabilitation-related scoping reviews. Rehabilitation scoping reviews had an exponential yearly increase since 2008 (r2=0.89; P<.01). The literature addressed diverse topics (eg, spread over 43 condition groupings); 43% were published in Canada. Examples of methodological limitations included: 39% of reviews did not cite the use of a methodological framework, 96% did not include the appropriate flow diagram, 8% did not report eligibility criteria, and 57% did not report data extraction details. CONCLUSIONS The increasing popularity of scoping reviews in rehabilitation has not been met by high standards in methodological quality. To increase the value of rehabilitation scoping reviews, rehabilitation stakeholders need to use existing methodological standards for the conduct, reporting, and appraisal of scoping reviews.
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Affiliation(s)
- Heather L Colquhoun
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada; Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada.
| | - Tiago S Jesus
- Global Health and Tropical Medicine and WHO Collaborating Centre for Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine - NOVA University of Lisbon, Lisbon, Portugal
| | - Kelly K O'Brien
- Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada; Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Andrea C Tricco
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Adora Chui
- Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada; Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
| | - Wasifa Zarin
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Erin Lillie
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Sander L Hitzig
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada; Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada; St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Samantha Seaton
- Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada
| | - Lisa Engel
- Department of Occupational Therapy, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Sharon E Straus
- Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
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Hüppe A, Langbrandtner J, Lill C, Raspe H. The Effectiveness of Actively Induced Medical Rehabilitation in Chronic Inflammatory Bowel Disease. DEUTSCHES ARZTEBLATT INTERNATIONAL 2020; 117:89-96. [PMID: 32102728 DOI: 10.3238/arztebl.2020.0089] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 07/10/2019] [Accepted: 11/28/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The poor evidence base is a major problem for the German rehabilitation sector. This trial focused on testing the efficacy and benefit of inpatient medical rehabilitation compared to routine care in a single common entity, namely, chronic inflammatory bowel disease (IBD). METHODS This pragmatic, multicenter, randomized controlled trial with a parallel group design included gainfully employed patients with IBD who were covered by one of four statutory health insurance providers. Patients in the intervention group were actively advised regarding options for rehabilitation and given support in applying for it; patients in the control group continued with the care they had been receiving before participation in the trial. The primary endpoint was social participation, and there were various secondary endpoints, including disease activity and sick days taken off from work. All parameters were assessed by questionnaire at the beginning of the trial and twelve months later. This was trial no. DRKS00009912 in the German clinical trials registry. RESULTS In a complete case analysis, the intervention group (211 patients, of whom 112 underwent rehabilitation) did better than the control group (220 patients, of whom 15 underwent rehabilitation) in multiple respects. The reported limitation in social participation was reduced by 7.3 points in the intervention group and 2.9 points in the control group (p = 0.018; d = 0.23). Significant improvements were also seen in disease activity, vitality, health-related quality of life, and self-management, with effect sizes between 0.3 and 0.4. No benefit was seen in outcomes related to working capacity. Sensitivity analyses lent further support to the findings. CONCLUSION Rehabilitation research can be conducted with individually randomized, controlled trials. The findings of this trial indicate the absolute effectiveness of ied rehabilitation for IBD patients, as well as its additional benefit compared to routine care.
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Affiliation(s)
- Angelika Hüppe
- Institute of Social Medicine and Epidemiology, University of Lübeck; Center for Population Medicine and Health Services Research, University of Lübeck
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Oral A, Arienti C, Lazzarini SG, Grubišić F, Kiekens C, Negrini S. The Cochrane Corners by Cochrane Rehabilitation. Eur J Phys Rehabil Med 2020; 56:529-534. [PMID: 32235822 DOI: 10.23736/s1973-9087.20.06258-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cochrane Rehabilitation (CR) is pursuing the goal of disseminating Cochrane evidence, in line with the Cochrane Knowledge Translation (KT) strategy theme 2: "Packaging, push, and support implementation", through several projects: the CR eBook project, blogshots, and Cochrane Corners. A Cochrane Corner is a KT vehicle in which the contents of the Cochrane Library are summarized and presented by a rehabilitation professional, using the qualitative statements proposed by Cochrane Norway to communicate the magnitude of rehabilitation intervention effects on specific outcomes, based on the certainty of evidence, and followed by a section on "clinical implication for rehabilitation professionals" (both for clinical and research practice). Our Cochrane Corners aim to inform about evidence produced by Cochrane in the field of rehabilitation from a rehabilitation professional perspective. After setting internal rules for Cochrane Corners, designing a template and preparing a guide for authors, the production of Cochrane Corners started. As of December 2019, CR signed Publication Agreements with 13 rehabilitation relevant Journals, contributed to Editorials as introductory articles for the launch of Cochrane Corners in some of these Journals and published 34 Cochrane Corners, in print or ahead of print, whereas 7 additional Cochrane Corners have been submitted to the Journals and will be published soon. This initiative provided a significant opportunity for CR to communicate with members of other groups within Cochrane as well as with journal editors. The impact of Cochrane Corners on the readers will need to be evaluated in the future: unfortunately, we have no instruments to measure it at present.
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Affiliation(s)
- Aydan Oral
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | | | - Frane Grubišić
- Department of Rheumatology, Physical Medicine and Rehabilitation, University Hospital Center "Sestre Milosrdnice", Zagreb, Croatia
| | - Carlotte Kiekens
- Spinal Unit, Montecatone Rehabilitation Institute, Imola, Bologna, Italy.,University Hospitals Leuven - KU Leuven, Leuven, Belgium
| | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Jesus TS, Hoenig H, Landry MD. Development of the Rehabilitation Health Policy, Systems, and Services Research field: Quantitative Analyses of Publications over Time (1990-2017) and across Country Type. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E965. [PMID: 32033180 PMCID: PMC7036950 DOI: 10.3390/ijerph17030965] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/29/2020] [Accepted: 02/02/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Health policy, systems and services research (HPSSR) is increasingly needed to enable better access to, and value of, rehabilitation services worldwide. We aim to quantify the growth of Rehabilitation HPSSR publications since 1990, compared to that of overall rehabilitation research and overall HPSSR. METHODS Quantitative, comparative analysis of publication trends using the PubMed database and its indexation system. Comprehensive search filters, based on Medical Subject Headings (MeSH), were built and calibrated to locate research articles with content on HPSSR and rehabilitation of physical impairments. Additional filters were used for locating research publications declaring funding support, publications in rehabilitation journals, and finally publications focused on high-income (HICs) or low- and middle-income countries (LMICs). The same approach was used for retrieving data on comparator fields-overall HPSSR and overall rehabilitation research. Linear regressions, with ANOVA, were used for analyzing yearly publication growths over the 28-year time frame. RESULTS Rehabilitation HPSSR publications in PubMed have grown significantly from 1990 to 2017 in the percentage of all rehabilitation research (from 11% to 18%) and all HPSSR (from 2.8% to 3.9%; both p < 0.001). The rate of Rehabilitation HPSSR published in rehabilitation journals did not change significantly over time (p = 0.47). The rates of publications with declared funding support increased significantly, but such growth did not differ significantly from that of the comparator fields. Finally, LMICs accounted for 9.3% of the country-focused rehabilitation HPSSR since 1990, but this percentage value increased significantly (p < 0.001) from 6% in 1990 to 13% in 2017. CONCLUSION Rehabilitation HPSSR publications, i.e., those indexed in PubMed with related MeSH terms, have grown in both absolute and relative values. Rehabilitation HPSSR publications focused on LMICs also grew significantly since 1990, but still remained a tiny portion of the Rehabilitation HPSSR publications with country-specific MeSH terms.
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Affiliation(s)
- Tiago S. Jesus
- Global Health and Tropical Medicine & WHO Collaborating Center on Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine-NOVA University of Lisbon, 1349-008 Lisbon, Portugal
| | - Helen Hoenig
- Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, NC 27705, USA;
- Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, NC 27710, USA
| | - Michel D. Landry
- School of Medicine, Duke University, Durham, NC 27710, USA;
- Duke Global Health Institute, Duke University, Durham, NC 27710, USA
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Oral A, Delarque A. Promoting the development and visibility of primary research in rehabilitation: Labs and My Rehab Thesis sessions in European Society of Physical and Rehabilitation Medicine 2018 Congress. Ann Phys Rehabil Med 2019; 62:389-391. [PMID: 31465866 DOI: 10.1016/j.rehab.2019.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 06/16/2019] [Indexed: 11/25/2022]
Affiliation(s)
- Aydan Oral
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey; Scientific Manager of ESPRM 2018 Labs and MRT sessions.
| | - Alain Delarque
- Aix Marseille Université, Department de Médecine Physique et de Réadaptation, CHU Timone, 13005 Marseille, France; ESPRM President (2015-2019)
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Pollet J, Negrini S, Arienti C, Lazzarini S, Kiekens C. Cochrane rehabilitation: Actions, functions, and role of the youngest rehabilitation stakeholder. THE JOURNAL OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE 2019. [DOI: 10.4103/jisprm.jisprm_16_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Negrini S. 3.5 Physical and rehabilitation medicine: Clinical Scope – Outcomes of physical and rehabilitation medicine programs. THE JOURNAL OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE 2019. [DOI: 10.4103/jisprm.jisprm_13_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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