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Ruiz-Casares M, Thombs BD, Mayo NE, Andrina M, Scott SC, Platt RW. The Families First Program to Prevent Child Abuse: Results of a Cluster Randomized Controlled Trial in West Java, Indonesia. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2022; 23:1457-1469. [PMID: 36098893 DOI: 10.1007/s11121-022-01433-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2022] [Indexed: 11/24/2022]
Abstract
The Families First parenting program is a 10-week paraprofessional-administered adaptation of the Positive Discipline in Everyday Parenting program for West Java, Indonesia. It has not been tested in a randomized controlled trial. The objective was to evaluate the effects of Families First on physical and emotional punishment. We conducted a cluster randomized controlled trial and randomly assigned 20 rural and urban villages in West Java, Indonesia, to intervention or waitlist. Caregivers of children aged 0-7 years in intervention villages received Families First. Between 2017 and 2018, measurements were taken before randomization, immediately post-intervention, and 6 months post-intervention. Primary outcome was presence versus absence of caregiver-reported physical or emotional punishment immediately post-intervention. Intention-to-treat regression models accounted for clustering within villages and were run to compare between groups. Participants and study personnel could not be blinded. There were 374 caregivers in the 10 intervention villages and 362 in the 10 waitlist villages included in the trial and in outcome analyses. The intervention did not result in a lower proportion of intervention families using punishment immediately post-intervention (odds ratio [OR] for physical or emotional punishment immediately post intervention = 1.20 (95% CI 0.79-1.82). There were no significant differences for positive and involved parenting, setting limits, and opinion on discipline, but caregivers in the intervention group had significantly lower odds of using positive discipline (OR = 0.65 (95% CI 0.53-0.80). Families First did not prevent punishment in a setting with low levels of reported punishment but should be tested in a setting with higher levels or among people selected for risk or presence.
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Affiliation(s)
- Mónica Ruiz-Casares
- Department of Psychiatry, McGill University, Montreal, QC, Canada. .,SHERPA University Institute, CIUSSS du centre-ouest-de-l'île-de-Montréal, 7085 Hutchison, 204.2.14, Montreal, QC, H3N 1Y9, Canada.
| | - Brett D Thombs
- Department of Psychiatry, McGill University, Montreal, QC, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
| | - Nancy E Mayo
- Research Institute, McGill University Health Centre, Montreal, QC, Canada.,Department of Medicine and School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | | | - Susan C Scott
- Research Institute, McGill University Health Centre, Montreal, QC, Canada
| | - Robert William Platt
- Research Institute, McGill University Health Centre, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
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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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Gao M, Zhang L, Wang Y, Li L, Wang C, Shen Q, Wang Y, Liao B. Influence of humanistic care based on Carolina care model for ovarian cancer patients on postoperative recovery and quality of life. Am J Transl Res 2021; 13:3390-3399. [PMID: 34017514 PMCID: PMC8129217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/14/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Our aim was to explore the influence of humanistic care based on Carolina care model on postoperative recovery and quality of life in patients with ovarian cancer (OC). METHODS In this prospective study, we selected 85 OC patients and randomly divided them into the Carolina group (n = 43) given humanistic care based on Carolina care model and the control group (n = 42) given routine nursing intervention. The postoperative recovery and Functional Assessment of Cancer Therapy-Ovary Cancer (FACT-O) scores were compared between the two groups. RESULTS After intervention, the time of first flatus and defecation after surgery, the time of first ambulation and the length of average postoperative hospital stay were much shorter, and the pain score, total complication rate, self-rating anxiety scale and self-rating depression scale scores as well as Cortisol, C-reactive protein and fasting blood glucose levels at 48 hours postoperatively were significantly lower in the Carolina group than in the control group. The nursing satisfaction in the Carolina group was markedly higher than that in the control group (97.67% vs. 78.57%, P<0.01). After 3 months of follow-up, the Carolina group showed higher dimension scores of FACT-O than the control group (all P<0.001). CONCLUSION Humanistic nursing care based on Carolina care model can significantly ameliorate the recovery of OC patients, reduce the physical and psychologic stress response, and effectively enhance the nursing satisfaction and quality of life.
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Affiliation(s)
- Min Gao
- Department of Obstetrics and Gynecology, University-Town Hospital of Chongqing Medical UniversityChongqing, China
| | - Lin Zhang
- Department of Obstetrics and Gynecology, University-Town Hospital of Chongqing Medical UniversityChongqing, China
| | - Yan Wang
- Department of Obstetrics and Gynecology, University-Town Hospital of Chongqing Medical UniversityChongqing, China
| | - Li Li
- Department of Obstetrics and Gynecology, University-Town Hospital of Chongqing Medical UniversityChongqing, China
| | - Chunjie Wang
- Department of Obstetrics and Gynecology, University-Town Hospital of Chongqing Medical UniversityChongqing, China
| | - Qian Shen
- Department of Obstetrics and Gynecology, University-Town Hospital of Chongqing Medical UniversityChongqing, China
| | - Yuhan Wang
- Department of Obstetrics and Gynecology, University-Town Hospital of Chongqing Medical UniversityChongqing, China
| | - Bizhen Liao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Chongqing Medical UniversityChongqing, China
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Dalton EJ, Churilov L, Lannin NA, Corbett D, Campbell BCV, Hayward KS. Early-phase dose articulation trials are underutilized for post-stroke motor recovery: A systematic scoping review. Ann Phys Rehabil Med 2021; 65:101487. [PMID: 33429089 DOI: 10.1016/j.rehab.2021.101487] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND To enable development of effective interventions, there is a need to complete systematic early-phase dose articulation research. This scoping review aimed to synthesize dose articulation research of behavioral motor interventions for stroke recovery. METHODS MEDLINE and EMBASE were systematically searched for dose articulation studies. Preclinical experiments and adult clinical trials were classified based on the discovery pipeline and analyzed to determine which dose dimensions were articulated (time, scheduling or intensity) and how they were investigated (unidimensional vs multidimensional approach). Reporting of dose, safety and efficacy outcomes were summarized. The intervention description, risk of bias, and quality was appraised. RESULTS We included 41 studies: 3 of preclinical dose preparation (93 rodents), 2 Phase I dose ranging (21 participants), 9 Phase IIA dose screening (198 participants), and 27 Phase IIB dose finding (1879 participants). All studies adopted a unidimensional approach. Time was the most frequent dimension investigated (53%), followed by intensity (29%), and scheduling (18%). Overall, 95% studies reported an efficacy outcome; however, only 65% reported dose and 45% reported safety. Across studies, 61% were at high risk of bias, and the average percentage reporting of intervention description and quality was 61% and 67%, respectively. CONCLUSION This review highlights a need to undertake more high-quality, early-phase studies that systematically articulate intervention doses from a multidimensional perspective in the field of behavioral motor stroke recovery. To address this gap, we need to invest in adapting early phase trial designs, especially Phase I, to support multidimensional dose articulation.
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Affiliation(s)
- Emily J Dalton
- Melbourne School of Health Sciences, University of Melbourne, Heidelberg, Australia
| | - Leonid Churilov
- Melbourne Medical School, University of Melbourne, Parkville, Australia
| | - Natasha A Lannin
- Department of Neurosciences, Central Clinical School, Monash University, Melbourne, Australia; Alfred Health, Melbourne, Australia
| | - Dale Corbett
- Cellular & Molecular Medicine and Canadian Partnership for Stroke Recovery, University of Ottawa, Canada
| | - Bruce C V Campbell
- Department of Medicine and Neurology, Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
| | - Kathryn S Hayward
- Melbourne School of Health Sciences and Florey Institute of Neuroscience and Mental Health, University of Melbourne, 245 Burgundy Street, 3084 Heidelberg, Australia.
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Wang D, Taylor-Vaisey A, Negrini S, Côté P. Criteria to Evaluate the Quality of Outcome Reporting in Randomized Controlled Trials of Rehabilitation Interventions. Am J Phys Med Rehabil 2021; 100:17-28. [PMID: 32969969 DOI: 10.1097/phm.0000000000001601] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT No standardized guideline for the reporting of outcomes measures in randomized controlled trials of rehabilitation interventions is currently available. This study includes four phases to identify, synthesize, and make recommendations for potential attributes of reporting criteria of outcome measures in rehabilitation randomized controlled trials. First, we surveyed the author instructions for rehabilitation journals to determine how journals require authors to report outcomes. Second, we reviewed all consolidated standards of reporting trials extensions to determine how other speciality groups require reporting of outcomes in randomized controlled trials. Third, we conducted a focused scoping review to examine the nature and variations of criteria used to evaluate the quality of outcome measures in randomized controlled trials. Finally, we synthesized the information from phases 1-3 and propose four criteria specific to the reporting of outcomes in randomized controlled trials of rehabilitation interventions: (1) clearly describe the construct to be measured as outcome(s); (2) justify the selection of outcome measures by mapping to World Health Organization International Classification of Function, Disability, and Health (International Classification of Functioning) framework; justify the psychometric properties (relevance, validity, reliability) of the selected measurement tool; (3) clearly describe the timing of outcome measurement, with consideration of the health condition, the course of disease, and hypothesized effect of intervention; and (4) complete and unselective reporting of outcome data.
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Affiliation(s)
- Dan Wang
- From the Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada (DW, AT-V, PC); Centre for Disability Prevention and Rehabilitation at Ontario Tech University and CMCC, Toronto, Ontario, Canada (DW, AT-V, PC); Department of Biomedical, Surgical and Dental Sciences, University "La Statale," Milan, Italy (SN); and Istituto Ortopedico Galeazzi, Milan, Italy (SN)
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Dalton E, Churilov L, Lannin NA, Corbett D, Hayward KS. Dose Articulation in Preclinical and Clinical Stroke Recovery: Refining a Discovery Research Pipeline and Presenting a Scoping Review Protocol. Front Neurol 2019; 10:1148. [PMID: 31781018 PMCID: PMC6851169 DOI: 10.3389/fneur.2019.01148] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/14/2019] [Indexed: 02/03/2023] Open
Abstract
Introduction: Despite an increase in the quality of clinical trials in stroke recovery, interventions have failed to markedly impact the trajectory of recovery after stroke. Failure may be due to the lack of consideration for the complexity of dose and its articulation within research trials. Prior to commencing the scoping review, we identified two research gaps to be addressed. Firstly, transparent application of a multidimensional definition of dose to clinical trial phases and secondly, the development of a quality tool to critique the articulation of dose across the pipeline. Building on this, we present the protocol for a scoping review that aims to synthesis what is known about dose articulation in stroke recovery in preclinical and clinical populations, and characterize research designs and statistical approaches used in dose articulation trials, and the associated advantages and disadvantages. Methods: The scoping review will apply Arksey and O'Malley's methodological framework. Two systematic searches that target preclinical and clinical literature will be run in Medline and Embase, which will be complimented by consultation with field experts and hand searching of included trials and relevant reviews. Search results will be imported into Covidence for transparent management. One reviewer will screen all abstracts and titles. Two reviewers will screen full text and a third reviewer included to resolve discrepancies. A standardized data charting form will be used to extract information and appraise the intervention description, risk of bias, and quality of both preclinical and clinical studies. Results will be summarized in tabular and narrative format to inform the development of recommendations for future research. Ethics approval is not required as data used will be secondary and de-identified. Conclusion: Development of a new quality tool to appraise the quality of both preclinical and clinical dose studies may serve to strengthen collaborative efforts between the fields. The findings from this review will advance the use of a discovery pipeline in stroke recovery research to ultimately inform clinical practice.
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Affiliation(s)
- Emily Dalton
- Department of Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Leonid Churilov
- Melbourne Medical School, University of Melbourne, Parkville, VIC, Australia.,NHMRC CRE in Stroke Rehabilitation and Brain Recovery, University of Melbourne, Heidelberg, VIC, Australia
| | - Natasha A Lannin
- Department of Neurosciences, Central Clinical School, Monash University, Melbourne, VIC, Australia.,Department of Occupational Therapy, Alfred Health, Prahran, VIC, Australia
| | - Dale Corbett
- Cellular and Molecular Medicine and Canadian Partnership for Stroke Recovery, University of Ottawa, Ottawa, ON, Canada
| | - Kathryn S Hayward
- Department of Physiotherapy, Melbourne School of Health Sciences, University of Melbourne, Parkville, VIC, Australia.,NHMRC CRE in Stroke Rehabilitation and Brain Recovery, University of Melbourne, Heidelberg, VIC, Australia.,AVERT Early Rehabilitation Research Group, Stroke Theme, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, VIC, Australia
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Goodwin VA, Hill JJ, Fullam JA, Finning K, Pentecost C, Richards DA. Intervention development and treatment success in UK health technology assessment funded trials of physical rehabilitation: a mixed methods analysis. BMJ Open 2019; 9:e026289. [PMID: 31467046 PMCID: PMC6720467 DOI: 10.1136/bmjopen-2018-026289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Physical rehabilitation is a complex process, and trials of rehabilitation interventions are increasing in number but often report null results. This study aimed to establish treatment success rates in physical rehabilitation trials funded by the National Institute of Health Research Health Technology Assessment (NIHR HTA) programme and examine any relationship between treatment success and the quality of intervention development work undertaken. DESIGN This is a mixed methods study. SETTING This study was conducted in the UK. METHODS The NIHR HTA portfolio was searched for all completed definitive randomised controlled trials of physical rehabilitation interventions from inception to July 2016. Treatment success was categorised according to criteria developed by Djulbegovic and colleagues. Detailed textual data regarding any intervention development work were extracted from trial reports and supporting publications and informed the development of quality ratings. Mixed methods integrative analysis was undertaken to explore the relationship between quantitative and qualitative data using joint displays. RESULTS Fifteen trials were included in the review. Five reported a definitive finding, four of which were in favour of the 'new' intervention. Eight trials reported a true negative (no difference) outcome. Integrative analysis indicated those with lower quality intervention development work were less likely to report treatment success. CONCLUSIONS Despite much effort and funding, most physical rehabilitation trials report equivocal findings. Greater focus on high quality intervention development may reduce the likelihood of a null result in the definitive trial, alongside high quality trial methods and conduct.
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Affiliation(s)
- Victoria A Goodwin
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Jacqueline J Hill
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - James A Fullam
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Katie Finning
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Claire Pentecost
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - David A Richards
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
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Borschmann K, Hayward KS, Raffelt A, Churilov L, Kramer S, Bernhardt J. Rationale for Intervention and Dose Is Lacking in Stroke Recovery Trials: A Systematic Review. Stroke Res Treat 2018; 2018:8087372. [PMID: 30515288 PMCID: PMC6234440 DOI: 10.1155/2018/8087372] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 10/08/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The ineffectiveness of most complex stroke recovery trials may be explained by inadequate intervention design. The primary aim of this review was to explore the rationales given for interventions and dose in stroke rehabilitation randomised controlled trials (RCTs). METHODS We searched the Cochrane Stroke Group library for RCTs that met the following criteria: (1) training based intervention; (2) >50% participants who were stroke survivors; (3) full peer-reviewed text; (4) English language. We extracted data on 16 quality items covering intervention dose (n= 3), trial design (n= 10), and risk of bias (n= 3) and 18 items related to trial method. Logistic regression analyses were performed to determine whether (1) reporting of trial quality items changed over time; (2) reporting of quality items was associated with the likelihood of a positive trial, adjusted for sample size and number of outcomes. RESULTS 27 Cochrane reviews were included, containing 9,044 participants from 194 trials. Publication dates were 1979 to 2013, sample size was median 32 (IQR 20,58), and primary outcome was reported in 49 trials (25%). The median total quality score was 4 (IQR 3,6) and improved significantly each year (OR 1.12, 95% CI 1.07, 1.16, p<0.001). Total quality score was not associated with likelihood of a positive trial, but trials containing a biological rationale for the intervention were more likely to find a difference in patient outcome (OR 2.18, 95% CI 1.14, 4.19, p=0.02). CONCLUSION To develop breakthrough treatments we need to build the rationale for research interventions and testing of intervention dosage. This will be achieved through a collective research agenda to understand the mechanistic principles that drive recovery and identification of clearer targets for clinical trials.
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Affiliation(s)
- Karen Borschmann
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, 245 Burgundy St., Heidelberg 3084, VIC, Australia
- NHMRC CRE Stroke Rehabilitation & Brain Recovery, 245 Burgundy St., Heidelberg 3084, VIC, Australia
| | - Kathryn S. Hayward
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, 245 Burgundy St., Heidelberg 3084, VIC, Australia
- NHMRC CRE Stroke Rehabilitation & Brain Recovery, 245 Burgundy St., Heidelberg 3084, VIC, Australia
- Brain Behaviour Laboratory, Department of Physical Therapy, The University of British Columbia, Koerner Pavilion UBC Hospital, 2211 Wesbrook Mall, Vancouver, BC, Canada V6T2B7
| | - Audrey Raffelt
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, 245 Burgundy St., Heidelberg 3084, VIC, Australia
| | - Leonid Churilov
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, 245 Burgundy St., Heidelberg 3084, VIC, Australia
- NHMRC CRE Stroke Rehabilitation & Brain Recovery, 245 Burgundy St., Heidelberg 3084, VIC, Australia
| | - Sharon Kramer
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, 245 Burgundy St., Heidelberg 3084, VIC, Australia
- NHMRC CRE Stroke Rehabilitation & Brain Recovery, 245 Burgundy St., Heidelberg 3084, VIC, Australia
| | - Julie Bernhardt
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, 245 Burgundy St., Heidelberg 3084, VIC, Australia
- NHMRC CRE Stroke Rehabilitation & Brain Recovery, 245 Burgundy St., Heidelberg 3084, VIC, Australia
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Kaur N, Figueiredo S, Bouchard V, Moriello C, Mayo N. Where have all the pilot studies gone? A follow-up on 30 years of pilot studies in Clinical Rehabilitation. Clin Rehabil 2017; 31:1238-1248. [PMID: 28786333 PMCID: PMC5557106 DOI: 10.1177/0269215517692129] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Introduction: Pilot studies are meritorious for determining the feasibility of a definitive clinical trial in terms of conduct and potential for efficacy, but their possible applications for planning a future trial are not always fully realized. The purpose of this review was to estimate the extent to which pilot/feasibility studies: (i) addressed needed objectives; (ii) led to definitive trials; and (iii) whether the subsequent undertaking of a definitive trial was influenced by the strength of the evidence of outcome improvement. Methods: Trials published in the journal Clinical Rehabilitation, since its inception, were eligible if the word ‘pilot’ or ‘feasibility’ was specified somewhere in the article. A total of 191 studies were reviewed, results were summarized descriptively, and between-group effect sizes were computed. Results: The specific purposes of piloting were stated in only 58% (n = 110) of the studies. The most frequent purpose was to estimate the potential for efficacy (85%), followed by testing the feasibility of the intervention (60%). Only 12% of the studies were followed by a definitive trial; <4% of studies had a main study underway or a published study protocol. There was no relationship between observed effect size and follow-up of pilot studies, although the confidence intervals were very wide owing to small number of trials that followed on. Discussion: Labelling and reporting of pilot studies needs to be improved to be concordant with the recently issued CONSORT guidelines. Feasibility needs to be fully tested and demonstrated prior to committing considerable human and monetary resources.
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Affiliation(s)
- Navaldeep Kaur
- 1 Division of Clinical Epidemiology, McGill University, Montreal, Quebec, Canada.,2 Center for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.,3 School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Sabrina Figueiredo
- 1 Division of Clinical Epidemiology, McGill University, Montreal, Quebec, Canada.,2 Center for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.,3 School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Vanessa Bouchard
- 1 Division of Clinical Epidemiology, McGill University, Montreal, Quebec, Canada.,2 Center for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.,3 School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Carolina Moriello
- 1 Division of Clinical Epidemiology, McGill University, Montreal, Quebec, Canada.,2 Center for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada
| | - Nancy Mayo
- 1 Division of Clinical Epidemiology, McGill University, Montreal, Quebec, Canada.,2 Center for Outcomes Research and Evaluation, McGill University Health Centre, Montreal, Quebec, Canada.,3 School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
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Colquhoun HL, Jesus TS, O'Brien KK, Tricco AC, Chui A, Zarin W, Lillie E, Hitzig SL, Straus S. Study protocol for a scoping review on rehabilitation scoping reviews. Clin Rehabil 2017; 31:1249-1256. [PMID: 28118743 DOI: 10.1177/0269215516688514] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Scoping reviews are increasingly popular in rehabilitation. However, significant variability in scoping review conduct and reporting currently exists, limiting potential for the methodology to advance rehabilitation research, practice and policy. Our aim is to conduct a scoping review of rehabilitation scoping reviews in order to examine the current volume, yearly distribution, proportion, scope and methodological practices involved in the conduct of scoping reviews in rehabilitation. Key areas of methodological improvement will be described. Methods and analysis: We will undertake the review using the Arksey and O'Malley scoping review methodology. Our search will involve two phases. The first will combine a previously conducted scoping review of scoping reviews (not distinct to rehabilitation, with data current to July 2014) together with a rehabilitation keyword search in PubMed. Articles found in the first phase search will undergo a full text review. The second phase will include an update of the previously conducted scoping review of scoping reviews (July 2014 to current). This update will include the search of nine electronic databases, followed by title and abstract screening as well as a full text review. All screening and extraction will be performed independently by two authors. Articles will be included if they are scoping reviews within the field of rehabilitation. A consultation exercise with key targets will inform plans to improve rehabilitation scoping reviews. Ethics and dissemination: Ethics will be required for the consultation phase of our scoping review. Dissemination will include peer-reviewed publication and conferences in rehabilitation-specific contexts.
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Affiliation(s)
- Heather L Colquhoun
- 1 Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.,2 Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada
| | - Tiago S Jesus
- 3 Global Health and Tropical Medicine (GHTM), Institute of Hygiene and Tropical Medicine - NOVA University of Lisbon (IHMT-UNL), Lisbon, Portugal.,4 WHO Collaborating Centre for Health Workforce Policy and Planning, Institute of Hygiene and Tropical Medicine - NOVA University of Lisbon (IHMT-UNL), Lisbon, Portugal
| | - Kelly K O'Brien
- 2 Rehabilitation Sciences Institute (RSI), University of Toronto, Toronto, Ontario, Canada.,5 Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.,6 Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada
| | - Andrea C Tricco
- 7 Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.,8 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Adora Chui
- 1 Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Wasifa Zarin
- 7 Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Erin Lillie
- 7 Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Sander L Hitzig
- 1 Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada.,9 St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Sharon Straus
- 7 Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
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