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What is the influence of randomisation sequence generation and allocation concealment on treatment effects of physical therapy trials? A meta-epidemiological study.

Armijo-Olivo S, Saltaji H, da Costa BR, Fuentes J, Ha C, Cummings GG - BMJ Open (2015)

Bottom Line: Data extraction including assessments of random sequence generation and allocation concealment was conducted independently by two reviewers.When pooling our results with those of Nuesch et al, we obtained a pooled statistically significant value (ES=0.14; 95% CI 0.02 to 0.26).Our results suggest that when evaluating risk of bias of primary RCTs in PT area, systematic reviewers and clinicians implementing research into practice should pay attention to these biases since they could exaggerate treatment effects.

View Article: PubMed Central - PubMed

Affiliation: CLEAR Outcomes (Connecting Leadership, Education and Research) Research Program, University of Alberta, Edmonton Clinic Health Academy (ECHA), Edmonton, Alberta, Canada Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada Faculty of Rehabilitation Medicine, Rehabilitation Research Center, University of Alberta, Edmonton, Alberta, Canada.

No MeSH data available.


Diagram for identification of studies.
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BMJOPEN2015008562F1: Diagram for identification of studies.

Mentions: The search identified 3901 Cochrane reviews, with 271 reviews potentially relevant to PT. Of these, 68 reviews included a meta-analysis of at least three studies of PT interventions and used a continuous outcome. We randomly selected 44 meta-analyses but excluded one 26 because it used follow-up data from the same group rather than a control group for comparison (figure 1). Forty-three meta-analyses including 393 trials and analysing 44 622 patients contributed to this study. Table 1 summarises the characteristics of the 43 Cochrane reviews. Briefly, the reviews were published between 2008 and 2011 and included meta-analyses of the effectiveness of PT interventions for musculoskeletal (22 reviews),27–35 cardiorespiratory (9 reviews),36–44 neurological (6 reviews)45–51 and other areas of physical therapy (6 reviews).51–56 A median number of six trials were included in the meta-analyses (IQR 5–8). Most trials were parallel group trials (367; 93.4%), single-centre studies (298; 76%) and had active control interventions (362; 92%). The most common intervention was exercise (n=282, 71.8%). Online Supplementary table S1 (appendix S1) lists the characteristics of each of the 43 meta-analyses.


What is the influence of randomisation sequence generation and allocation concealment on treatment effects of physical therapy trials? A meta-epidemiological study.

Armijo-Olivo S, Saltaji H, da Costa BR, Fuentes J, Ha C, Cummings GG - BMJ Open (2015)

Diagram for identification of studies.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4563231&req=5

BMJOPEN2015008562F1: Diagram for identification of studies.
Mentions: The search identified 3901 Cochrane reviews, with 271 reviews potentially relevant to PT. Of these, 68 reviews included a meta-analysis of at least three studies of PT interventions and used a continuous outcome. We randomly selected 44 meta-analyses but excluded one 26 because it used follow-up data from the same group rather than a control group for comparison (figure 1). Forty-three meta-analyses including 393 trials and analysing 44 622 patients contributed to this study. Table 1 summarises the characteristics of the 43 Cochrane reviews. Briefly, the reviews were published between 2008 and 2011 and included meta-analyses of the effectiveness of PT interventions for musculoskeletal (22 reviews),27–35 cardiorespiratory (9 reviews),36–44 neurological (6 reviews)45–51 and other areas of physical therapy (6 reviews).51–56 A median number of six trials were included in the meta-analyses (IQR 5–8). Most trials were parallel group trials (367; 93.4%), single-centre studies (298; 76%) and had active control interventions (362; 92%). The most common intervention was exercise (n=282, 71.8%). Online Supplementary table S1 (appendix S1) lists the characteristics of each of the 43 meta-analyses.

Bottom Line: Data extraction including assessments of random sequence generation and allocation concealment was conducted independently by two reviewers.When pooling our results with those of Nuesch et al, we obtained a pooled statistically significant value (ES=0.14; 95% CI 0.02 to 0.26).Our results suggest that when evaluating risk of bias of primary RCTs in PT area, systematic reviewers and clinicians implementing research into practice should pay attention to these biases since they could exaggerate treatment effects.

View Article: PubMed Central - PubMed

Affiliation: CLEAR Outcomes (Connecting Leadership, Education and Research) Research Program, University of Alberta, Edmonton Clinic Health Academy (ECHA), Edmonton, Alberta, Canada Faculty of Rehabilitation Medicine, Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada Faculty of Rehabilitation Medicine, Rehabilitation Research Center, University of Alberta, Edmonton, Alberta, Canada.

No MeSH data available.