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Berg A, Lyons NB, Badami A, Reynolds J, Pizano L, Pust GD, Meizoso J, Namias N, Yeh DD. Statistical Power of Randomized Controlled Trials in Trauma Surgery. J Am Coll Surg 2023; 237:731-736. [PMID: 37417653 DOI: 10.1097/xcs.0000000000000800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
BACKGROUND Our purpose was to conduct a bibliometric study investigating the prevalence of underpowered randomized controlled trials (RCTs) in trauma surgery. STUDY DESIGN A medical librarian conducted a search of RCTs in trauma published from 2000 to 2021. Data extracted included study type, sample size calculation, and power analyses. Post hoc calculations were performed using a power of 80% and an alpha level of 0.05. A CONSORT checklist was then tabulated from each study as well as a fragility index for studies with statistical significance. RESULTS In total 187 RCTs from multiple continents and 60 journals were examined. A total of 133 (71%) were found to have "positive" findings consistent with their hypothesis. When evaluating their methods, 51.3% of articles did not report how they calculated their intended sample size. Of those that did, 25 (27%) did not meet their target enrollment. When examining post hoc power, 46%, 57%, and 65% were adequately powered to detect small, medium, and large effect sizes, respectively. Only 11% of RCTs had complete adherence with CONSORT reporting guidelines and the average CONSORT score was 19 out of 25. For positive superiority trials with binary outcomes, the fragility index median (interquartile range) was 2 (2 to 8). CONCLUSIONS A concerningly large proportion of recently published RCTs in trauma surgery do not report a priori sample size calculations, do not meet enrollment targets, and are not adequately powered to detect even large effect sizes. There exists opportunity for improvement of trauma surgery study design, conduct, and reporting.
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Affiliation(s)
- Arthur Berg
- From the Department of Trauma and Surgical Critical Care, Jackson Memorial Hospital, Miami, FL (Berg, Lyons, Badami, Reynolds, Pizano, Pust, Meizoso, Namias)
| | - Nicole B Lyons
- From the Department of Trauma and Surgical Critical Care, Jackson Memorial Hospital, Miami, FL (Berg, Lyons, Badami, Reynolds, Pizano, Pust, Meizoso, Namias)
| | - Abbasali Badami
- From the Department of Trauma and Surgical Critical Care, Jackson Memorial Hospital, Miami, FL (Berg, Lyons, Badami, Reynolds, Pizano, Pust, Meizoso, Namias)
| | - John Reynolds
- From the Department of Trauma and Surgical Critical Care, Jackson Memorial Hospital, Miami, FL (Berg, Lyons, Badami, Reynolds, Pizano, Pust, Meizoso, Namias)
| | - Louis Pizano
- From the Department of Trauma and Surgical Critical Care, Jackson Memorial Hospital, Miami, FL (Berg, Lyons, Badami, Reynolds, Pizano, Pust, Meizoso, Namias)
| | - Gerd Daniel Pust
- From the Department of Trauma and Surgical Critical Care, Jackson Memorial Hospital, Miami, FL (Berg, Lyons, Badami, Reynolds, Pizano, Pust, Meizoso, Namias)
| | - Jonathan Meizoso
- From the Department of Trauma and Surgical Critical Care, Jackson Memorial Hospital, Miami, FL (Berg, Lyons, Badami, Reynolds, Pizano, Pust, Meizoso, Namias)
| | - Nicholas Namias
- From the Department of Trauma and Surgical Critical Care, Jackson Memorial Hospital, Miami, FL (Berg, Lyons, Badami, Reynolds, Pizano, Pust, Meizoso, Namias)
| | - Daniel Dante Yeh
- and the Department of Trauma and Surgical Critical Care, Denver Health, Denver, CO (Yeh)
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Jones H, Young M, Guyton K, Idemoto E, Ferraro A, AlHeresh R. Effectiveness of ergonomic interventions on work activity limitations in adults with rheumatoid arthritis: A systematic review. Work 2022; 73:79-91. [DOI: 10.3233/wor-210016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Rheumatoid arthritis (RA) is one of the leading causes of work disability in the United States. Ergonomic interventions offer an individualized treatment approach, and when used in conjunction with pharmacological treatment interventions, may improve work outcomes and improve the overall quality of life for individuals with RA. OBJECTIVE: To identify the current body of evidence regarding the effectiveness of ergonomic interventions in reducing work activity limitations in adults with RA. METHODS: A systematic review was conducted to identify articles of ergonomic interventions targeting working adults with RA. The CONsolidated Standards of Reporting Trials (CONSORT) checklist and Non-Pharmacological Treatment (NPT) Extension evaluated the reporting quality of each randomized controlled trial (RCT), and the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) evaluated the quality of the evidence. RESULTS: Six studies were identified and reviewed for the quality of their reporting on evidence related to work activity limitations. Sixty-six percent of the items on the CONSORT checklist were fully reported by all studies and analysis through the GRADE framework demonstrated moderate confidence that the reported effects of ergonomic interventions on work activity limitations in the studies are accurate. This review revealed varied results for the effectiveness of ergonomic interventions on work activity limitations and at-work productivity. CONCLUSION: The results of this review indicate a need for further investigation. Future studies should focus on reviewing specific ergonomic interventions to determine the dosage needed to see results in reducing work activity limitations for working adults with RA.
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Affiliation(s)
- Heather Jones
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - Megan Young
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - Kyndel Guyton
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - Emily Idemoto
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - Alicia Ferraro
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - Rawan AlHeresh
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
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Bachelet VC, Navarrete MS, Barrera-Riquelme C, Carrasco VA, Dallaserra M, Díaz RA, Ibarra ÁA, Lizana FJ, Meza-Ducaud N, Saavedra MG, Tapia-Davegno C, Vergara AF, Villanueva J. A multiyear systematic survey of the quality of reporting for randomised trials in dentistry, neurology and geriatrics published in journals of Spain and Latin America. BMC Med Res Methodol 2021; 21:153. [PMID: 34311704 PMCID: PMC8314448 DOI: 10.1186/s12874-021-01337-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 06/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Iberoamerican Cochrane Network is currently developing an extensive project to identify Spanish-language journals that publish original clinical research in Spain and Latin America. The project is called BADERI (Database of Iberoamerican Essays and Journal) and feeds the research articles, mainly randomised clinical trials (RCTs), into CENTRAL (Cochrane Collaboration Central Register of Controlled Trials). This study aims to assess the quality of reporting of RCTs published in Spanish and Latin American journals for three clinical fields and assess changes over time. METHODS We did a systematic survey with time trend analysis of RCTs for dentistry, geriatrics, and neurology. These fields were chosen for pragmatic reasons as they had not yet been completed in BADERI. After screening RCTs from 1990 to 2018 for randomised or quasi-randomised clinical trials, we extracted data for 23 CONSORT items. The primary outcome was the total score of the 23 predefined CONSORT 2010 items for each RCT (score range from 0 to 34). The secondary outcome measure was the score for each one of these 23 items. RESULTS A total of 392 articles from 1990 to 2018 were included as follows: dentistry (282), neurology (80), and geriatrics (30). We found that the overall compliance score for the CONSORT items included in this study for all 392 RCTs analysed was 12.6 on a scale with a maximum score of 34. With time, the quality of reporting improved slightly for all RCTs. None of the articles achieved the complete individual CONSORT item compliance score. The lowest overall compliance percentage was for item 10 (Randomisation implementation) and item 24 (Protocol registration), with a dismal 1% compliance across all included RCTs, regardless of country. CONCLUSIONS CONSORT compliance is very poor in the 392 analysed RCTs. The impact of the CONSORT statement on improving the completeness of RCT reporting in Latin America and Spain is not clear. Iberoamerican journals should become more involved in endorsing and enforcing adherence to the CONSORT guidelines.
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Affiliation(s)
- Vivienne C Bachelet
- Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Avenida Libertador Bernardo OHiggins 3363, Santiago, Estación Central, Chile.
| | - María S Navarrete
- Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Avenida Libertador Bernardo OHiggins 3363, Santiago, Estación Central, Chile
| | - Constanza Barrera-Riquelme
- Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Avenida Libertador Bernardo OHiggins 3363, Santiago, Estación Central, Chile
| | - Víctor A Carrasco
- Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Avenida Libertador Bernardo OHiggins 3363, Santiago, Estación Central, Chile
| | - Matías Dallaserra
- Departamento de Cirugía Maxilofacial, Facultad de Odontología, Universidad de Chile, Santiago, Chile
| | - Rubén A Díaz
- Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Avenida Libertador Bernardo OHiggins 3363, Santiago, Estación Central, Chile
| | - Álvaro A Ibarra
- Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Avenida Libertador Bernardo OHiggins 3363, Santiago, Estación Central, Chile
| | - Francisca J Lizana
- Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Avenida Libertador Bernardo OHiggins 3363, Santiago, Estación Central, Chile
| | - Nicolás Meza-Ducaud
- Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Avenida Libertador Bernardo OHiggins 3363, Santiago, Estación Central, Chile
| | - Macarena G Saavedra
- Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Avenida Libertador Bernardo OHiggins 3363, Santiago, Estación Central, Chile
| | - Camila Tapia-Davegno
- Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Avenida Libertador Bernardo OHiggins 3363, Santiago, Estación Central, Chile
| | - Alonso F Vergara
- Escuela de Medicina, Facultad de Ciencias Médicas, Universidad de Santiago de Chile (USACH), Avenida Libertador Bernardo OHiggins 3363, Santiago, Estación Central, Chile
| | - Julio Villanueva
- Departamento de Cirugía Maxilofacial, Facultad de Odontología, Universidad de Chile, Santiago, Chile
- Hospital Clínico San Borja-Arriarán, Santiago, Chile
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Lu R, Lloyd-Randolfi D, Jones H, Connor LT, AlHeresh R. Assessing adherence to physical activity programs post-stroke at home: A systematic review of randomized controlled trials. Top Stroke Rehabil 2020; 28:207-218. [PMID: 32787644 DOI: 10.1080/10749357.2020.1803573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Physical activity at home provides significant benefits post-stroke. Adherence assessments contribute to objective evaluation of treatment effectiveness across settings. OBJECTIVES The aims of this study were to (1) conduct a systematic review with focus on analyzing the reporting quality of RCTs that incorporate home physical activity interventions among people post-stroke, and utilize a physical activity adherence assessment and to: (2) identify, group, and critically appraise physical activity adherence assessments within the identified studies. METHODS A literature search for RCTs was conducted. Articles needed to (1) study adult, post-stroke participants, (2) include a physical activity intervention at home, (3) utilize a physical activity adherence assessment, (4) be published in English in a peer reviewed journal. Two independent reviewers assessed the reporting quality of each RCT for conformity to 39 Consolidated Standards of Reporting Trials (CONSORT) items, followed by an evaluation of adherence assessment methods. RESULTS Eleven studies met the inclusion criteria and none of them reported all CONSORT items. The median number of "fully reported" items was 7 out of 39. Ten of the 11 RCTs employed the adherence diary as an assessment method. The adherence parameters of frequency and duration were applied with greater frequency than intensity and accuracy. No evidence of an objective method of adherence assessment was found. CONCLUSIONS This systematic review revealed suboptimal reporting of RCTs of physical activity interventions. The use of a diary with the post-stroke population at home was common, despite the lack of an objective method of adherence assessment. Stricter compliance to CONSORT guidelines and complementary direct adherence measurement is advised to improve activity adherence research.
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Affiliation(s)
- Richard Lu
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - Dominic Lloyd-Randolfi
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - Heather Jones
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - Lisa Tabor Connor
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
| | - Rawan AlHeresh
- Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA, USA
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A Systematic Review of Completeness of Reporting in Randomized Controlled Trials in Dermatologic Surgery: Adherence to CONSORT 2010 Recommendations. Dermatol Surg 2016; 42:1325-1334. [DOI: 10.1097/dss.0000000000000902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Harvey LA. Physiotherapy rehabilitation for people with spinal cord injuries. J Physiother 2016; 62:4-11. [PMID: 26701156 DOI: 10.1016/j.jphys.2015.11.004] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/11/2015] [Accepted: 11/13/2015] [Indexed: 01/13/2023] Open
Affiliation(s)
- Lisa A Harvey
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, Australia
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How to grade level of evidence of physical interventions for people with spinal cord injury? Spinal Cord 2014; 53:249. [PMID: 25535155 DOI: 10.1038/sc.2014.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Guidelines for the reporting of clinical research. Spinal Cord 2014; 52:787. [PMID: 25376246 DOI: 10.1038/sc.2014.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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