A review of music-based intervention reporting in pediatrics

Characteristics and impacts of live music interventions on health and wellbeing for children, families, and health care professionals in paediatric hospitals: a scoping review

PURPOSE

The objective of this scoping review is to compile and examine characteristics and impacts of live music interventions on the health and wellbeing of children, families, and health care professionals in paediatric hospital care.

METHODS

We searched four scientific databases for peer-reviewed publications of empirical studies of all study designs. The first author screened the publications, with spot-checks for eligibility by the second and third authors. Data extraction and quality assessment were made by the first author with support from the second and third. Additionally, the included studies were screened for quality appraisal. The analysis followed an inductive, interpretive approach for synthesis.

RESULTS

Quantitative features were screened and compiled, and qualitative inductive analyses of findings were elaborated into categories connected to research questions. The reported impacts were thematized through emergent features of importance and prerequisites beneficial for successful interventions. Recurrent outcomes present themes of positive affect, copingand reduced hospitalization. Emotional regulation, play and participation, age, session design, adaptivity, and familiarity present benefits, barriers, and facilitators for outcomes.

CONCLUSIONS

Findings from collected empirical research display philosophy, practice, and relations as keys for characteristics, impacts, and implications of live music interventions in paediatric hospital care. The communicative aspects of music appear at the core of importance.

Identification and Illustration of Means to a Critical Assessment of Music and Health Research Literature

In 2019, the WHO released a scoping review investigating art therapies in evidence-based healthcare practices to identify and understand the gaps in the literature. However, the studies curated were not evaluated for their quality. To address this limitation, several assessment tools to critically appraise music-based research studies that investigate therapies pertaining to preventative healthcare were investigated. Two critical appraisal tools were selected for their robustness and appropriateness for the studies in question: the Joanna Briggs Institute checklists and the Music-Based Intervention Guidelines. These tools were tested by two assessors on a total of 23 music studies from the Preventative and Prevention Health section of the WHO report. Based on the requirements for each critical appraisal tool, seven studies received a full assessment utilizing both checklists. Of these seven, two studies scored on the higher index, indicating that the studies followed a detailed methodology to provide concrete and accurate results. The findings of the study highlighted the limitations of study designs and music-based interventions. With this information, beneficial recommendations for future research in this domain are provided to improve the quality of research, ensuring its place in evidence-based healthcare practices.

The role of music therapy in the treatment of children with cancer: A systematic review of literature

BACKGROUND

and purpose: Music Therapy has become a consolidated strategy to relief stress in children during hospitalization, and previous research demonstrated its efficacy on individuals' health. This is a systematic review of literature on the application of music therapy with children and adolescent with cancer, with the aim of evaluating its feasibility and its benefits, in terms of physical and mental health.

METHODS

Database search was carried out via PubMed, PsycINFO and SCOPUS, using an age restriction of 0-24 years and the following keywords: (cancer OR oncology) AND music. Search was conducted from inception to June 2020.

RESULTS

From 462 studies retrieved, 19 were selected and included in this research, with 596 participants. They received three different types of music therapy: receptive music therapy (n = 4), active music therapy (n = 9) and the combined method of receptive and active interventions (n = 6). These studies indicated a significant reduction of psychological distress (n = 9) and an increase in well-being (n = 8). 8 articles evaluated the effects on subjective pain and other biological parameters, with inconclusive results.

CONCLUSION

Music therapy, in paediatric oncology, seems to have a good feasibility and positive effects on mental and physical health. Nevertheless, some critical issues have emerged, such as the heterogeneity of interventions and study designs, which make generalizability still difficult. These and other clinical implications are discussed.

Effect of Personalized Music Intervention in Mechanically Ventilated Children in the PICU: A Pilot Study

OBJECTIVES

To determine the feasibility of a personalized music intervention with mechanically ventilated patients in the PICU.

DESIGN

Pilot study with a quasi-experimental design.

SETTING

Tertiary children's hospital in China with a 40-bed PICU.

PATIENTS

Children, 1 month to 7 years, with mechanical ventilation were recruited and assigned to music group (n = 25) and control group (n = 25).

INTERVENTIONS

Children in the music group received their own favorite music and listened for 60 minutes three times a day. The control group receive routine care without music.

MEASUREMENTS AND MAIN RESULTS

Primary outcome measure was comfort measured with the COMFORT Behavior scale 5 minutes before and after the music. Secondary outcome measures were physiologic variables; heart rate, respiration, blood pressure, oxygen saturation. Mechanical ventilation time, length of stay, and sedation medication were also collected. Qualitative analysis revealed that nurses had a positive attitude in delivering the interventions and identified improvements for the main trial. Children in the music group had lower COMFORT Behavior scores (15.7 vs 17.6; p = 0.011). Children in the music group had better physiologic outcomes; heart rate (140 vs 144; p = 0.039), respiration rate (40 vs 43; p = 0.036), systolic blood pressure (93 vs 95 mm Hg; p = 0.031), oxygen saturation (96% vs 95%; p < 0.001), diastolic blood pressure was not significantly (52 vs 53 mm Hg; p = 0.11). Children in the music group had a shorter ventilation time (148.7 vs 187.6; p = 0.044) and a shorter length of stay, but not significant (11.2 vs 13.8; p = 0.071). Children in the control group had higher total amount of on-demand midazolam (29 vs 33 mg; p = 0.040).

CONCLUSIONS

Our pilot study indicates that personalized music intervention is feasible and might improve the comfort of children with mechanical ventilation. Further studies are needed to provide conclusive evidence in confirming the effectiveness of music interventions comforting critically ill children in PICUs.

Reporting quality of music intervention research in healthcare: A systematic review

INTRODUCTION

Concomitant with the growth of music intervention research, are concerns about inadequate intervention reporting and inconsistent terminology, which limits validity, replicability, and clinical application of findings.

OBJECTIVE

Examine reporting quality of music intervention research, in chronic and acute medical settings, using the Checklist for Reporting Music-based Interventions. In addition, describe patient populations and primary outcomes, intervention content and corresponding interventionist qualifications, and terminology.

METHODS

Searching MEDLINE, PubMed, CINAHL, HealthSTAR, and PsycINFO we identified articles meeting inclusion/exclusion criteria for a five-year period (2010-2015) and extracted relevant data. Coded material included reporting quality across seven areas (theory, content, delivery schedule, interventionist qualifications, treatment fidelity, setting, unit of delivery), author/journal information, patient population/outcomes, and terminology.

RESULTS

Of 860 articles, 187 met review criteria (128 experimental; 59 quasi-experimental), with 121 publishing journals, and authors from 31 countries. Overall reporting quality was poor with <50% providing information for four of the seven checklist components (theory, interventionist qualifications, treatment fidelity, setting). Intervention content reporting was also poor with <50% providing information about the music used, decibel levels/volume controls, or materials. Credentialed music therapists and registered nurses delivered most interventions, with clear differences in content and delivery. Terminology was varied and inconsistent.

CONCLUSIONS

Problems with reporting quality impedes meaningful interpretation and cross-study comparisons. Inconsistent and misapplied terminology also create barriers to interprofessional communication and translation of findings to patient care. Improved reporting quality and creation of shared language will advance scientific rigor and clinical relevance of music intervention research.

Investigating the Adequacy of Intervention Descriptions in Recent Speech-Language Pathology Literature: Is Evidence From Randomized Trials Useable?

PURPOSE

To evaluate the completeness of intervention descriptions in recent randomized controlled trials of speech-language pathology treatments.

METHOD

A consecutive sample of entries on the speechBITE database yielded 129 articles and 162 interventions. Interventions were rated using the Template for Intervention Description and Replication (TIDieR) checklist. Rating occurred at 3 stages: interventions as published in the primary article, secondary locations referred to by the article (e.g., protocol papers, websites), and contact with corresponding authors.

RESULTS

No interventions were completely described in primary publications or after analyzing information from secondary locations. After information was added from correspondence with authors, a total of 28% of interventions was rated as complete. The intervention elements with the most information missing in the primary publications were tailoring and modification of interventions (in 25% and 13% of articles, respectively) and intervention materials and where they could be accessed (18%). Elements that were adequately described in most articles were intervention names (in 100% of articles); rationale (96%); and details of the frequency, session duration, and length of interventions (69%).

CONCLUSIONS

Clinicians and researchers are restricted in the usability of evidence from speech-language pathology randomized trials because of poor reporting of elements essential to the replication of interventions.

How completely are physiotherapy interventions described in reports of randomised trials?

BACKGROUND

Incomplete descriptions of interventions are a common problem in reports of randomised controlled trials. To date no study has evaluated the completeness of the descriptions of physiotherapy interventions.

OBJECTIVES

To evaluate the completeness of the descriptions of physiotherapy interventions in a random sample of reports of randomised controlled trials (RCTs).

DATA SOURCES

A random sample of 200 reports of RCTs from the PEDro database.

STUDY SELECTION OR ELIGIBILITY CRITERIA

We included full text papers, written in English, and reporting trials with two arms. We included trials evaluating any type of physiotherapy interventions and subdisciplines.

DATA EXTRACTION AND DATA SYNTHESIS

The methodological quality was evaluated using the PEDro scale and completeness of intervention description using the Template for Intervention Description and Replication (TIDieR) checklist. The proportion and 95% confidence interval were calculated for intervention and control groups, and used to present the relationship between completeness and methodological quality, and subdisciplines.

RESULTS

Completeness of intervention reporting in physiotherapy RCTs was poor. For intervention groups, 46 (23%) trials did not describe at least half of the items. Reporting was worse for control groups, 149 (75%) trials described less than half of the items. There was no clear difference in the completeness across subdisciplines or methodological quality.

LIMITATIONS

Our sample were restricted to trials published in English in 2013.

CONCLUSION AND IMPLICATIONS OF KEY FINDINGS

Descriptions of interventions in physiotherapy RCTs are typically incomplete. Authors and journals should aim for more complete descriptions of interventions in physiotherapy trials.

Recommendations and evidence for reporting items in pediatric clinical trial protocols and reports: two systematic reviews

BACKGROUND

Complete and transparent reporting of clinical trial protocols and reports ensures that these documents are useful to all stakeholders, that bias is minimized, and that the research is not wasted. However, current studies repeatedly conclude that pediatric trial protocols and reports are not appropriately reported. Guidelines like SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) and CONSORT (Consolidated Standards of Reporting Trials) may improve reporting, but do not offer guidance on issues unique to pediatric trials. This paper reports two systematic reviews conducted to build the evidence base for the development of pediatric reporting guideline extensions: 1) SPIRIT-Children (SPIRIT-C) for pediatric trial protocols, and 2) CONSORT-Children (CONSORT-C) for pediatric trial reports.

METHOD

MEDLINE, the Cochrane Methodology Register, and reference lists of included studies were searched. Publications of any type were eligible if they included explicit recommendations or empirical evidence for the reporting of potential items in a pediatric protocol (SPIRIT-C systematic review) or trial report (CONSORT-C systematic review). Study characteristics, recommendations and evidence for pediatric extension items were extracted. Recurrent themes in the recommendations and evidence were identified and synthesized. All steps were conducted by two reviewers.

RESULTS

For the SPIRIT-C and CONSORT-C systematic reviews 366 and 429 publications were included, respectively. Recommendations were identified for 48 of 50 original reporting items and sub-items from SPIRIT, 15 of 20 potential SPIRIT-C reporting items, all 37 original CONSORT items and sub-items, and 16 of 22 potential CONSORT-C reporting items. The following overarching themes of evidence to support or refute the utility of reporting items were identified: transparency; reproducibility; interpretability; usefulness; internal validity; external validity; reporting bias; publication bias; accountability; scientific soundness; and research ethics.

CONCLUSION

These systematic reviews are the first to systematically gather evidence and recommendations for the reporting of specific items in pediatric protocols and trials. They provide useful and translatable evidence on which to build pediatric extensions to the SPIRIT and CONSORT reporting guidelines. The resulting SPIRIT-C and CONSORT-C will provide guidance to the authors of pediatric protocols and reports, respectively, helping to alleviate concerns of inappropriate and inconsistent reporting, and reduce research waste.

The systematic review as a research process in music therapy

BACKGROUND

Music therapists are challenged to present evidence on the efficacy of music therapy treatment and incorporate the best available research evidence to make informed healthcare and treatment decisions. Higher standards of evidence can come from a variety of sources including systematic reviews.

OBJECTIVE

To define and describe a range of research review methods using examples from music therapy and related literature, with emphasis on the systematic review. In addition, the authors provide a detailed overview of methodological processes for conducting and reporting systematic reviews in music therapy.

METHODS

The systematic review process is described in five steps. Step 1 identifies the research plan and operationalized research question(s). Step 2 illustrates the identification and organization of the existing literature related to the question(s). Step 3 details coding of data extracted from the literature. Step 4 explains the synthesis of coded findings and analysis to answer the research question(s). Step 5 describes the strength of evidence evaluation and results presentation for practice recommendations.

RESULTS

Music therapists are encouraged to develop and conduct systematic reviews. This methodology contributes to review outcome credibility and can determine how information is interpreted and used by clinicians, clients or patients, and policy makers.

CONCLUSIONS

A systematic review is a methodologically rigorous research method used to organize and evaluate extant literature related to a clinical problem. Systematic reviews can assist music therapists in managing the ever-increasing literature, making well-informed evidence based practice and research decisions, and translating existing music-based and nonmusic based literature to clinical practice and research development.

Poor description of non-pharmacological interventions: analysis of consecutive sample of randomised trials

OBJECTIVES

To evaluate the completeness of descriptions of non-pharmacological interventions in randomised trials, identify which elements are most frequently missing, and assess whether authors can provide missing details.

DESIGN

Analysis of consecutive sample of randomised trials of non-pharmacological interventions.

DATA SOURCES AND STUDY SELECTION

All reports of randomised trials of non-pharmacological interventions published in 2009 in six leading general medical journals; 133 trial reports, with 137 interventions, met the inclusion criteria.

DATA COLLECTION

Using an eight item checklist, two raters assessed the primary full trial report, plus any reference materials, appendices, or websites. Questions about missing details were emailed to corresponding authors, and relevant items were then reassessed.

RESULTS

Of 137 interventions, only 53 (39%) were adequately described; this was increased to 81 (59%) by using 63 responses from 88 contacted authors. The most frequently missing item was the "intervention materials" (47% complete), but it also improved the most after author response (92% complete). Whereas some authors (27/70) provided materials or further information, other authors (21/70) could not; their reasons included copyright or intellectual property concerns, not having the materials or intervention details, or being unaware of their importance. Although 46 (34%) trial interventions had further information or materials readily available on a website, many were not mentioned in the report, were not freely accessible, or the URL was no longer functioning.

CONCLUSIONS

Missing essential information about interventions is a frequent, yet remediable, contributor to the worldwide waste in research funding. If trial reports do not have a sufficient description of interventions, other researchers cannot build on the findings, and clinicians and patients cannot reliably implement useful interventions. Improvement will require action by funders, researchers, and publishers, aided by long term repositories of materials linked to publications.

Reporting Guidelines for Music-based Interventions

Music-based interventions are used to address a variety of problems experienced by individuals across the developmental lifespan (infants to elderly adults). In order to improve the transparency and specificity of reporting music-based interventions, a set of specific reporting guidelines is recommended. Recommendations pertain to reporting seven different components of music-based interventions including intervention theory, intervention content, intervention delivery schedule, interventionist, treatment fidelity, setting, and unit of delivery. Recommendations are intended to support CONSORT and TREND statements for transparent reporting of interventions while taking into account the variety, complexity, and uniqueness of music-based interventions.

Reporting guidelines for music-based interventions

Music-based interventions are used to address a variety of problems experienced by individuals across the developmental lifespan (infants to elderly adults). In order to improve the transparency and specificity of reporting music-based interventions, a set of specific reporting guidelines is recommended. Recommendations pertain to seven different components of music-based interventions, including theory, content, delivery schedule, interventionist, treatment fidelity, setting, and unit of delivery. Recommendations are intended to support Consolidated Standards for Reporting Trials (CONSORT) and Transparent Reporting of Evaluations with Non-randomized Designs (TREND) statements for transparent reporting of interventions while taking into account the variety, complexity, and uniqueness of music-based interventions.