Methodological Quality of Randomized Clinical Trials of Respiratory Physiotherapy in Coronary Artery Bypass Grafting Patients in the Intensive Care Unit: a Systematic Review

Lorscheitter, Jaqueline; Stein, Cinara; Plentz, Rodrigo Della Méa

doi:10.21470/1678-9741-2017-0014

Cited by 2 publications

(2 citation statements)

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“…The publications reporting in favour of IHC were more likely to have uncertain/high risk of bias ratings across most domains than publications reporting no differences between groups, or effects in favour of usual care. While low methodological quality may be associated with larger estimates of treatment effect in some disciplines and disease areas, this phenomenon is not universal . As such, the degree to which this phenomenon applies to IHC research requires further exploration.…”

Section: Discussionmentioning

confidence: 99%

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The effectiveness of integrative healthcare for chronic disease: A systematic review

et al. 2019

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Background The past few decades have witnessed a surge in consumer, clinician and academic interest in the field of integrative healthcare (IHC). Yet, there is still uncertainty regarding the effectiveness of IHC for complex, long‐term health conditions. Objective To assess the effectiveness of IHC for the management of any chronic health condition. Methods Seven databases and four clinical trial registries were searched from inception through to May 2018 for comparative/controlled clinical trials investigating the effectiveness of IHC for any chronic disease, and assessing any outcome. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias tool. Results The search yielded 6,926 results. Eight studies met the inclusion criteria. All studies had at least three design features that carried an uncertain/high risk of bias. Differences in physiological, psychological and functional outcomes, and quality of life between patients receiving IHC and patients receiving conventional/usual care were varied and inconsistent. Changes in patient satisfaction with care were inconclusive. No studies reported the effectiveness of IHC on workforce‐ or administration‐related parameters. Evidence from one trial suggested IHC may be more cost‐effective than conventional care. Conclusions The findings indicate some promising effects for the use of IHC to manage chronic disease. However, the uncertain/high risk of bias across multiple domains, diverse and inconsistent findings, and heterogeneity of outcome measures and study populations prevents firm conclusions from being reached. Along with conducting further well‐designed, long‐term studies in this field, there is a need to ensure interventions closely align with the definition/principles of IHC.

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Section: Discussionmentioning

confidence: 99%

“…While low methodological quality may be associated with larger estimates of treatment effect in some disciplines and disease areas, 41,42 this phenomenon is not universal. 43,44 As such, the degree to which this phenomenon applies to IHC research requires further exploration.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of integrative healthcare for chronic disease: A systematic review

et al. 2019

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Is Scientific Medical Literature Related to Endometriosis Treatment Evidence-Based? A Systematic Review on Methodological Quality of Randomized Clinical Trials

2019

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Background and objectives: Informed decision-making requires the ability to identify and integrate high-quality scientific evidence in daily practice. We aimed to assess whether randomized controlled trials (RCTs) on endometriosis therapy follow methodological criteria corresponding to the RCTs’ specific level in the hierarchy of evidence in such details to allow the reproduction and replication of the study. Materials and Methods: Using the keywords “therapy” and “endometriosis” and “efficacy” three bibliographic databases were searched for English written scientific articles published from 1 January 2008 to 3 March 2018. Only the randomized clinical trials (RCTs) were evaluated in terms of whether they provided the appropriate level of scientific evidence, equivalent to level 1, degree 1b in the hierarchy of evidence. A list of criteria to ensure study replication and reproduction, considering CONSORT guideline and MECIR standards, was developed and used to evaluate RCTs’ methodological soundness, and scores were granted. Three types of bias, namely selection bias (random sequence generation and allocation concealment), detection bias (blinding of outcome assessment), and attrition bias (incomplete outcome data) were also evaluated. Results: We found 387 articles on endometriosis therapy, of which 38 were RCTs: 30 double-blinded RCTs and 8 open-label RCTs. No article achieved the maximum score according to the evaluated methodological criteria. Even though 73.3% of the double-blinded RCTs had clear title, abstract, introduction, and objectives, only 13.3% provided precise information regarding experimental design and randomization, and also showed a low risk of bias. The blinding method was poorly reported in 43.3% of the double-blinded RCTs, while allocation concealment and random sequence generation were inadequate in 33.3% of them. Conclusions: None of the evaluated RCTs met all the methodological criteria, none had only a low risk of bias and provided sufficient details on methods and randomization to allow for the reproduction and replication of the study. Consequently, the appropriate level of scientific evidence (level 1, degree 1b) could not be granted. On endometriosis therapy, this study evaluated the quality of reporting in RCTs and not the quality of how the studies were performed.

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Methodological Quality of Randomized Clinical Trials of Respiratory Physiotherapy in Coronary Artery Bypass Grafting Patients in the Intensive Care Unit: a Systematic Review

Cited by 2 publications

References 61 publications

The effectiveness of integrative healthcare for chronic disease: A systematic review

The effectiveness of integrative healthcare for chronic disease: A systematic review

Is Scientific Medical Literature Related to Endometriosis Treatment Evidence-Based? A Systematic Review on Methodological Quality of Randomized Clinical Trials

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