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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
general
PEDro or Cochrane to assess the quality of clinical trials? A meta-epidemiological study
PLoS ONE, Volume 10, No. 7, Article e0132634, Year 2015
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Description
Objective: There is debate on how the methodological quality of clinical trials should be assessed. We compared trials of physical therapy (PT) judged to be of adequate quality based on summary scores from the Physiotherapy Evidence Database (PEDro) scale with trials judged to be of adequate quality by Cochrane Risk of Bias criteria. Design: Meta-epidemiological study within Cochrane Database of Systematic Reviews. Methods: Meta-analyses of PT trials were identified in the Cochrane Database of Systematic Reviews. For each trial PeDro and Cochrane assessments were extracted from the PeDro and Cochrane databases. Adequate quality was defined as adequate generation of random sequence, concealment of allocation, and blinding of outcome assessors (Cochrane criteria) or as trials with a PEDro summary score ≥5 or ≥6 points. We combined trials of adequate quality using random-effects meta-analysis. Results Forty-one Cochrane reviews and 353 PT trials were included. All meta-analyses included trials with PEDro scores ≥5,37 (90.2%) included trials with PEDro scores ≥6 and only 22 (53.7%) meta-analyses included trials of adequate quality according to the Cochrane criteria. Agreement between PeDro and Cochrane was poor for PeDro scores of ≥5 points (kappa = 0.12; 95% CI 0.07 to 0.16) and slight for ≥6 points (kappa 0.24; 95% CI 0.16-0.32). When combining effect sizes of trials deemed to be of adequate quality according to PEDro or Cochrane criteria, we found that a substantial difference in the combined effect size (≥0.15) was evident in 9 (22%) out of the 41 meta-analyses for PEDro cutoff >5and 10 (24%) for cutoff ≥6. Conclusions: The PeDro and Cochrane approaches lead to different sets of trials of adequate quality, and different combined treatment estimates from meta-analyses of these trials. A consistent approach to assessing RoB in trials of physical therapy should be adopted. Copyright: © 2015 Armijo-Olivo et al.
Authors & Co-Authors
da Costa, Bruno Roza
Switzerland, Bern
University of Bern
Cummings, Greta G.
Canada, Edmonton
University of Alberta
Saltaji, Humam
Canada, Edmonton
University of Alberta
Egger, Matthias
Switzerland, Bern
University of Bern
Statistics
Citations: 110
Authors: 4
Affiliations: 3
Identifiers
Doi:
10.1371/journal.pone.0132634
ISSN:
19326203
Study Approach
Systematic review