Chard J A, Tallon D, Dieppe P A
MRC-Health Services Research Collaboration, Department of Social Medicine, University of Bristol, UK.
Ann Rheum Dis. 2000 Jun;59(6):414-8. doi: 10.1136/ard.59.6.414.
To assess the published research base for interventions for osteoarthritis of the knee, and to identify areas in need of further research.
Literature searches were conducted on electronic databases (Medline, Embase, ISI, and Cochrane library), bibliographies of existing review articles were hand searched, and a postal questionnaire was sent to members of the Osteoarthritis Research Society International. All relevant articles were copied and searched for treatment type, study methodology, statistical results, conclusions, funding source, researcher affiliations, and year of publication, using a predetermined data extraction form.
There have been marked changes in the literature over the period studied (1950-98), with a recent rise in trials of physical therapy, educational interventions, and complementary treatments. However, overall, most research was either drug (59.1%) or surgically (25.6%) related. Most of the studies reported positive results (94%). Research on oral drugs was significantly more likely to provide a positive result than research on any other intervention (p<0.001 by chi(2) test). Commercially funded studies were significantly more likely to produce a positive result than non-commercially funded research (p=0.0027 by chi(2) test).
Analysis of time trends indicates that the research agenda does shadow changes in consumer demands. However, there are significant gaps in the research base that need to be considered.
评估已发表的关于膝关节骨关节炎干预措施的研究基础,并确定需要进一步研究的领域。
在电子数据库(Medline、Embase、ISI和Cochrane图书馆)中进行文献检索,人工查阅现有综述文章的参考文献,并向国际骨关节炎研究协会的成员发送邮政调查问卷。使用预先确定的数据提取表,对所有相关文章进行复制,并搜索治疗类型、研究方法、统计结果、结论、资金来源、研究人员所属机构和发表年份。
在所研究的时期(1950 - 1998年)内,文献有显著变化,近期物理治疗、教育干预和补充治疗的试验有所增加。然而,总体而言,大多数研究与药物(59.1%)或手术(25.6%)相关。大多数研究报告了阳性结果(94%)。与其他任何干预措施的研究相比,口服药物研究更有可能得出阳性结果(卡方检验p<0.001)。商业资助的研究比非商业资助的研究更有可能产生阳性结果(卡方检验p = 0.0027)。
对时间趋势的分析表明,研究议程确实反映了消费者需求的变化。然而,研究基础中仍存在重大差距,需要加以考虑。