van Tulder Maurits, Malmivaara Antti, Hayden Jill, Koes Bart
Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands.
Spine (Phila Pa 1976). 2007 Jul 15;32(16):1785-90. doi: 10.1097/BRS.0b013e3180b9ef49.
Critical appraisal of the literature.
The objective of this study was to assess if results of back pain trials are statistically significant and clinically important.
There seems to be a discrepancy between conclusions reported by authors and actual results of randomized controlled trials. Little attention has been paid to the problem of over-reporting of conclusions.
All 43 trials of the Cochrane review on exercise therapy for low back pain were included. Descriptive analyses were conducted.
Eighteen trials reported positive conclusions in favor of exercise. Only six of the 43 studies showed both clinically important and statistically significant differences in favor of the exercise groups on function, and 4 on pain.
It seems that many conclusions of studies of exercise therapy for chronic low back pain have been based on statistical significance of results rather than on clinical importance and, consequently, may have been too positive. Authors of trials should report not only statistical significance of results but also clinical importance.
文献的批判性评价。
本研究的目的是评估腰痛试验的结果在统计学上是否显著以及在临床上是否重要。
作者报告的结论与随机对照试验的实际结果之间似乎存在差异。对结论过度报告的问题关注较少。
纳入了Cochrane系统评价中关于运动疗法治疗下腰痛的所有43项试验。进行了描述性分析。
18项试验报告了支持运动的阳性结论。43项研究中只有6项显示运动组在功能方面有临床上重要且在统计学上显著的差异，4项显示在疼痛方面有此类差异。
慢性下腰痛运动疗法研究的许多结论似乎基于结果的统计学显著性而非临床重要性，因此可能过于乐观。试验作者不仅应报告结果的统计学显著性，还应报告临床重要性。
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