IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
University of Applied Sciences, Faculty of Business and Social Sciences, Osnabrück, Germany; Faculties of Rehabilitation Medicine and Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Arch Phys Med Rehabil. 2021 Aug;102(8):1614-1622.e14. doi: 10.1016/j.apmr.2021.04.006. Epub 2021 May 11.
To identify, synthesize, and categorize the methodological issues faced by the rehabilitation field.
A scoping review was conducted using studies identified in MEDLINE, the Cochrane Library, EMBASE, Web of Science, Scopus, Physiotherapy Evidence Database, and Google Scholar up to August 2018.
We included all type of publications describing methodological issues in rehabilitation research where rehabilitation is described as a multimodal process. The methodological issues have been categorized and classified.
The synthesis included qualitative and quantitative analysis. To focus the attention on rehabilitation, we post hoc divided in "specific issues" (highly related to, even if not exclusive of, rehabilitation research) and "generic issues" (common in biomedical research).
Seventy-one publications were included: 68% were narrative reviews, 15% systematic reviews, 7% editorials, 4% meta-epidemiologic studies, and 5% others. Specific methodological issues include the following: problematic application of randomized controlled trials (32%), absent definition of core outcome sets (28%), poor interventions description (22%), weak methodological (conducting) and reporting quality (21%), scarce clinical practice applicability (14%), lack of blinding assessor (10%), inadequate randomization methods or inadequate allocation concealment (8%), and inadequate participants description and recruitment (8%). "Generic" issues included the following: data and statistical description (31%), authors' methodological training (7%), peer review process (6%, n=4), funding declaration (6%), ethical statement (3%), protocol registration (3%), and conflict of interest declaration (1%).
Methodological and reporting issues might influence the quality of the evidence produced in rehabilitation research. The next steps to move forward in the field of rehabilitation could be to evaluate the influence of all these issues on the validity of trial results through meta-epidemiologic studies and to develop specific checklists to provide guidance to authors to improve the reporting and conduct of trials in this field.
确定、综合和分类康复领域面临的方法学问题。
使用 MEDLINE、Cochrane 图书馆、EMBASE、Web of Science、Scopus、Physiotherapy Evidence Database 和 Google Scholar 中截至 2018 年 8 月确定的研究进行了范围综述。
我们纳入了所有描述康复研究中方法学问题的出版物，其中康复被描述为一种多模式的过程。将方法学问题进行了分类和分类。
综合包括定性和定量分析。为了专注于康复，我们事后将其分为“特定问题”（与康复研究高度相关，即使不是专门针对康复研究）和“通用问题”（在生物医学研究中常见）。
共纳入 71 篇文献：32%为叙述性综述，15%为系统评价，7%为社论，4%为元流行病学研究，5%为其他。具体的方法学问题包括以下几个方面：随机对照试验的应用问题（32%）、缺乏核心结局集的定义（28%）、干预措施描述不佳（22%）、方法学（实施）和报告质量较差（21%）、临床实践适用性低（14%）、缺乏评估者盲法（10%）、随机化方法不充分或分配隐藏不充分（8%）以及参与者描述和招募不充分（8%）。“通用”问题包括以下几个方面：数据和统计描述（31%）、作者的方法学培训（7%）、同行评审过程（6%，n=4）、资金申报（6%）、伦理声明（3%）、方案注册（3%）和利益冲突声明（1%）。
方法学和报告问题可能会影响康复研究产生的证据质量。下一步是通过元流行病学研究评估所有这些问题对试验结果有效性的影响，并制定特定的清单，为作者提供指导，以提高该领域试验的报告和实施。
