制定“可靠”的系统综述和荟萃分析的方案,以评估手动治疗干预措施治疗神经肌肉骨骼损伤的效果。

Protocol for the development of a 'trustworthy' living systematic review and meta analyses of manual therapy interventions to treat neuromusculoskeletal impairments.

机构信息

Department of Rehabilitation Sciences, University of Hartford, West Hartford, CT, USA.

Duke Center for Excellence in Manual and Manipulative Therapy, Duke University, Durham, NC, USA.

出版信息

J Man Manip Ther. 2023 Aug;31(4):220-230. doi: 10.1080/10669817.2022.2119528. Epub 2022 Sep 9.

Abstract

BACKGROUND

Preprocessed research resources are believed to be highly 'trustworthy' when translating research to clinical practice. However, the overall 'trustworthiness' is unknown if this evidence contains randomized clinical trials (RCTs) where prospective has not been/cannot be verified, has low confidence in estimated effects, and if they are not up to date.

OBJECTIVES

This protocol will be used to create a baseline benchmark for a series of trustworthy living systematic reviews (SRs) regarding manual therapy interventions.

METHODS

Data will originate from RCTs related to manual therapy neuromusculoskeletal interventions, indexed in 6 search engines in English from 1 January 2010, to the present. Two blinded reviewers will identify the RCTs and extract data using Covidence. The data will be synthesized based on consensus and analyzed using the Cochrane collaboration's Review Manager.

EXPECTED OUTCOMES

It is expected that there will be a shortage of RCTs with at least a moderate confidence in estimated effects that will allow for strong practice recommendations.

DISCUSSION

Identifying evidence that can be translated into strong practice recommendations is essential to identify beneficial and harmful interventions, decrease practice variability, and identify neuromusculoskeletal manual therapy interventions that require further disciplined methodological focus.

摘要

背景

在将研究转化为临床实践时,预处理后的研究资源被认为具有高度的“可信度”。然而,如果这些证据中包含前瞻性尚未/无法验证、估计效果置信度低且未及时更新的随机对照试验(RCT),则整体“可信度”是未知的。

目的

本方案旨在为一系列关于手动治疗干预的可信循证系统评价(SR)创建基准。

方法

数据将源自 2010 年 1 月 1 日至当前期间在 6 个英文搜索引擎中索引的与手动治疗神经肌肉骨骼干预相关的 RCT。两名盲审员将使用 Covidence 识别 RCT 并提取数据。将根据共识对数据进行综合,并使用 Cochrane 协作的 Review Manager 进行分析。

预期结果

预计至少在估计效果方面具有中度置信度的 RCT 数量不足,这将无法提供强有力的实践建议。

讨论

确定可以转化为强有力实践建议的证据对于识别有益和有害干预措施、减少实践变异性以及确定需要进一步进行严格方法学关注的神经肌肉骨骼手动治疗干预措施至关重要。

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