Epidural administration (from Ancient GreekScales to Assess the Quality of Randomized Controlled Trials: A Systematic Review. The medical literature is an important resource to guide clinical decision making and research. The evaluation of the methodological quality of studies is an essential step in the process of selecting the best clinical literature. According to Verhagen et al,1 assessment of methodological quality involves evaluation of internal validity (the degree to which a study's design, conduct, and analysis have minimized biases) and external validity (the extent to which the results of a study can be generalized outside the experimental situation) as well as statistical analysis of primary research. Taken together, these validity constructs are important in determining the methodological quality of primary research. Khan et al. 2 pointed out that some reasons for performing quality assessment include: to determine a minimum quality threshold for the selection of the primary studies for a systematic review; to explore differences in quality as an explanation for heterogeneity in study results; to weigh the results in proportion to the quality in meta- analysis; and, more importantly, to guide interpretation of findings, help determine the strength of inferences, and guide recommendations for future research and clinical practice. The assessment of the quality of controlled trials is essential because variations in the quality of trials can affect the conclusions about the existing evidence. In a review of trials evaluating primarily medical treatments, Moher and colleagues. These facts emphasize the importance of methodological quality assessment in order to provide accurate information on therapeutic effects. Trial quality can be divided into 2 categories (which overlap to some degree): methodological quality and reporting quality. Methodological quality is defined as “the confidence that the trial design, conduct, and analysis have minimized or avoided biases in its treatment comparisons.”6(p. Reporting quality is defined as “the provided information about the design, conduct and analysis of the trial.”6(p. What are the effects of surgical interventions for hip fracture? UNLIKELY TO BE BENEFICIAL Conservative vs. Operative Treatment for Most Types of Hip Fracture.
Electroconvulsive therapy (ECT) is a safe and effective treatment for severe medication-resistant depression. ECT is often undertaken on remote sites in. Inadequate reporting makes the interpretation of studies difficult if not impossible. Scales and checklists are 2 types of instruments that may be used to assess the methodological quality of clinical trials. These 2 types have been used interchangeably; however, they are actually quite distinct. Scales and checklists both include items measuring quality; however, with a scale, the responses to the individual items are summed to create an overall summary score representing trial quality. For example, with the Physiotherapy Evidence Database (PEDro) scale, a summary quality score can be created by determining the number of “yes” responses to items 2 through 1. A single score of trial quality is obviously appealing because it seems easier to interpret than a series of ticks on a checklist. However, unless accepted guidelines have been followed in scale development and the scale has performed well in subsequent psychometric testing (panel of experts; Delphi procedure; and tested for reliability, responsiveness, and content, construct, and concurrent validity),7 scale scores may provide a false impression of meaningfulness. The identification of a reliable and valid scale to assess the literature on a specific topic minimizes the chances of errors when determining the quality of the scientific literature. Thus, the purposes of this systematic review were: (1) to summarize the content, construction, areas of development, and psychometric properties of scales used to evaluate the quality of the randomized controlled trials (RCTs) in health care research and (2) to identify an appropriate scale to evaluate methodological quality of RCTs in the physical therapy and rehabilitation research field. Method. Search Strategy. A computerized database search was performed to identify relevant articles. For this review, the literature was searched for published studies describing or using a scale to evaluate the methodological quality of RCTs in health care research. The studies were searched in all languages according to the search strategy of Dickersin and Lefebvre. The search included studies from 1. March 2, 2. 00. 7, which were obtained through an extensive search of bibliographic databases, including MEDLINE (1. February 2. 00. 7, week 4); EMBASE (1. CINAHL (Cumulative Index to Nursing and Allied Health Literature) (1. February 2. 00. 7, week 3); ISI Web of Science (1. March 2, 2. 00. 7); EBM (Evidence- Based Medicine) Reviews- Cochrane Central Register of Controlled Trials (CCTR), Cochrane Library, and Best Evidence (1. All EBM Reviews, comprising the Cochrane Database of Systematic Reviews (CDSR), ACP (American College of Physicians) Journal Club, Database of Abstracts of Reviews of Effects (DARE), and CCTR (1. Global Health (1. Health. STAR (1. 91. February 2. 00. 7). Key words used in the search were: “scale,” “critical appraisal,” “critical appraisal review,” “appraisal of methodology,” “research design review,” “quality assessment,” “randomized controlled trial,” and “RCT.” Subject subheadings and some word truncations, according to each database, were used as well to map all possible key words. Table 1 provides details on the specific search terms and combinations. The selection of these terms was made with the help of a librarian specializing in health sciences databases. In addition, the literature search also involved manual search of bibliographies of the identified papers, looking for key authors (ie, Jadad, Moher, and Chalmers) and relevant information to meet the objectives of this study. In addition, each study in which the original scale development was described was tracked through the Web of Science database in order to access all studies that referenced the original scale development. Table 1. Search Results From Different Electronic Databasesa. Inclusion and Exclusion Criteria. Published studies reporting on scale development or the psychometric evaluation of a scale were eligible for inclusion. The inclusion criterion was: published scales developed to evaluate methodological quality of RCTs in any area of medical research. No unpublished scales were included. Scales were excluded if they were developed for the analysis of the methodological quality for only one specific systematic review or if the development of the scale was not described and the psychometric properties of the scale were not tested. Based on this information, we believe that, although the inclusion of these excluded scales would greatly increase the number of scales in this review, these scales would not contribute to the results because they were most likely not developed systematically. Checklists that clearly were not designed to be summed also were excluded from this systematic review. Data Extraction. Five independent reviewers (SAO, LGM, ICG, JF, and TS) screened abstracts and titles for eligibility. When the reviewers felt that the abstract or title was potentially useful, full copies of the article were retrieved and considered for eligibility by all reviewers. When discrepancies occurred between reviewers, the reasons were identified and a final decision was made based on the agreement of all reviewers. STATA software (version 9. The next step involved extracting the information regarding the content, construction, special features (eg, area of development, number of items, how items were selected for inclusion, time to complete, how scales and items were scored, the use of guidelines), and psychometric properties for each scale. Psychometric properties that were extracted and analyzed were: face validity, content validity, construct validity, concurrent validity, internal consistency, and reproducibility (intrarater and interrater reliability/agreement). We used the definitions of Streiner and Norman. Terwee et al. 12 to determine quality of measurement properties. In short, quality of measurement included internal components of validity (ie, content validity: internal consistency, relevance of items and representativeness of items of the scale) as well as the external component of validity (ie, construct validity: the relationship with other tests in a manner that is consistent with theoretically derived hypotheses). In addition, intrarater and interrater reliability (ie, repeatability of measurements taken by the same tester at different times and repeatability of measurements taken by different testers, respectively) also were considered. Scales were identified as being important to physical therapy if the authors specifically stated that the scale was developed for the physical therapy practice area or was developed by a group of physical therapist researchers, or if the Web of Science search identified that the scale was used in at least 2 physical therapy reviews. Results. The initial electronic database search of the literature resulted in a total of 7,7. Tab. Of these, 4. After the complete article was read, however, only 1. Thirty papers were excluded after reading the complete article. The main reasons for exclusion were: (1) the tool was a checklist and not a scale, (2) the tool was developed for a single systematic review, and (3) information regarding the scale's construction, development, and psychometric properties was missing or impossible to obtain. The agreement between the reviewers in selecting these articles after applying the inclusion and exclusion criteria was analyzed with a kappa statistic for multiple raters, which resulted in a value of . A total of 3,1. 58 articles were found by tracking each scale. From these, 5. 6 new articles were selected from the Web of Science. Thirty- six articles also were obtained through a hand search (ie, bibliographies of the identified papers, key authors). Thus, a total of 1. The Figure details the searches. Figure. QUORUM (Quality of Reporting of Meta- analyses) statement flow diagram of the literature search. The included studies accounted for 2.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. Archives
January 2017
Categories |