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Maissan F.1,2, Pool J.1, de Raaij E.1,2, Mollema J.1, Ostelo R.2,3, Wittink H.1
1HU University of Applied Sciences Utrecht, Research Group Lifestyle and Health, Utrecht, Netherlands, 2VU University, Department of Health Sciences and EMGO Institute for Health and Care Research, Amsterdam, Netherlands, 3VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam, Netherlands
Background: Randomised clinical trials (RCTs) are thought to provide the highest level of evidence for interventions. For effective treatment of non-specific neck pain, physical therapists rely on this evidence However, to transfer findings from research to clinical practice, the Randomised Controlled Trial (RCT) should have a recognizable clinical reasoning process within the methodology to be externally valid. To date no study has evaluated the clinical reasoning process in RCT's with patients with non-specific neck pain.
Purpose: To evaluate the completeness of the description of the clinical reasoning process in RCTs with patients with non-specific neck pain.
Methods: Pubmed, Cinahl and Pedro were systematically searched from inception to July 2016. Articles published in English were included when these involved patients with non-specific neck pain receiving physical therapy. Data extraction included study characteristics and HOAC II based clinical reasoning process outcomes. To determine completeness of the clinical reasoning process a 6-item HOAC II based rating scale was developed and used by two independent raters to evaluate the clinical reasoning process. All 6 items had to be scored positive to be considered a complete clinical reasoning process.
Results: Thirty-seven of the included one hundred and twenty-two studies scored a complete clinical reasoning process of which three had an unclear cause, twenty-eight had an argued cause and seven a diagnosed cause.
Conclusion(s): Thirty-seven studies scored a complete clinical reasoning process.
Only 11 (9%) of the included studies had a diagnosed cause with at least one goal related outcome, making it possible to understand why the intervention should be used in daily physical therapy practice.
Implications: Physical therapists needs more RCTs with a complete clinical reasoning process to optimize the transfer of findings from research to clinical practice.
Funding acknowledgements: The work was unfunded.
Topic: Research methodology & knowledge translation
Ethics approval: Ethics approval was not required.
All authors, affiliations and abstracts have been published as submitted.
