Moseley A1,2, De Barros Pinheiro M1,2, van der Wees P3, Elkins M4,5
1Institute for Musculoskeletal Health, Sydney, Australia, 2The University of Sydney, Sydney School of Public Health, Sydney, Australia, 3Radboud University Medical Center, IQ Healthcare, Nijmegen, Netherlands, 4Sydney Local Health District, Sydney, Australia, 5The University of Sydney, Sydney Medical School, Sydney, Australia
Background: High-quality clinical research drives innovation and optimises patient outcomes. The process of using research to inform care is termed evidence-based practice. The best research method to evaluate the effects of intervention is the randomised controlled trial (or a systematic review of trials). The good news for physiotherapists wanting to use trials to guide their practice is that a large number of published trials evaluate physiotherapy interventions. A challenge to implementing evidence-based practice is keeping up to date with this rapidly expanding research base.
Purpose: The primary aim of this study is to determine the total number of trials evaluating physiotherapy interventions and estimate the rate of growth in physiotherapy trials. The secondary aim is to describe the characteristics (area of practice, methodological quality, publication language) of these trials.
Methods: We have conducted an analysis of the trial reports indexed in the Physiotherapy Evidence Database (PEDro; www.pedro.org.au) in July 2018. The cumulative number of trials available each year was calculated. An exponential growth curve was fitted to these data. The area of practice, methodological quality (total PEDro score) and publication language of the trial reports were evaluated.
Results: In July 2018 31,924 trial reports were indexed in PEDro. There has been exponential growth in the number of trials, with a very good fit of an exponential growth curve (number of trials = exp(0.12 x years since 1929); r2 = 0.97). Using this exponential function, the number of trial reports is doubling every 6 years. Musculoskeletal was the most common area of practice for trials (26%), followed by cardiothoracics (18%). However, the area of practice with the highest rate of growth was oncology (4% of trials). The mean total PEDro score was 5.1 out of 10 (standard deviation 1.5). Approximately one third of trials (37%) were of moderate to high quality. Trials were published in 29 languages, with the most prevalent being English (89%), Chinese (6%) and German (1%).
Conclusion(s): The number of trials evaluating physiotherapy interventions has increased exponentially. If this rate of growth continues, there will be 64,000 physiotherapy trials in 2024. However, the low quality of a substantial proportion of these trials highlights the need for a change in how trials are conducted and reported.
Implications: The challenge for researchers is to improve the quality and reporting of trials. Physiotherapy clinicians, students, educators and policy-makers need resources to help them quickly identify the best trials to guide practice and learning. Evidence resources like PEDro need to develop and test new strategies to optimise the provision of unbiased and high-quality information to users, particularly for areas of practice where there are large cohorts of trials and rapid growth.
Keywords: Evidence-based practice, randomised controlled trials, physiotherapy
Funding acknowledgements: PEDro is funded by the Australian Physiotherapy Association, Chartered Society of Physiotherapy, and 44 other WCPT MOs.
Purpose: The primary aim of this study is to determine the total number of trials evaluating physiotherapy interventions and estimate the rate of growth in physiotherapy trials. The secondary aim is to describe the characteristics (area of practice, methodological quality, publication language) of these trials.
Methods: We have conducted an analysis of the trial reports indexed in the Physiotherapy Evidence Database (PEDro; www.pedro.org.au) in July 2018. The cumulative number of trials available each year was calculated. An exponential growth curve was fitted to these data. The area of practice, methodological quality (total PEDro score) and publication language of the trial reports were evaluated.
Results: In July 2018 31,924 trial reports were indexed in PEDro. There has been exponential growth in the number of trials, with a very good fit of an exponential growth curve (number of trials = exp(0.12 x years since 1929); r2 = 0.97). Using this exponential function, the number of trial reports is doubling every 6 years. Musculoskeletal was the most common area of practice for trials (26%), followed by cardiothoracics (18%). However, the area of practice with the highest rate of growth was oncology (4% of trials). The mean total PEDro score was 5.1 out of 10 (standard deviation 1.5). Approximately one third of trials (37%) were of moderate to high quality. Trials were published in 29 languages, with the most prevalent being English (89%), Chinese (6%) and German (1%).
Conclusion(s): The number of trials evaluating physiotherapy interventions has increased exponentially. If this rate of growth continues, there will be 64,000 physiotherapy trials in 2024. However, the low quality of a substantial proportion of these trials highlights the need for a change in how trials are conducted and reported.
Implications: The challenge for researchers is to improve the quality and reporting of trials. Physiotherapy clinicians, students, educators and policy-makers need resources to help them quickly identify the best trials to guide practice and learning. Evidence resources like PEDro need to develop and test new strategies to optimise the provision of unbiased and high-quality information to users, particularly for areas of practice where there are large cohorts of trials and rapid growth.
Keywords: Evidence-based practice, randomised controlled trials, physiotherapy
Funding acknowledgements: PEDro is funded by the Australian Physiotherapy Association, Chartered Society of Physiotherapy, and 44 other WCPT MOs.
Topic: Research methodology & knowledge translation; Professional issues; Education
Ethics approval required: No
Institution: The University of Sydney
Ethics committee: The University of Sydney Human Research Ethics Committee
Reason not required: The research is a survey of published reports of randomised controlled trials.
All authors, affiliations and abstracts have been published as submitted.
