S. Davidson1,2, C. Williams1,2, S. Kamper3,4, R. Haskins5,1
1University of Newcastle, School of Medicine and Public Health, Newcastle, Australia, 2Hunter New England Local Health District, Population Health, Wallsend, Australia, 3University of Sydney, School of Health Sciences, Sydney, Australia, 4Nepean Blue Mountains Local Health District, Allied Health, Penrith, Australia, 5Hunter New England Local Health District, Outpatient Services, New Lambton Heights, Australia

Background: Low back pain (LBP) is highly prevalent and has a significant individual and economic burden on society. Extensive research has been undertaken examining exercise as a treatment and it is widely recommended by international guidelines. Poor reporting of clinical trials limits their translation to clinical practice, to address this numerous reporting checklists have been introduced. The Template for Intervention Description and Replication (TIDieR) and the Consensus on Exercise Reporting Template (CERT) are two such checklists.

Purpose: To assess the reporting quality of exercise interventions from clinical trials of LBP.

Methods: We conducted a systematic review to investigate the reporting quality of randomised controlled trials that assessed the effect of exercise interventions for patients with LBP. Five online databases and Clinical Trial Registries were searched (October 2018). The TIDieR and CERT reporting templates were then used to assess quality of reporting of included studies.

Results: 585 trials were deemed eligible for inclusion. Due to the feasibility, 100 of these studies were randomly selected for data extraction. Coding with the TIDieR and CERT tools was completed on the 180 exercise interventions reported in these studies. The overall completeness of reporting (median (IQR)) of TIDieR items was 59% (45%-73%) and CERT was 33% (22%-53%). Neither TIDieR nor CERT scores improved across decades. With TIDieR scores for the ‘90s, ‘00s, ‘10s, being 64% (55%-73%), 64% (55%-73%), and 55% (45%-73%) respectively; and CERT scores for the ‘90s, ‘00s, ‘10s, being 47% (26%-65%), 39% (25%-53%), and 33% (20%-50%) respectively.

Conclusion(s): Despite ongoing attention and checklists targeted at the issue, poor reporting of clinical trials continues. This review examined published descriptions of 180 intervention groups for studies using exercise for LBP and found poor reporting using the TIDieR and the CERT reporting guidelines. Further work is required to improve reporting by researchers and increase uptake of guideline use in journals.

Implications: Without appropriate reporting, clinicians may not be able to reproduce evidence-based treatments in clinical practice. While reporting of factors like the underlying theory behind the exercise, adherence rates, and motivation strategies are useful when considering a program from a research point of view, reporting of the actual exercise parameters is likely to be most beneficial for clinicians wishing to deliver the intervention clinically. Deviations from the researched exercise programs may also lead to suboptimal benefits or potential harm to patients. Without good reporting, clinicians are unable to use research.
 Our review shows that most of these trials may not inform clinical practice as critical detail regarding the exercise interventions is missing from the reports. We also found no improvement in reporting over time. Given that LBP is the leading cause of disability worldwide, more accountability is required to improve reporting quality to enable better use of evidence-based interventions and reduce research waste.

Funding, acknowledgements: This project was partially funded by a grant from the University of Newcastle Priority Research Centre for Health Behaviour.

Keywords: Back, Pain, Reporting

Topic: Musculoskeletal: spine

Did this work require ethics approval? Yes
Institution: Hunter New England Local Health District
Committee: Hunter New England Human Research Ethics Committee
Ethics number: 2019/ETH12178

All authors, affiliations and abstracts have been published as submitted.

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