| Popis: |
Low back pain (LBP) is a common condition affecting 540 million people globally at any point in time, and is a leading cause of disability. Research has suggested that manual therapy has positive effects on pain, quality of life, and functional status, and is recommended in LBP clinical practice guidelines. Despite the strong recommendation for the use of manual therapy for individuals with LBP, it is often unclear how transparent this research is. Scientific literature has recently been subject to increased demands on reporting and transparency. Transparency in research includes information on trial registration and protocol and statistical analysis adherence as well as data collection, coding and analysis in a way that is visible to the public. A lack of transparency can indicate possible bias, making the results potentially misleading to the public and to the average clinician. Advantages to reporting transparency are the reduction of bias, improvement of the peer-review process, and access to all the elements for systematic reviews or meta-analyses.8 Bias in reporting can be a large problem as some researchers may wait to register their trial until they receive positive findings. Becoming more transparent with their process, and the reporting of the process, can help decrease the suspicion of selective reporting bias. Furthermore, misinterpretation of results and misapplication of treatments may lead to inappropriate care, perpetuating disability and potential wasted healthcare expenditures for the patient. One method of enhancing transparency is through pre-trial registration. It allows researchers to improve the quality of study design and reliability of the scientific evidence through peer-reviewed analysis of methods and results, supports international scientific cooperation and reduces the likelihood of negative findings being underreported. However, many trials are not registered on a timely basis. In one recent study, the date of trial registration preceded the month of the study start in only 13.8% and the start dates coincided in 19.5% of the eligible studies, indicating that only a small portion of studies were actually registered prior to their beginning of the trial. Although registration alone does not guarantee transparency, it helps clarify whether proper protocols and initial study intent were followed. The accuracy of outcome reporting and statistical methodology can also be problematic, as only 73.0% and 53.4% of the studies for primary outcomes and 41.8% and 28.6% for secondary outcomes were reported or matched between registry and publication. While some may argue that 73.0% of studies reporting their intended primary outcome is positive, it leaves 1 in 4 studies at risk for bias for not reporting this variable alone. Poorly reported clinical trials can also lead to a compromise in the clinician’s confidence in the effectiveness of their treatments. The purpose of this methodological review will be to explore the transparency of the reporting of clinical trials for manual therapy in patients with LBP. |
