How have research questions and methods used in clinical trials published in Clinical Rehabilitation changed over the last 30 years?
Nancy E Mayo, Navaldeep Kaur, Skye P Barbic and 20 others
PMID 27496695WHAT IT FOUND
Rehabilitation trials published over decades grew, but many still lacked clear primary outcomes, blinding, follow-up, or missing-data handling.
Read them cautiously: samples were often small, and methodological improvements were modest.
Key findings
01Of the 390 trials reviewed, only 43% clearly separated primary from secondary outcomes.
02Intention-to-treat analysis was planned or carried out in 194 studies, but results were reported in only 95 of them.
03The conclusions did not match the results in 36% of studies.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only trials published in Clinical Rehabilitation were reviewed, so the results may not represent all rehabilitation journals. The authors said the findings are likely generalizable to other rehabilitation journals, but that is their judgement, not a tested result. Pilot studies were excluded, so 191 pilot studies were not analysed. The review did not use the full PEDRO checklist; nine of 11 criteria could be rated from the abstracted elements. Reviewers were rehabilitation researchers trained by the senior author, which may have influenced how methodological items were judged.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research, authorship, or publication.
The easy way to misread this
Do not read the growth in published trials and better CONSORT reporting as proof that rehabilitation trials are now trustworthy. Many trials still had unclear primary outcomes, rare participant blinding, incomplete intention-to-treat reporting, and conclusions that did not match the results.