Issues affecting the level of prosthetics research evidence

Brian J. Hafner · Andrew B. Sawers

27 citations0/0 files storedProsthetics and Orthotics International

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Meta-analysis and systematic reviews Health Sciences Research and Education Clinical practice guidelines implementation

Abstract

BACKGROUND: Systematic reviews of scientific literature are valuable sources of synthesized knowledge. Systematic review results may also be used to inform readers about challenges inherent to an area of research, guide future research efforts, and facilitate improvements in evidence quality. OBJECTIVES: To identify methodological issues that affected the overall level of scientific evidence reported in a contemporary systematic review and to offer suggestions for enhancing publications' contribution to the overall evidence. STUDY DESIGN: Secondary analysis of a systematic review. METHODS: Publications included in a systematic review related to microprocessor-controlled prosthetic knees were analyzed with respect to established methodological quality criteria. Common issues were identified and discussed. RESULTS: Internal validity was commonly affected by variable comparison conditions, limited justification of accommodation time, potential fatigue and learning effects, lack of blinding, small sample sizes, limited evidence of measurement reliability, subject attrition, and limited descriptions of selection criteria. Similarly, external validity was affected by limited descriptions of the study sample, indeterminate representativeness, and suboptimal description of the interventions. CONCLUSION: Results suggest that efforts to address methodological limitations, educate evidence consumers, and improve research reporting are needed to advance the quality and use of evidence in the field of prosthetics. CLINICAL RELEVANCE: Critical analysis of the strengths and limitations of publications included in a systematic review can inform evidence consumers and contributors about challenges inherent to a field of research. Results of this analysis suggest that efforts to address identified limitations are needed to enhance the overall level of prosthetics evidence.

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References

2009Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement 2009The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration 2014Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide 2007Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration 2011GRADE guidelines: 3. Rating the quality of evidence 1998The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions.2003Reliability of the PEDro Scale for Rating Quality of Randomized Controlled Trials 2000Measures of Reliability in Sports Medicine and Science

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