Abstract:
STUDY DESIGN:This was a review of criteria-based meta-analyses. OBJECTIVES:To assess the methodological quality of published randomized clinical trials on the efficacy of commonly used interventions in low back pain. SUMMARY OF BACKGROUND DATA:During the last several decades, the number of published randomized clinical trials regarding low back pain has continued to grow. For some interventions, considerable numbers of trials are available. Trials have been shown to vary substantially regarding their quality. METHODS:A computer-aided search was conducted of published randomized clinical trials into the efficacy of spinal manipulation and mobilization, exercise therapy, back schools, bed rest, orthoses, and traction therapy. There was additional screening of journals not covered by Medline and Embase. The methodological quality of the studies was assessed using a set of predefined criteria. RESULTS:Sixty-nine different randomized clinical trials were identified. Methodological scores varied between 16 and 82 points (maximum was 100 points). Methodological quality tended to be associated with the outcomes of the studies. Methodological shortcomings were frequently found--e.g., small sample sizes, no description of the randomization procedure, no description of drop-outs, no placebo-control group, and lack of blinded outcome assessments. CONCLUSIONS:Although a considerable number of randomized clinical trials have been carried out to evaluate the efficacy of interventions in low back pain, their methodological quality appears to be disappointingly low. Future trials are clearly needed, but much more attention should be paid to the methods of such studies.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Koes BW,Bouter LM,van der Heijden GJdoi
10.1097/00007632-199501150-00021subject
Has Abstractpub_date
1995-01-15 00:00:00pages
228-35issue
2eissn
0362-2436issn
1528-1159journal_volume
20pub_type
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