Evidence map›Paper›PMID 29282267›Full record

Trial reportBMJ open2017

Stepped care approach for medial tibiofemoral osteoarthritis (STrEAMline): protocol for a randomised controlled trial.

Sarah Rubia Robbins, Luciano Ricardo S Melo, Hema Urban, Leticia A Deveza, Rebecca Asher, Victoria L Johnson, David J Hunter

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Sarah Rubia RobbinsKolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney, Sydney, Australia.ORCID 0000-0003-2587-1649
Luciano Ricardo S MeloKolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney, Sydney, Australia.
Hema UrbanKolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney, Sydney, Australia.ORCID 0000-0003-1390-8109
Leticia A DevezaKolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney, Sydney, Australia.
Rebecca AsherNHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia.
Victoria L JohnsonKolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney, Sydney, Australia.
David J HunterKolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney, Sydney, Australia.ORCID 0000-0003-3197-752X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCurrent guidelines recommend tailored interventions to optimise knee osteoarthritis (OA) management. However, models of care still have a 'one size fits all' approach, which is suboptimal as it ignores patient heterogeneity. This study aims to compare a stepped care strategy with standard care for overweight and obese persons with medial tibiofemoral OA. METHODS AND ANALYSIS: Participants will be randomised into two groups (85 each). The intervention will receive a diet and exercise programme for 18 weeks in the first step of the study. Disease remission will then be assessed using the Patient Acceptable Symptom State (PASS). PASS is defined as the highest level of symptom beyond which patients consider themselves well and takes into account pain intensity, patient's global assessment of disease activity and degree of functional impairment. In the second step, participants in remission will continue with diet and exercise. If remission is not achieved, participants will be assigned in a hierarchical order to cognitive behavioural therapy, knee brace or muscle strengthening for 12 weeks. The intervention will be decided based on their clinical presentation for symptoms of depression and varus malalignment. Participants without depression or varus malalignment will undertake a muscle strengthening programme. The control group will receive educational material related to OA management. Main inclusion criteria are age ≥50 years, radiographic medial tibiofemoral OA, body mass index (BMI) ≥28 kg/m ETHICS AND DISSEMINATION: The local ethics committee approved this protocol (HREC/14/HAWKE/381). Dissemination will occur through presentations at international conferences and publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ACTRN12615000227594.

Indexed as

Diet TherapyExercise TherapyHumansKnee JointLogistic ModelsOsteoarthritis, KneePainPain ManagementPain MeasurementQuadriceps MuscleRange of Motion, ArticularResearch DesignTreatment Outcomeclinical trialKnee osteoarthritisobesityresearch design

Identifiers

PMID29282267
PMCPMC5770832

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.