Evidence map›Paper›PMID 31536575›Full record

ArticlePloS one2019

Agreement between the Cochrane risk of bias tool and Physiotherapy Evidence Database (PEDro) scale: A meta-epidemiological study of randomized controlled trials of physical therapy interventions.

Anne M Moseley, Prinon Rahman, George A Wells, Joshua R Zadro, Catherine Sherrington, Karine Toupin-April, Lucie Brosseau

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 85 papers, 45 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
85citing papers in PubMed, 45 pooled it
–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

85 citing papers in PubMed, 45 syntheses or guidelines pooled it.

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25 more citing papers are in PubMed but not listed here.

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.

Anne M MoseleyInstitute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-9426-7376
Prinon RahmanPhysiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.
George A WellsSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Joshua R ZadroInstitute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Catherine SherringtonInstitute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Karine Toupin-AprilChildren's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
Lucie BrosseauPhysiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Cochrane risk of bias (CROB) tool and Physiotherapy Evidence Database (PEDro) scale are used to evaluate risk of bias of randomized controlled trials. We assessed the level of agreement between the instruments.

methodsWe searched the Cochrane Library to identify trials included in systematic reviews evaluating physical therapy interventions. For trials that met our inclusion criteria (primary reference in Cochrane review, review used CROB (2008 version), indexed in PEDro), CROB items were extracted from the reviews and PEDro items and total score were downloaded from PEDro. Kappa statistics were used to determine the agreement between CROB and PEDro scale items that evaluate similar constructs (e.g., randomization). The total PEDro score was compared to the CROB summary score (% of items met) using an Intraclass Correlation Coefficient. Sensitivity analyses explored the impact of the CROB "unclear" category and variants of CROB blinding items. Kappa statistics were used to determine agreement between different thresholds for "acceptable" risk of bias between CROB and PEDro scale summary scores.

resultsWe included 1442 trials from 108 Cochrane reviews. Agreement was "moderate" for three of the six CROB and PEDro scale items that evaluate similar constructs (allocation concealment, participant blinding, assessor blinding; Kappa = 0.479-0.582). Agreement between the summary scores was "poor" (Intraclass Correlation Coefficient = 0.285). Agreement was highest when the CROB "unclear" category was collapsed with "high" and when participant, personnel and assessor blinding were evaluated separately in CROB. Agreement for different thresholds for "acceptable" risk of bias between CROB and PEDro summary scores was, at best, "fair".

conclusionThere was moderate agreement for half of the PEDro and CROB items that evaluate similar constructs. Interpretation of the CROB "unclear" category and variants of the CROB blinding items substantially influenced agreement. Either instrument can be used to quantify risk of bias, but they can't be used interchangeably.

Indexed as

BiasEpidemiologic StudiesExerciseExercise TherapyHumansPhysical Therapy ModalitiesRandomized Controlled Trials as TopicSystematic Reviews as Topic

Identifiers

PMID31536575
PMCPMC6752782

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Registered trials

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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.