Evidence map›Paper›PMID 33106251›Full record

ReviewBritish journal of sports medicine2020

Comparative effectiveness of treatments for patellofemoral pain: a living systematic review with network meta-analysis.

Marinus Winters, Sinéad Holden, Carolina Bryne Lura, Nicky J Welton, Deborah M Caldwell, Bill T Vicenzino, Adam Weir, Michael Skovdal Rathleff

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in British journal of sports medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 6 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

14 citing papers in PubMed, 6 syntheses or guidelines pooled it.

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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

8 authors.

Marinus WintersCentre for General Practice at Aalborg University, Aalborg, Denmark marinuswinters@hotmail.com.ORCID http://orcid.org/0000-0001-5742-7441
Sinéad HoldenCentre for General Practice at Aalborg University, Aalborg, Denmark.ORCID http://orcid.org/0000-0002-7314-2152
Carolina Bryne LuraCentre for General Practice at Aalborg University, Aalborg, Denmark.
Nicky J WeltonPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Deborah M CaldwellPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Bill T VicenzinoSchool of Health and Rehabilitation Sciences: Physiotherapy, University of Queensland, Brisbane, Queensland, Australia.ORCID http://orcid.org/0000-0003-0253-5933
Adam WeirSports Groin Pain Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.
Michael Skovdal RathleffCentre for General Practice at Aalborg University, Aalborg, Denmark.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the comparative effectiveness of all treatments for patellofemoral pain (PFP).

designLiving systematic review with network meta-analysis (NMA). DATA SOURCES: Sensitive search in seven databases, three grey literature resources and four trial registers. ELIGIBILITY CRITERIA: Randomised controlled trials evaluating any treatment for PFP with outcomes 'any improvement', and pain intensity. DATA EXTRACTION: Two reviewers independently extracted data and assessed risk of bias with Risk of Bias Tool V.2. We used Grading of Recommendations, Assessment, Development and Evaluation to appraise the strength of the evidence. PRIMARY OUTCOME MEASURE: 'Any improvement' measured with a Global Rating of Change Scale.

resultsTwenty-two trials (with forty-eight treatment arms) were included, of which approximately 10 (45%) were at high risk of bias for the primary outcome. Most comparisons had a low to very low strength of the evidence. All treatments were better than wait and see for any improvement at 3 months (education (OR 9.6, 95% credible interval (CrI): 2.2 to 48.8); exercise (OR 13.0, 95% CrI: 2.4 to 83.5); education+orthosis (OR 16.5, 95% CrI: 4.9 to 65.8); education+exercise+patellar taping/mobilisations (OR 25.2, 95% CrI: 5.7 to 130.3) and education+exercise+patellar taping/mobilisations+orthosis (OR 38.8, 95% CrI: 7.3 to 236.9)). Education+exercise+patellar taping/mobilisations, with (OR 4.0, 95% CrI: 1.5 to 11.8) or without orthosis (OR 2.6, 95% CrI: 1.7 to 4.2), were superior to education alone. At 12 months, education or education+any combination yielded similar improvement rates. SUMMARY/

conclusionEducation combined with a physical treatment (exercise, orthoses or patellar taping/mobilisation) is most likely to be effective at 3 months. At 12 months, education appears comparable to education with a physical treatment. There was insufficient evidence to recommend a specific type of physical treatment over another. All treatments in our NMA were superior to wait and see at 3 months, and we recommend avoiding a wait-and-see approach. PROSPERO REGISTERATION NUMBER: PROSPERO registration CRD42018079502.

Indexed as

kneesports and exercise medicine

Identifiers

PMID33106251
PMCPMC7982922

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.