Evidence map›Paper›PMID 33463020›Full record

Trial reportArthritis care & research2022

Application of Heterogeneity of Treatment-Effects Methods: Exploratory Analyses of a Trial of Exercise-Based Interventions for Knee Osteoarthritis.

Cynthia J Coffman, Liubov Arbeeva, Todd A Schwartz, Leigh F Callahan, Yvonne M Golightly, Adam P Goode, Kim M Huffman, Kelli D Allen

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Arthritis care & research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 25% of its field
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Exercise for osteoarthritis of the knee.The Cochrane database of systematic reviews · 2024
    Pooled it
  2. Trial
  3. Advances in neural information processing systems · 2024
    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

8 authors at 4 institutions in 1 country.

Cynthia J CoffmanDurham Veterans Administration Healthcare System and Duke University Medical Center, Durham, North Carolina.ORCID 0000-0002-4554-1463
Liubov ArbeevaUniversity of North Carolina at Chapel Hill.
Todd A SchwartzGillings School of Global Public Health, University of North Carolina at Chapel Hill.
Leigh F CallahanUniversity of North Carolina at Chapel Hill.
Yvonne M GolightlyUniversity of North Carolina at Chapel Hill.ORCID 0000-0003-1205-2759
Adam P GoodeDuke University School of Medicine and Duke University Medical Center, Durham, North Carolina.ORCID 0000-0002-0793-3298
Kim M HuffmanDuke University Medical Center, Durham, North Carolina.
Kelli D AllenUniversity of North Carolina at Chapel Hill and Durham Veterans Administration Healthcare System, Durham, North Carolina.
University of North Carolina at Chapel Hill · USDuke Medical Center · USDuke University · USDurham VA Health Care System · US

Funding

UNC Core Center for Clinical ResearchP30AR072580 · NIAMS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Amanda E Nelson · 2019 to 2026
$6.1M
HSR&D Senior Research Career Scientist AwardIK6HX002838 · VA · DURHAM VA MEDICAL CENTER · PI Kelli D. Allen · 2020 to 2026
–
HSRD VA IK6 HX002838NIAMS NIH HHS P30 AR072580Patient-Centered Outcomes Research Institute CER-1306-02043
6 · The paper itself

Abstract

objectiveTo evaluate heterogeneity of treatment effects in a trial of exercise-based interventions for knee osteoarthritis (OA).

methodsParticipants (n = 350) were randomized to standard physical therapy (PT; n = 140), internet-based exercise training (IBET; n = 142), or wait list (WL; n = 68) control. We applied qualitative interaction trees (QUINT), a sequential partitioning method, and generalized unbiased interaction detection and estimation (GUIDE), a regression tree approach, to identify subgroups with greater improvements in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score over 4 months. Predictors included 24 demographic, clinical, and psychosocial characteristics. We conducted internal validation to estimate optimism (bias) in the range of mean outcome differences among arms.

resultsBoth QUINT and GUIDE indicated that for participants with lower body mass index (BMI), IBET was better than PT (improvements of WOMAC ranged from 6.3 to 9.1 points lower), and for those with higher BMI and a longer duration of knee OA, PT was better than IBET (WOMAC improvement was 6.3 points). In GUIDE analyses comparing PT or IBET to WL, participants not employed had improvements in WOMAC ranging from 1.8 to 6.8 points lower with PT or IBT versus WL. From internal validation, there were large corrections to the mean outcome differences among arms; however, after correction, some differences remained in the clinically meaningful range.

conclusionResults suggest there may be subgroups who experience greater improvement in symptoms from PT or IBET, and this finding could guide referrals and future trials. However, uncertainty persists for specific treatment-effects size estimates and how they apply beyond this study sample.

Indexed as

Osteoarthritis, KneeExerciseHumansPhysical Therapy ModalitiesResearch DesignTime Factors

Identifiers

PMID33463020
PMCPMC8286274
OpenAlexW3123799119

What OpenQuestion holds

Textmetadata
LicenceTDM
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.