Evidence map›Paper›PMID 34898461›Full record

ArticleJMIR research protocols2021

Validation of a Musculoskeletal Digital Assessment Routing Tool: Protocol for a Pilot Randomized Crossover Noninferiority Trial.

Cabella Lowe, Harry Hanuman Sing, William Marsh, Dylan Morrissey

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in JMIR research protocols, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04904029 (Validation and Implementation of a Digital Assessment Routing Tool), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 37% 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.

NCT04904029 nacompletednot on this mapstarted 2022, after this paper: background citation

Validation and Implementation of a Digital Assessment Routing Tool (DART) as an Alternative to Physiotherapy-led Remote Triage for Musculoskeletal Disorders: Protocol for a Pilot Randomised Crossover Non-inferiority Trial

TypeinterventionalSponsorQueen Mary University of LondonRan2022 to 2022Enrolled78ConditionsMusculoskeletal Diseases or ConditionsArmsDigital Assessment Routing Tool [DART], Physiotherapy-led remote triage (usual care)
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. 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

4 authors at 1 institution in 1 country.

Cabella LoweCentre for Sports & Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom.ORCID https://orcid.org/0000-0002-1168-8731
Harry Hanuman SingCentre for Sports & Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom.ORCID https://orcid.org/0000-0003-3429-9648
William MarshRisk and Information Systems Research Group, School of Electronic Engineering and Computer Science, Queen Mary University of London, London, United Kingdom.ORCID https://orcid.org/0000-0003-0212-6363
Dylan MorrisseyCentre for Sports & Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom.ORCID https://orcid.org/0000-0001-7045-3644
Queen Mary University of London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMusculoskeletal conditions account for 16% of global disability, resulting in a negative effect on millions of patients and an increasing demand for health care use. Digital technologies to improve health care outcomes and efficiency are considered a priority; however, innovations are rarely tested with sufficient rigor in clinical trials, which is the gold standard for clinical proof of safety and efficacy. We have developed a new musculoskeletal digital assessment routing tool (DART) that allows users to self-assess and be directed to the right care. DART requires validation in a real-world setting before implementation.

objectiveThis pilot study aims to assess the feasibility of a future trial by exploring the key aspects of trial methodology, assessing the procedures, and collecting exploratory data to inform the design of a definitive randomized crossover noninferiority trial to assess DART safety and effectiveness.

methodsWe will collect data from 76 adults with a musculoskeletal condition presenting to general practitioners within a National Health Service (NHS) in England. Participants will complete both a DART assessment and a physiotherapist-led triage, with the order determined by randomization. The primary analysis will involve an absolute agreement intraclass correlation (A,1) estimate with 95% CI between DART and the clinician for assessment outcomes signposting to condition management pathways. Data will be collected to allow the analysis of participant recruitment and retention, randomization, allocation concealment, blinding, data collection process, and bias. In addition, the impact of trial burden and potential barriers to intervention delivery will be considered. The DART user satisfaction will be measured using the system usability scale.

resultsA UK NHS ethics submission was done during June 2021 and is pending approval; recruitment will commence in early 2022, with data collection anticipated to last for 3 months. The results will be reported in a follow-up paper in 2022.

conclusionsThis study will inform the design of a randomized controlled crossover noninferiority study that will provide evidence concerning mobile health DART system clinical signposting in an NHS setting before real-world implementation. Success should produce evidence of a safe, effective system with good usability, potentially facilitating quicker and easier patient access to appropriate care while reducing the burden on primary and secondary care musculoskeletal services. This rigorous approach to mobile health system testing could be used as a guide for other developers of similar applications.

trial registrationClinicalTrials.gov NCT04904029; http://clinicaltrials.gov/ct2/show/NCT04904029. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/31541.

Indexed as

digital healthdigital technologyeHealthmHealthmobile healthmobile phonemusculoskeletalphysiotherapy triagetriagevalidation

Identifiers

PMID34898461
PMCPMC8713101
OpenAlexW3213333081

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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.