SynthesisBMJ open2025
Research waste in randomised trials of exercise treatments for chronic low back pain: trial sequential and cumulative meta-analyses by publication date and size.
Synthesis in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
4 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Research Waste in Randomised Control Trials of Spinal Manipulative Therapy for Chronic Low Back Pain: Evidence From Trial Sequential Analysis.European journal of pain (London, England) · 2026Pooled it
- Effectiveness of exercise therapy for osteoarthritis: an overview of systematic reviews and randomised controlled trials.RMD open · 2026Pooled it
- Research waste of randomized controlled trials related to deep brain stimulation: a cross-sectional analysis.Frontiers in aging neuroscience · 2026Article
- Characteristics and research waste of immunotherapy randomized clinical trials: a cross-sectional analysis.Frontiers in immunology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine if there is research waste in controlled trials of exercise therapies compared with usual care/no treatment for adults with chronic non-specific lower back pain. DESIGN AND DATA SOURCES: Secondary analysis of previously published systematic review (Cochrane review). ELIGIBILITY CRITERIA: Randomised controlled trials comparing exercise treatments for chronic low back pain to usual care/no treatment eligible for inclusion in the 2021 Cochrane review of exercise interventions for chronic low back pain. DATA EXTRACTION AND SYNTHESIS: All data were taken from the 2021 Cochrane review of exercise therapy for chronic lower back pain and the UK BEAM trial. We did trial-sequential meta-analysis and cumulative meta-analyses, exploring changes in effect estimates over time and by trial size.
resultsRespective superiority boundaries for pain and disability were crossed in 2004 after four and five trials (n=358/415) were published. A further 43 trials with 2626 participants were included in the Cochrane review. In 2004, the mean effect sizes for pain and disability were -12.85 (95% CI -24.89 to -0.81) and -6.67 (95% CI -11.27 to 3.36), respectively; similar to those reported by Cochrane in 2021. Including small trials substantially affected effect size estimates. When the 33 and 36 trials, respectively, with fewer than 70 participants are excluded, the limits of the 95% CIs for effect size estimates exclude the clinically important differences ((pain; -8.8 (95% CI -11.38 to -5.63): disability -4.27 (95% CI -6.12 to -2.24).
conclusionsIt may be difficult to justify any further trials comparing exercise interventions to usual care/no treatment for chronic low back pain. The inclusion of small studies in meta-analyses has produced biased results in previous meta-analyses. Exercise treatments might not have a clinically important effect on people with chronic low back pain.
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What OpenQuestion holds
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.