Evidence map›Paper›PMID 42342285›Full record

Observational studyRMD open2026

Therapist effects in real-world rehabilitation outcomes: a cohort study of the nationwide GLA:D osteoarthritis management programme in Denmark.

Philips Edomwonyi Obasohan, Joe Palmer, David Alderson, Dahai Yu, Dorte T Grønne, Ewa M Roos, Søren T Skou, George M Peat

Abstract readObservational StudyMulticenter Study
In one paragraph

Observational study in RMD open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Philips Edomwonyi ObasohanDepartment of Liberal Studies, College of Administrative and Business Studies, Niger State Polytechnic, Bida, Nigeria.
Joe PalmerCentre for Applied Health & Social Care Research (CARe), Sheffield Hallam University, Sheffield, UK.
David AldersonCentre for Applied Health & Social Care Research (CARe), Sheffield Hallam University, Sheffield, UK.
Dahai YuSchool of Medicine, Keele University, Keele, UK.ORCID http://orcid.org/0000-0002-8449-7725
Dorte T GrønneCenter for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.ORCID http://orcid.org/0000-0002-8235-1175
Ewa M RoosCenter for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
Søren T SkouCenter for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.ORCID http://orcid.org/0000-0003-4336-7059
George M PeatCentre for Applied Health & Social Care Research (CARe), Sheffield Hallam University, Sheffield, UK g.peat@shu.ac.uk.ORCID http://orcid.org/0000-0002-9008-0184

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveUnlike several other fields of healthcare, little is known about the size of 'therapist effects' on patient outcomes following rehabilitation for musculoskeletal conditions. We aimed to estimate the proportion of variance in patient outcomes from a structured rehabilitation programme explained by therapist effects.

methodsFor our observational cohort study, we accessed data from the national multicentre Good Life with osteoArthritis in Denmark (GLA:D) osteoarthritis management programme. Analyses included 23 021 consecutive eligible adults with hip or knee osteoarthritis (mean (SD) age 65.0 (9.8) years, 71% female) treated by 657 therapists between October 2014 and February 2019. The primary outcome was ≥30% reduction in pain intensity on 0-100 visual analogue scale (VAS) at 3 months. Therapist effects were estimated as the variance partition coefficient (intraclass correlation coefficient (ICC)) from two-level random intercept logistic regression models before and after adjusting for patient-level case-mix factors and therapist-level characteristics (number of patients treated, days since therapist certification). Analyses were repeated for a range of secondary outcomes using multiply imputed data and complete-case analysis.

results52% of patients reported a ≥30% reduction in pain intensity on 0-100 VAS at 3 months. In the null model, the ICC was 0.007 (95% CI 0.005 to 0.009), which changed little after adjusting for patient-level and therapist-level covariates. Upper confidence limits for ICC estimates across all secondary outcomes in multiply imputed data and complete-case analyses were <0.03.

conclusionsIn a nationally implemented osteoarthritis management programme delivered by trained healthcare professionals, therapist effects made a minimal contribution to variation in patient outcomes.

Indexed as

OsteoarthritisOsteoarthritis, HipOsteoarthritis, KneeAgedCohort StudiesDenmarkFemaleHumansMaleMiddle AgedPain MeasurementTreatment OutcomeHealth services researchOsteoarthritisPatient Reported Outcome MeasuresRehabilitation

Identifiers

PMID42342285
PMCPMC13295872

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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.