Literature DB >> 17632400

Statistical significance versus clinical importance: trials on exercise therapy for chronic low back pain as example.

Maurits van Tulder1, Antti Malmivaara, Jill Hayden, Bart Koes.   

Abstract

STUDY
DESIGN: Critical appraisal of the literature.
OBJECTIVES: The objective of this study was to assess if results of back pain trials are statistically significant and clinically important. SUMMARY OF BACKGROUND DATA: There seems to be a discrepancy between conclusions reported by authors and actual results of randomized controlled trials. Little attention has been paid to the problem of over-reporting of conclusions.
METHODS: All 43 trials of the Cochrane review on exercise therapy for low back pain were included. Descriptive analyses were conducted.
RESULTS: Eighteen trials reported positive conclusions in favor of exercise. Only six of the 43 studies showed both clinically important and statistically significant differences in favor of the exercise groups on function, and 4 on pain.
CONCLUSION: It seems that many conclusions of studies of exercise therapy for chronic low back pain have been based on statistical significance of results rather than on clinical importance and, consequently, may have been too positive. Authors of trials should report not only statistical significance of results but also clinical importance.

Entities:  

Mesh:

Year:  2007        PMID: 17632400     DOI: 10.1097/BRS.0b013e3180b9ef49

Source DB:  PubMed          Journal:  Spine (Phila Pa 1976)        ISSN: 0362-2436            Impact factor:   3.468


  16 in total

Review 1.  Epidemiology of spine care: the back pain dilemma.

Authors:  Janna Friedly; Christopher Standaert; Leighton Chan
Journal:  Phys Med Rehabil Clin N Am       Date:  2010-11       Impact factor: 1.784

2.  Comparing Person-Centered Communication Education in Long-Term Care Using Onsite and Online Formats.

Authors:  Carissa K Coleman; Kim Fanning; Kristine N Williams
Journal:  J Gerontol Nurs       Date:  2015-05-28       Impact factor: 1.254

3.  Spinal pain--good sleep matters: a secondary analysis of a randomized controlled trial.

Authors:  Kari Paanalahti; Maria M Wertli; Ulrike Held; Torbjörn Åkerstedt; Lena W Holm; Margareta Nordin; Eva Skillgate
Journal:  Eur Spine J       Date:  2015-06-11       Impact factor: 3.134

4.  Stabilization exercises combined with neuromuscular electrical stimulation for patients with chronic low back pain: a randomized controlled trial.

Authors:  Muhammad Alrwaily; Michael Schneider; Gwendolyn Sowa; Michael Timko; Susan L Whitney; Anthony Delitto
Journal:  Braz J Phys Ther       Date:  2018-10-18       Impact factor: 3.377

5.  Does classification of persons with fibromyalgia into Multidimensional Pain Inventory subgroups detect differences in outcome after a standard chronic pain management program?

Authors:  M L Verra; F Angst; R Brioschi; S Lehmann; F J Keefe; J Bart Staal; R A de Bie; A Aeschlimann
Journal:  Pain Res Manag       Date:  2009 Nov-Dec       Impact factor: 3.037

6.  The long-term effects of naprapathic manual therapy on back and neck pain - results from a pragmatic randomized controlled trial.

Authors:  Eva Skillgate; Tony Bohman; Lena W Holm; Eva Vingård; Lars Alfredsson
Journal:  BMC Musculoskelet Disord       Date:  2010-02-05       Impact factor: 2.362

7.  Minimal important differences of the SRS-22 Patient Questionnaire following surgical treatment of idiopathic scoliosis.

Authors:  Juan Bagó; Francisco J S Pérez-Grueso; Esther Les; Pablo Hernández; Ferran Pellisé
Journal:  Eur Spine J       Date:  2009-06-16       Impact factor: 3.134

8.  Specifying the target difference in the primary outcome for a randomised controlled trial: guidance for researchers.

Authors:  Jonathan A Cook; Jenni Hislop; Douglas G Altman; Peter Fayers; Andrew H Briggs; Craig R Ramsay; John D Norrie; Ian M Harvey; Brian Buckley; Dean Fergusson; Ian Ford; Luke D Vale
Journal:  Trials       Date:  2015-01-15       Impact factor: 2.279

9.  Sample size calculation of clinical trials published in two leading endodontic journals.

Authors:  Arash Shahravan; Ali-Akbar Haghdoost; Maryam Rad; Maryamalsadat Hashemipoor; Maryam Sharifi
Journal:  Iran Endod J       Date:  2013-12-24

10.  Chronic non-specific low back pain - sub-groups or a single mechanism?

Authors:  Benedict Martin Wand; Neil Edward O'Connell
Journal:  BMC Musculoskelet Disord       Date:  2008-01-25       Impact factor: 2.362

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