Do not make clinical decisions based on abstracts of healthcare research: A systematic review.

OBJECTIVE: To summarize the reporting quality of healthcare abstracts and inconsistencies between abstracts and full texts. STUDY DESIGN AND SETTING: This systematic review included overviews of randomized controlled trials (RCTs) and systematic reviews (SRs) that summarized data of healthcare abstracts on reporting of abstracts and consistency of abstracts with the full text. Searches were performed in PubMed, CENTRAL, Cochrane Library and EMBASE databases from 1900 to February 2019. Two authors screened the overviews and extracted the data. All analyses were descriptive and divided into two main groups: abstracts' reporting quality and abstracts' consistency with the full text. Abstracts were considered poorly reported and inconsistent with the full text if more than 5% of abstracts' information was not fully reported or not consistent with the full text. RESULTS: 27 overviews analyzing 5,194 RCTs and 866 SRs were retrieved for reporting quality of abstracts. A total of 22 overviews analyzing 2,025 RCTs and 551 SRs were included for consistency of abstracts with the full text. Abstracts across all healthcare areas presented poor reporting quality and were inconsistent with the full texts, with results and conclusions as the most inconsistent sections. CONCLUSION: Abstracts of healthcare RCTs and SRs have shown a large room for improvement in reporting quality and consistency with the full text. Authors, journal editors and reviewers need to give the highest priority to this matter.

Abstracts of low back pain trials are poorly reported, contain spin of information and are inconsistent with the full text: An overview study.

OBJECTIVE: To investigate trials abstracts evaluating treatments for low back pain with regards to completeness of reporting, spin (i.e., interpretation of study results that overemphasizes the beneficial effects of the intervention), and inconsistencies in data with the full text. DATA SOURCES: The search was performed on Physiotherapy Evidence Database (PEDro) in February 2016. STUDY SELECTION: This is an overview study of a random sample of 200 low back pain trials published between 2010 and 2015. The languages of publication were restricted to English, Spanish and Portuguese. DATA EXTRACTION: Completeness of reporting was assessed using the CONSORT for Abstracts checklist (CONSORT-A). Spin was assessed using a SPIN-checklist. Consistency between abstract and full text were assessed by applying the assessment tools to both the abstract and full text of each trial and calculating inconsistencies in the summary score (paired t test) and agreement in the classification of each item (Kappa statistics). Methodological quality was analyzed using the total PEDro score. DATA SYNTHESIS: The mean number of fully reported items for abstracts using the CONSORT-A was 5.1 (SD 2.4) out of 15 points and the mean number of items with spin was 4.9 (SD 2.6) out of 7 points. Abstract and full text scores were statistically inconsistent (P=0.01). There was slight to moderate agreement between items of the CONSORT-A in the abstracts and full text (mean Kappa 0.20 SD 0.13) and fair to moderate agreement for items of the SPIN-checklist (mean Kappa 0.47 SD 0.09). CONCLUSIONS: The abstracts were incomplete, with spin and inconsistent with the full text. We advise health care professionals to avoid making clinical decisions based solely upon abstracts. Journal editors, reviewers and authors are jointly responsible for improving abstracts, which could be guided by amended editorial policies.

Experimental diabetes modulates collagen remodelling of joints in rats.

UNLABELLED: The aim of this study was to evaluate extracellular matrix components in articular cartilage, ligaments and synovia in an experimental model of diabetes. Young Wistar rats were divided into a streptozotocin-induced (STZ; 35 mg/kg) diabetic group (DG; n=15) and a control group (CG; n=15). Weight, blood glucose and plasma anti-carboxymethyllysine were measured 70 days after STZ infusions. Knee joints, patellar ligaments, and lateral and medial collateral ligaments were isolated and stained with hematoxylin-eosin and Picrosirius. The total collagen content was determined by morphometry. Immunofluorescence was employed to evaluate types I, III, and V collagen in ligaments and synovial tissues and types II and XI collagen in cartilage. RESULTS: Higher blood glucose levels and plasma anti-carboxymethyllysine were observed in DG rats when compared to those in CG rats. The final weight was significantly lower in the DG rats than in the CG rats. Histomorphometric evaluation depicted a small quantity of collagen fibers in ligaments and articular cartilage in DG rats, as well as increased collagen in synovial tissue. There was a decrease in cartilage proteoglycans in DG rats when compared with CG rats. Immunofluorescence staining revealed an increase of collagen III and V in ligaments, collagen XI in cartilage, and collagen I in synovial tissue of DG rats compared with CG rats. CONCLUSION: The ligaments, cartilage and synovia are highly affected following STZ-induced diabetes in rats, due the remodeling of collagen types in these tissues. This process may promote the degradation of the extracellular matrix, thus compromising joint function. Our data may help to better understand the pathogenesis of joint involvement related to diabetes.

Physical activity improves strength, balance and endurance in adults aged 40-65 years: a systematic review.

QUESTION: Can physical activity in adults aged 40-65 years enhance strength and balance and prevent falls? DESIGN: Systematic review with meta-analysis of randomised clinical trials. PARTICIPANTS: Healthy adults aged 40-65 years. INTERVENTION: Programs that involved the performance of any physical activity in community settings and workplaces. OUTCOME MEASURES: Strength, balance, endurance, and falls rate. RESULTS: Twenty-three eligible trials were identified and 17 of these were pooled in the meta-analyses. The meta-analysis of strength outcomes found a moderate effect of physical activity on strength (SMD=0.54, 95% CI 0.38 to 0.70). Larger effects were observed from programs that specifically targeted strength (SMD=0.68, 95% CI 0.49 to 0.87), when compared to those that did not (SMD=0.32, 95% CI 0.09 to 0.55). This difference was statistically significant (effect of strength in meta-regression p=0.045). Physical activity also had a moderate effect on both balance (SMD=0.52, 95% CI 0.24 to 0.79) and endurance (SMD=0.73, 95% CI 0.50 to 0.96). No trials reported effects of physical activity on falls soon after receiving the intervention. A statistically non-significant effect on falls 15 years after receiving a physical activity intervention was found in one trial (RR=0.82, 95% CI 0.53 to 1.26). CONCLUSIONS: This review found that muscle strength, balance, and endurance can be improved by physical activity in people aged 40-65 years. There were bigger effects on muscle strength from programs that used resistance exercises, indicating the need to include a resistance training component if strength enhancement is the goal.

A critical review of methods used to determine the smallest worthwhile effect of interventions for low back pain.

OBJECTIVE: To critically and systematically review methods used to estimate the smallest worthwhile effect of interventions for nonspecific low back pain. STUDY DESIGN AND SETTING: A computerized search was conducted of MEDLINE, CINAHL, LILACS, and EMBASE up to May 2011. Studies were included if they were primary reports intended to measure the smallest worthwhile effect of a health intervention (although they did not need to use this terminology) for nonspecific low back pain. RESULTS: The search located 31 studies, which provided a total of 129 estimates of the smallest worthwhile effect. The estimates were given a variety of names, including the Minimum Clinically Important Difference, Minimum Important Difference, Minimum Worthwhile Reductions, and Minimum Important Change. Most estimates were obtained using anchor- or distribution-based methods. These methods are not (or not directly) based on patients' perceptions, are not intervention-specific, and are not formulated in terms of differences in outcomes with and without intervention. CONCLUSION: The methods used to estimate the smallest worthwhile effect of interventions for low back pain have important limitations. We recommend that the benefit-harm trade-off method be used to estimate the smallest worthwhile effects of intervention because it overcomes these limitations.

Discriminative and reliability analyses of ultrasound measurement of abdominal muscles recruitment.

Rehabilitative ultrasound imaging has a great potential to be used as a tool in the assessment of trunk muscle function in patients with low back pain (LBP). However, a further investigation of the discriminative ability of this tool as well as the effect of operators' levels of training on reliability is warranted. Discriminative analysis of ultrasound and electromyography (EMG) measurements of transversus abdominus (TrA), obliquus internus (OI), and obliquus externus (OE) muscles function between people with and without LBP and the effect of operator's training on reliability of TrA muscle function of chronic LBP patients were conducted. For the discriminative study, measurements were collected from 10 subjects with LBP and 10 matched controls during isometric low load tasks with their limbs suspended. For the reliability study, in stage 1 the reliability of single ultrasonographic static images involved 4 operators (1 trained and 3 non-trained), whereas, in stage 2, two operators (1 trained and 1 non-trained) were used to determine the reliability of TrA thickness change. Methods used in the statistical analysis were pearson correlation and receiver operating characteristic curve for the discriminative study and intraclass correlation coefficient (ICC) for the reliability study. While ultrasound measures of OE muscle function showed poor association with EMG (r = 0.28, p = 0.22), TrA and OI function showed moderate to excellent association (TrA: r = 0.74, p < 0.000; OI: r = 0.85, p < 0.000). Ultrasound and EMG measures of TrA and OI function discriminated LBP patients from controls. Reliability of the assessment of TrA function with a trained operator (ICC = 0.92; 95% CI: 0.81-0.97) was substantially higher than a non-trained one (ICC = 0.44; 95% CI: -0.41-0.78). In conclusion, ultrasound measures of deep trunk function is a valid discriminative tool in LBP but highly dependent on operator's level of training.