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ATRAS Work Package 2 Published Evidence. AT Definition An AT is a mechanical or electrical device used in a functional task orientated training process.

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Presentation on theme: "ATRAS Work Package 2 Published Evidence. AT Definition An AT is a mechanical or electrical device used in a functional task orientated training process."— Presentation transcript:

1 ATRAS Work Package 2 Published Evidence

2 AT Definition An AT is a mechanical or electrical device used in a functional task orientated training process which will have a systemic or rehabilitative effect on the person.

3 WP Progress Searched databasesSearched databases Initial Screening AuditedInitial Screening Audited Developed Website FormsDeveloped Website Forms Allocated PapersAllocated Papers Inter-Library LoansInter-Library Loans Share point import dataShare point import data Access Excel Spreadsheets for ‘Agreeing Score’Spreadsheets for ‘Agreeing Score’

4 Databases searched AMED,CINAHL, Cochrane Library including DARE CSA Illumina, EMBASE,MEDLINEPsycInfo, Web of Science, PeDRoCOMPENDEXINSPEC RECAL Legacy RECAL Legacy CIRRIE, REHABDATA National Research Register (clinical trials), Reports from professional bodies (RCP Guidelines, CSP),

5 Papers for scoring 763 Screening checked by 2 nd reviewer 763 Screening checked by 2 nd reviewer 2424 Titles found 2424 Titles found 464 Accepted 464 Accepted 95 Review papers 299 Rejected 299 Rejected 1361 Failed selection criteria 369 Research papers

6 Initial Screening

7 Study Designs LevelType of Study Number of Studies 1 Case studies or single system study design 95 2 Quasi-controlled studies (same sample repeated measure design) Quasi-controlled studies (independent sample design) 33 4 Randomised controlled study design (not powered or powered below 80% and 0.05 significance level) 78

8 RCTs & Quasi-Controlled studies TechnologyLevel 4Level 3 BF35 CIT233 ES259 R115 TMS50 Trig EMG65 VR11 CPM10 CS23 Splint+Btx11

9 ATs, Joints & Design

10 Review Paper Assessment

11 CRD GuidanceCRD Guidance PeDRoPeDRo DAREDARE PRISMAPRISMA

12 Review Paper Assessment 1. Is the purpose of the review clearly defined? 2. Type of review paper 3. Peer reviewed 4. Were search terms reported? 5. Were search terms comprehensive? 6. Was the search strategy reported? 7. Was the search strategy satisfactory? 8. Were relevant databases searched? 9. No papers excluded on basis of language? 10. Unlimited search timeframe? 11. How many reviewers independently reviewed each paper? 12. How was the validity of studies assessed? 13. Name lowest quality of studies retained for data extraction? 14. Was raw data extracted from papers and/or the research team? 15. Was a meta-analysis carried out? 16. Were study details synthesised and summarised?

13 RPA Results 95 Review papers 1 Duplicate 2 Non-English 15 Experimemtal not Review papers 77 Review papers Scored 77 Review papers Scored Scored with Van tulder 24 Metanalysis

14 Meta-analysis Woodford HJ; Price CIM EMG biofeedback for the recovery of motor function after stroke Nov2005 Pomeroy VM; King LM; Baily- Hallam A; Langhorne P Electrostimulation for promoting recovery of movement or functional ability after stroke (Review) Jan 2004 Mehrholz J; PlatzT; Kugler J; Pohl M Electromechanical and robot-assisted arm training for improving arm function and activities of daily living after stroke (Review) Oct 2007 Price, CIM Electrical stimulation for preventing and treating post-stroke shoulder pain: a systematic Cochrane review Dec1999 Brosseau, L - The Ottawa Panel Ottawa Panel evidence-based clinical practice guidelines for post-stroke rehabilitation Dec2004 Ada, L Strengthening interventions increase strength and improve activity after stroke: a systematic review Jan Review papers Scored 77 Review papers Scored ScoreNumber ≤651

15 van Tulder Scoring

16 Reviewer Name * Reviewer Name * Reviewer Order * Reviewer Order * Author Name * Author Name * Title of article * Title of article * Year * Year * Ref Works ID * Ref Works ID * 1. Were the eligibility criteria specified? 2. Was a method of randomization performed? 2. Was a method of randomization performed? 3. Was treatment allocation concealed? 3. Was treatment allocation concealed? 4. Were prognostic indicators similar for groups at baseline? 4. Were prognostic indicators similar for groups at baseline? 5.Were the index & control interventions explicitly described? 6. Was the care provider blinded to the intervention? 7.Were co-interventions avoided or comparable? 8. Was the compliance reported in all groups? 9. Was the patient blinded to the intervention? 10.Was the outcome assessor blinded to the intervention? 11.Were the outcome measures relevant? 12.Were adverse effects described? 13.Was the withdrawal/drop-out rate described? 14.Was a short-term follow-up measurement performed? 15.Was a long-term follow-up measurement performed? 16.Was timing comparable for outcome assessment in both groups? 17.Was the sample size for each group described? 18.Did the analysis include an intention-to-treat analysis? 19.Was the variability given for primary outcome measures? Reviewer's Remarks *

17 Van Tulder Update papers require 384 agreed scores = 74 Agreed Scores 542 completed forms 45 same score with out discussion 154 single reviews

18 Tasks Complete van Tulder ScreeningComplete van Tulder Screening Screen and review updatesScreen and review updates Prepare data extraction formPrepare data extraction form WP2 –Data extraction familiarization meeting (wb May 17 th at Keele)WP2 –Data extraction familiarization meeting (wb May 17 th at Keele)

19 Data Extraction Treatment related Impairment or Activity –Odds Ratio (OR) –Effect Size Adverse events (OR) Complexity –Duration (set up / treatment) –Frequency –Expertise Stroke related Time Severity L:R

20 Tasks 2 Audit van Tulder ProcessAudit van Tulder Process Check Cochrane database and clinical trials registerCheck Cochrane database and clinical trials register Complete data extraction –July/AugustComplete data extraction –July/August Prepare Report / Matrix for Sept meetingPrepare Report / Matrix for Sept meeting

21 Join us in May Thanks For Reviewing


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