TY - JOUR
T1 - Exercise therapy for chronic low back pain
T2 - Protocol for an individual participant data meta-analysis
AU - Hayden, Jill A.
AU - Cartwright, Jennifer L.
AU - Riley, Richard D.
AU - vanTulder, Maurits W.
AU - Chronic Low Back Pain IPD Meta-analysis Group
AU - Bendix, Tom
AU - Cairns, Melinda
AU - Cecchi, Francesca
AU - Costa, Leonardo
AU - Dufour, Ninna
AU - Ferreira, Manuela
AU - Foster, Nadine
AU - Frost, Helen
AU - Gudavalli, Ram
AU - Hartvigsen, Jan
AU - Helmhout, Pieter
AU - Kool, Jan
AU - Koumantakis, George
AU - Kovacs, Francisco
AU - Kuukkanen, Tiina
AU - Long, Audrey
AU - Machado, Luciana
AU - Maher, Chris
AU - Mehling, Wolf
AU - Rasmussen-Barr, Eva
AU - Ryan, Cormac
AU - Sherman, Karen
AU - Sjögren, Tuulikki
AU - Smeets, Rob
AU - Staal, Bart
AU - Unsgaard-Tøndel, Monica
AU - Vollenbroek, Miriam
PY - 2012/12/21
Y1 - 2012/12/21
N2 - Background: Low back pain (LBP) is one of the leading causes of disability and has a major socioeconomic impact. Despite a large amount of research in the field, there remains uncertainty about the best treatment approach for chronic LBP, and identification of relevant patient subgroups is an important goal. Exercise therapy is a commonly used strategy to treat chronic low back pain and is one of several interventions that evidence suggests is moderately effective.In parallel with an update of the 2005 Cochrane review, we will undertake an individual participant data (IPD) meta-analysis, which will allow us to standardize analyses across studies and directly derive results, and to examine differential treatment effects across individuals to estimate how patients' characteristics modify treatment benefit.Methods/design: We will use standard systematic review methods advocated by the Cochrane Collaboration to identify relevant trials. We will include trials evaluating exercise therapy compared to any or no other interventions in adult non-specific chronic LBP. Our primary outcomes of interest include pain, functional status, and return-to-work/absenteeism. We will assess potential risk of bias for each study meeting selection criteria, using criteria and methods recommended by the Cochrane BRG.The original individual participant data will be requested from the authors of selected trials having moderate to low risk of bias. We will test original data and compile a master dataset with information about each trial mapped on a pre-specified framework, including reported characteristics of the study sample, exercise therapy characteristics, individual patient characteristics at baseline and all follow-up periods, subgroup and treatment effect modifiers investigated. Our analyses will include descriptive, study-level meta-analysis and meta-regression analyses of the overall treatment effect, and individual-level IPD meta-analyses of treatment effect modification. IPD meta-analyses will be conducted using a one-step approach where the IPD from all studies are modeled simultaneously while accounting for the clustering of participants with studies.Discussion: We will analyze IPD across a large number of LBP trials. The resulting larger sample size and consistent presentation of data will allow additional analyses to explore patient-level heterogeneity in treatment outcomes and prognosis of chronic LBP.
AB - Background: Low back pain (LBP) is one of the leading causes of disability and has a major socioeconomic impact. Despite a large amount of research in the field, there remains uncertainty about the best treatment approach for chronic LBP, and identification of relevant patient subgroups is an important goal. Exercise therapy is a commonly used strategy to treat chronic low back pain and is one of several interventions that evidence suggests is moderately effective.In parallel with an update of the 2005 Cochrane review, we will undertake an individual participant data (IPD) meta-analysis, which will allow us to standardize analyses across studies and directly derive results, and to examine differential treatment effects across individuals to estimate how patients' characteristics modify treatment benefit.Methods/design: We will use standard systematic review methods advocated by the Cochrane Collaboration to identify relevant trials. We will include trials evaluating exercise therapy compared to any or no other interventions in adult non-specific chronic LBP. Our primary outcomes of interest include pain, functional status, and return-to-work/absenteeism. We will assess potential risk of bias for each study meeting selection criteria, using criteria and methods recommended by the Cochrane BRG.The original individual participant data will be requested from the authors of selected trials having moderate to low risk of bias. We will test original data and compile a master dataset with information about each trial mapped on a pre-specified framework, including reported characteristics of the study sample, exercise therapy characteristics, individual patient characteristics at baseline and all follow-up periods, subgroup and treatment effect modifiers investigated. Our analyses will include descriptive, study-level meta-analysis and meta-regression analyses of the overall treatment effect, and individual-level IPD meta-analyses of treatment effect modification. IPD meta-analyses will be conducted using a one-step approach where the IPD from all studies are modeled simultaneously while accounting for the clustering of participants with studies.Discussion: We will analyze IPD across a large number of LBP trials. The resulting larger sample size and consistent presentation of data will allow additional analyses to explore patient-level heterogeneity in treatment outcomes and prognosis of chronic LBP.
KW - Exercise therapy
KW - Low back pain
KW - Meta-analysis
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=84876197625&partnerID=8YFLogxK
U2 - 10.1186/2046-4053-1-64
DO - 10.1186/2046-4053-1-64
M3 - Article
C2 - 23259855
AN - SCOPUS:84876197625
SN - 2046-4053
VL - 1
SP - 1
EP - 10
JO - Systematic Reviews
JF - Systematic Reviews
M1 - 64
ER -