ETD

Conflicts of Interest and Researcher Allegiance in Clinical Trial of Dry Needling for Musculoskeletal Pain Disorders: A Systematic Appraisal

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MLA citation style (9th ed.)

Ware, John. Conflicts of Interest and Researcher Allegiance In Clinical Trial of Dry Needling for Musculoskeletal Pain Disorders: A Systematic Appraisal. . 0625. uindy.hykucommons.org/concern/etds/a4083ad0-e915-444f-874f-e3ea3e9148d8?locale=en.

APA citation style (7th ed.)

W. John. (0625). Conflicts of Interest and Researcher Allegiance in Clinical Trial of Dry Needling for Musculoskeletal Pain Disorders: A Systematic Appraisal. https://uindy.hykucommons.org/concern/etds/a4083ad0-e915-444f-874f-e3ea3e9148d8?locale=en

Chicago citation style (CMOS 17, author-date)

Ware, John. Conflicts of Interest and Researcher Allegiance In Clinical Trial of Dry Needling for Musculoskeletal Pain Disorders: A Systematic Appraisal. 0625. https://uindy.hykucommons.org/concern/etds/a4083ad0-e915-444f-874f-e3ea3e9148d8?locale=en.

Note: These citations are programmatically generated and may be incomplete.

Creator
Abstract
  • Concerns over potential bias due to conflicts of interest (COI) have gained increased attention in the biomedical and psychotherapy literature in recent years. However, little formal analysis of COI in clinical trials of physical therapy (PT) interventions has occurred. As in psychotherapy, PT interventions are often characterized by complex treatment rituals that influence the clinician-patient interaction and therefore the outcome of treatment. One such intervention that has gained significant popularity among physical therapists is dry needling (DN) to treat pain and disability due to musculoskeletal disorders (MSDs). In the psychotherapy literature, a form of non-financial COI has been described as researcher allegiance (RA), which occurs when a clinician-researcher demonstrates a preference for an intervention based on a belief in its superiority over other treatments. The purpose of this study was twofold: 1) to determine the frequency and methods of COI in published DN trials, and 2) to determine the frequency of RA and the nature of reported COI in DN trials and their association. A systematic search of the literature was undertaken to identify trials of DN published between January 1, 2013 and July 16, 2018. Two independent reviewers extracted COI and RA data from published reports. In addition, authors were contacted to obtain information on funding in reports that lacked this information. Finally, study authors were sent a survey inquiring about the presence of RA, and these responses were compared to RA items identified in those study reports combined with a random subset of 14 reports. Sixteen systematic reviews contained 62 unique trials of DN for MSDs. Only 56% per cent of DN trials had a COI statement and just 37% had information on funding in the report. Just 1 report disclosed a “potential” COI; therefore, no association between COI and RA could be determined. A post hoc analysis showed only 5% of journals in which DN trials were published were members of the International Committee of Journal Editors, which requires comprehensive COI reporting. Authors from 20 (32%) DN trials responded to the RA survey. At least 1 RA item was present in 100% of DN trials according to the surveys but in just half of reports. A nearly 5-fold greater magnitude of RA per trial was found in the survey responses (3.75/5) compared to study reports (0.80/5). The disparities in COI and RA reporting in published trials compared to survey responses suggest that COI and RA might be under-reported in DN trials. Trials of psychotherapy interventions have found significant effects of RA on outcomes, and the effect increases with the magnitude of RA. Improved reporting of COI/RA in clinical trials of PT interventions may improve trustworthiness of results and help identify the various factors involved in complex interventions provided by physical therapists. Doing so, could help optimize PT treatments.

Keyword
Date
Type
Rights
Degree
  • Doctor of Health Science

Level
  • Doctoral

Discipline
  • Health Science

Grantor
  • University of Indianapolis

Committee member
  • Stephanie Combs Miller, PT, PhD

  • David Scalzitti, Pt, PhD

  • Thomas Hoogeboom, PT, PhD

  • Heather Freeman, PT, DHS, CSCS

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