Methodological Issues in Evaluation of Innovative Training Approaches to Stroke Rehabilitation
Notice bibliographique
Résumé
Objectives The assessment was undertaken to describe key methodological issues in studies designed to evaluate stroke rehabilitation therapies. Data Sources MEDLINE®, CINAHL®, PsycINFO®, and the Cochrane Database of Systematic Reviews (CDSR). Search scope varied, but the widest range was from January 2000 through late–January 2008. Review Methods Purposive sampling (PS) and a review of reviews (RR) were employed to describe study methodology. Eligibility criteria for PS were English-language, comparative studies with human subjects and a main focus on stroke (or cerebrovascular accident). Also, any type of rehabilitation therapy could be included, provided its effect was evaluated using an outcome in one of six domains of interest: ambulation, cognition, quality of life, daily activities, dysphagia and communication. We only included drug studies if the medications were used to treat cognitive impairment. Eligibility for RR was articles that were systematic reviews of the literature. Results For the PS, a total of 1,674 citations were retrieved in the literature search. After screening, data were abstracted for 99 studies in six domains. For the RR, the initial literature search yielded a total of 949 English-language citations. After screening, a final set of 38 systematic reviews were data abstracted. Conclusions In the PS, major methodological problems involved sample size and the psychometric properties of outcome measurement instruments. Sample size was sometimes too small to have adequate power to detect meaningful effects. Many authors failed to show sample size calculations or report a minimum clinically important difference (MCID). For many of the instruments used to measure outcomes, the psychometric properties were not tested in the stroke population. Most systematic reviews were of good quality and presented the evidence for stroke rehabilitation adequately. Many of the reviews evaluated high level study designs (e.g., randomized trials). From a methods perspective, the majority of reviews evaluated randomization, blinding, and withdrawals/dropouts. Fewer reviews evaluated baseline comparability, adverse events, or co-intervention or contamination. Many reviews indicated that blinding of the patient and the provider was not possible in stroke rehabilitation and as such did not evaluate eligible studies for this criterion. These findings concur with those of the purposive sampling. Regarding outcome measures, the PR and RR found that no single stroke-related measure captures all relevant dimensions of important attributes of interest to patients and clinicians. This implies that multiple measures may need to be included in future studies to capture all relevant attributes.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,016 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».