Physiotherapy Journal Editors Research Articles

No Estimation without Inference

The International Society of Physiotherapy Journal Editors (ISPJE) recently published an editorial warning that many of their journals would soon prohibit the use of null hypothesis tests and instead require authors to interpret 95% confidence intervals relative to clinically important values. Although I encourage the reporting of confidence intervals and the discussing of uncertainty in the context of a research question, the ISPJE’s proposed ban is illogical and there are several instances of flawed statistical reasoning in the editorial. In brief, the editorial: (1) fails to adequately grapple with the inherent connection between hypothesis testing and estimation, (2) presents several misleading arguments about the perceived flaws of hypothesis tests, and (3) presents an alternative to hypothesis testing that is, in itself, a form of hypothesis test – the minimal effects test – albeit done informally. If the editorials’ arguments are taken at face value, then that will lower the statistical literacy in our field and readers will have a flawed understanding of p-values. Further, if the editorials’ proposed ban is put into practice, I fear that could decrease the scientific integrity of our research as it removes quantitative benchmarks in favor of a more subjective interpretation of confidence intervals. Ultimately, I think that many of the ISPJE’s concerns that led to the editorial are valid, but I think those problems are the result of questionable research practices stemming from poor methodological training for authors, reviewers, and editors. These problems will only be fixed through better and continuing education, not the banning of statistically valid methods.

In Defense of Hypothesis Testing: A Response to the Joint Editorial From the International Society of Physiotherapy Journal Editors on Statistical Inference Through Estimation.

In Defense of Hypothesis Testing: A Response to the Joint Editorial From the International Society of Physiotherapy Journal Editors on Statistical Inference Through Estimation.

Statistical inference through estimation: recommendations from the International Society of Physiotherapy Journal Editors.

Statistical inference through estimation: recommendations from the International Society of Physiotherapy Journal Editors.

Statistical inference through estimation: Recommendations from the International Society of Physiotherapy Journal Editors

Statistical inference through estimation: Recommendations from the International Society of Physiotherapy Journal Editors

Statistical inference through estimation: recommendations from the International Society of Physiotherapy Journal Editors

Statistical inference through estimation: recommendations from the International Society of Physiotherapy Journal Editors

The Unknown Prevalence of Postrandomization Bias in 15 Physical Therapy Journals: A Methods Review.

To determine the prevalence of prospective clinical trial registration and postrandomization bias in published musculoskeletal physical therapy randomized clinical trials (RCTs). A methods review. Articles indexed in MEDLINE and published between January 2016 and July 2020 were included. Two independent blinded reviewers identified the RCTs using Covidence. We included RCTs related to musculoskeletal interventions that were published in International Society of Physiotherapy Journal Editors member journals. Data were extracted independently for the variables of interest from the identified RCTs by 2 blinded reviewers. The data were presented descriptively or in frequency tables. One hundred thirty-eight RCTs were identified. One third of RCTs were consistent with their prospectively registered intent (49/138); consistency with prospectively registered intent could not be determined for two thirds (89/138) of the RCTs. Four RCTs (8%)reported inconsistent results with the primary aims and 7 (14%) with the outcomes from the prospective clinical trial registry, despite high methodological quality (Physiotherapy Evidence Database [PEDro] scale score). Differences between prospectively registered and non-prospectively registered RCTs for PEDro scale scores had a medium effect size (r = 0.30). Two of 15 journals followed their clinical trial registration policy 100% of the time; in 1 journal, the published RCTs were consistent with the clinical trial registration. Postrandomization bias in musculoskeletal physical therapy RCTs could not be ruled out, due to the lack of prospective clinical trial registration and detailed data analysis plans. J Orthop Sports Phys Ther 2021;51(11):542-550. Epub 21 Sep 2021. doi:10.2519/jospt.2021.10491.

L’enregistrement des essais cliniques

Costa, L. O. P., Lin, C.-W. C., Grossi, D. B., Mancini, M. C., Swisher, A. K., Cook, C., . . . Strupstad, J. H. (2013). Clinical trial registration in physical therapy journals: Recommendations from the International Society of Physiotherapy Journal Editors. Physical Therapy, 93, 6–10. doi:10.2522/ptj.2013.93.1.6 International Committee of Medical Journal Editors. (n.d.). Clinical trial registration. Retrieved October 12, 2015, from http:// www.icmje.org/recommendations/browse/publishing-and-editorialissues/clinical-trial-registration.html US National Institutes of Health. (n.d.a). ClinicalTrial.gov: Submit studies. Retrieved from https://clinicaltrials.gov/ct2/manage-recs/ US National Institutes of Health. (n.d.b). ClinicalTrial.gov: Why should I register and submit results. Retrieved from https://clinical trials.gov/ct2/manage-recs/background World Health Organization. (n.d.). International clinical trials registry platform (ICTRP): Welcome to the WHO ICTRP. Retrieved October 12, 2015, from http://www.who.int/ictrp/en

Clinical Trial Registration in Physical Therapy Journals: A Cross-Sectional Study

Clinical trial registration has become an important part of editorial policies of various biomedical journals, including a few physical therapy journals. However, the extent to which editorial boards enforce the need for trial registration varies across journals. The purpose of this study was to identify editorial policies and reporting of trial registration details in MEDLINE-indexed English-language physical therapy journals. This study was carried out using a cross-sectional design. Editorial policies on trial registration of MEDLINE-indexed member journals of the International Society of Physiotherapy Journal Editors (ISPJE) (Journal of Geriatric Physical Therapy, Journal of Hand Therapy, Journal of Neurologic Physical Therapy, Journal of Orthopaedic and Sports Physical Therapy, Journal of Physiotherapy [formerly Australian Journal of Physiotherapy], Journal of Science and Medicine in Sport, Manual Therapy, Physical Therapy, Physical Therapy in Sport, Physiotherapy, Physiotherapy Research International, Physiotherapy Theory and Practice, and Revista Brasileira de Fisioterapia) were reviewed in April 2013. Full texts of reports of clinical trials published in these journals between January 1, 2008, and December 31, 2012, were independently assessed for information on trial registration. Among the 13 journals, 8 recommended trial registration, and 6 emphasized prospective trial registration. As of April 2013, 4,618 articles were published between January 2008 and December 2012, of which 9% (417) were clinical trials and 29% (121/417) of these reported trial registration details. A positive trend in reporting of trial registration was observed from 2008 to 2012. The study was limited to MEDLINE-indexed ISPJE member journals. Editorial policies on trial registration of physical therapy journals and a rising trend toward reporting of trial registration details indicate a positive momentum toward trial registration. Physical therapy journal editors need to show greater commitment to prospective trial registration to make it a rule rather than an option.

Clinical Trial Registration in Physiotherapy Journals: Recommendations from the International Society of Physiotherapy Journal Editors

Clinical Trial Registration in Physiotherapy Journals: Recommendations from the International Society of Physiotherapy Journal Editors

Editorial: Clinical Trial Registration in Physiotherapy Journals: Recommendations from the International Society of Physiotherapy Journal Editors

Editorial: Clinical Trial Registration in Physiotherapy Journals: Recommendations from the International Society of Physiotherapy Journal Editors

Clinical Trial Registration in Physical Therapy Journals: Recommendations from the International Society of Physiotherapy Journal Editors

Clinical trial registration involves placing the protocol for a clinical trial on a free, publicly available, and electronically searchable register. Registration is considered to be prospective if the protocol is registered before the trial commences (ie, before the first participant is enrolled). Prospective registration has several potential advantages. It could help avoid trials being duplicated unnecessarily, and it could allow people with health problems to identify trials in which they might participate. Perhaps more important, however, it tackles 2 big problems in clinical research: selective reporting and publication bias. Selective reporting involves investigators reporting only the most favorable results when they publish a trial, instead of reporting the results for all the outcomes that were measured. Reporting only favorable outcomes can create a misleading appearance of the effect of a therapy in the published literature. For example, imagine that a completely ineffective intervention is tested across several trials, and each trial measures multiple outcomes. Most outcomes will show no significant effect of the intervention. However, occasionally an outcome will show significant benefit or harm simply by chance. If the researchers publish the positive outcomes but not all of the nonsignificant and negative outcomes, readers could interpret falsely that the intervention is beneficial. A similar problem could occur when outcomes are analyzed at multiple time points. Researchers may report that an intervention improves walking speed at 6 months, but fail to mention that it does not improve walking speed at 1, 2, 3, 9, 12, and 24 months. Prospective registration of clinical trials combats this problem in several ways. Journal editors and reviewers can compare the range of outcomes reported in a manuscript against those listed in the registered protocol, requesting that any discrepancies be resolved by following the protocol. Readers also can compare the outcomes in the registered protocol against …

Testing Teaching

The 2013 special issue of the Journal of Physical Therapy Education (JOPTE) is the 13th special issue that we have published and has as its focus the ways that we will teach physical therapy students in the 21st century. Guest Editor and Editorial Board Member Vanina Dal Bello-Hass, PT, PhD, MEd, has selected a range of articles that will describe several ways in which our instructional methods are and will likely be changing in the near future. The entire postsecondary educational enterprise in this country is consumed with the challenges facing colleges and universities, as well as professional and graduate education. The ubiquitous use of educational technology, starting with elementary-level education, in this country might be identified as the lynchpin in these discussions. In professional education, we might ask ourselves, “What instructional methods are most effective for learners in their 17th year of education?” This issue provides several research reports that address this question, but there are many more research questions about effective and efficient instructional practices in physical therapy education to be answered. Dal Bello-Hass encourages us as educational researchers to strengthen our methods for testing our teaching. A similar initiative related to clinical trials research is growing in use, both in the US and internationally. This initiative is the Clinical Trials Registry, a process whereby the researchers conducting clinical trials of patient interventions submit to one of several government or private agencies a detailed description of their planned research methods prior to initiation of their study. When a manuscript is submitted for publication, this research plan is then reviewed to determine the extent to which the researcher followed the original research plan. This process for clinical trial registration is described in more detail in the following editorial, prepared by the International Society of Physiotherapy Journal Editors. The editors of JOPTE have agreed to publish this joint editorial to show our support for the clinical trial registry as a process that will enhance the quality of clinical research. The JOPTE editorial board will discuss the application of these principles to educational research in the coming year, and we will keep our educational community informed as we adopt changes in procedures for publication of educational experimental research.

Recommendations From the International Society of Physiotherapy Journal Editors: Clinical Trial Registration in Physiotherapy Journals

Costa, Leonardo O.P.1; Lin, Chung-Wei Christine1; Grossi, Debora Bevilaqua2; Mancini, Marisa Cota2; Swisher, Anne K.3; Cook, Chad4; Vaughn, Dan4; Elkins, Mark R5; Sheikh, Umer6; Moore, Ann7; Jull, Gwendolen7; Craik, Rebecca L.8; Maher, Christopher G.8; de Jesus Guirro, Rinaldo Roberto9; Marques, Amélia Pasqual9; Harms, Michele10; Brooks, Dina11; Simoneau, Guy G.12; Strupstad, John Henry13 Author Information

Clinical trial registration in physiotherapy journals: recommendations from the International Society of Physiotherapy Journal Editors

Clinical trial registration in physiotherapy journals: recommendations from the International Society of Physiotherapy Journal Editors

Clinical Trial Registration in Physiotherapy Journals: Recommendations From the International Society of Physiotherapy Journal Editors

Clinical trial registration involves placing the protocol for a clinical trial on a free, publicly available, and electronically searchable register. Registration is considered to be prospective if the protocol is registered before the trial commences (ie, before the first participant is enrolled). Prospective registration has several potential advantages. It could help avoid trials being duplicated unnecessarily and it could allow people with health problems to identify trials in which they might participate. Perhaps more importantly, however, it tackles 2 big problems in clinical research: selective reporting and publication bias. Prospective clinical trial registration is of great potential value to the clinicians, consumers, and researchers who rely on clinical trial data, and that is why the International Society of Physiotherapy Journal Editors (ISPJE) is recommending that members enact a policy for prospective trial registration.

Clinical trial registration in physiotherapy journals: recommendations from the International Society of Physiotherapy Journal Editors

Clinical trial registration involves placing the protocol for a clinical trial on a free, publicly available, and electronically searchable register. Registration is considered to be prospective if the protocol is registered before the trial commences (ie, before the first participant is enrolled). Prospective registration has several potential advantages. It could help avoid trials being duplicated unnecessarily and it could allow people with health problems to identify trials in which they might participate. Perhaps more importantly, however, it tackles 2 big problems in clinical research: selective reporting and publication bias. Prospective clinical trial registration is of great potential value to the clinicians, consumers, and researchers who rely on clinical trial data, and that is why the International Society of Physiotherapy Journal Editors (ISPJE) is recommending that members enact a policy for prospective trial registration.

Clinical trial registration in physical therapy journals: recommendations from the International Society of Physiotherapy Journal Editors

Clinical trial registration involves placing the protocol for a clinical trial on a free, publicly available, and electronically searchable register. Registration is considered to be prospective if the protocol is registered before the trial commences (ie, before the first participant is enrolled). Prospective registration has several potential advantages. It could help avoid trials being duplicated unnecessarily, and it could allow people with health problems to identify trials in which they might participate. Perhaps more important, however, it tackles 2 big problems in clinical research: selective reporting and publication bias. Selective reporting involves investigators reporting only the most favorable results when they publish a trial, instead of reporting the results for all the outcomes that were measured. Reporting only favorable outcomes can create a misleading appearance of the effect of a therapy in the published literature. For example, imagine that a completely ineffective intervention is tested across several trials, and each trial measures multiple outcomes. Most outcomes will show no significant effect of the intervention. However, occasionally an outcome will show significant benefit or harm simply by chance. If the researchers publish the positive outcomes but not all of the nonsignificant and negative outcomes, readers could interpret falsely that the intervention is beneficial. A similar problem could occur when outcomes are analyzed at multiple time points. Researchers may report that an intervention improves walking speed at 6 months, but fail to mention that it does not improve walking speed at 1, 2, 3, 9, 12, and 24 months. Prospective registration of clinical trials combats this problem in several ways. Journal editors and reviewers can compare the range of outcomes reported in a manuscript against those listed in the registered protocol, requesting that any discrepancies be resolved by following the protocol. Readers also can compare the outcomes in the registered protocol against …

International Society of Physiotherapy Journal Editors

The International Society of Physiotherapy Journal Editors (ISPJE) is a network of the World Confederation of Physical Therapy that is open to editors and editorial board members of journals that publish material related to physiotherapy. It was established in 2007 to provide a forum to discuss issues related to the publication of physiotherapy journals, to enhance collaboration between editorial staff of those journals, and to foster improvements in the quality of physiotherapy publications. Journal of Physiotherapy is a member journal. The purpose of this editorial is to present the activities of the ISPJE and how they can benefit physiotherapy clinicians and researchers.

A Different Kind of Global Warming

I confess. I registered for the 15th International Congress of the World Confederation for Physical Therapy (WCPT) meeting in Vancouver, BC, to participate in a session for more than 40 editors of physical therapy journals and newsletters from around the world. And the session was wonderful! We adopted a constitution and became the International Society of Physiotherapy Journal Editors. It was remarkable to see a diverse international group come to agreement in less than 2 hours about the need to enhance collaboration among our journals and to improve standards of publication within the field of physical therapy. When I removed my “editor in chief” blinders, however, I realized that attending WCPT was important for a larger reason. More than 3,500 physical therapists from about 80 countries participated in programs that offered excellent science as well as …