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The Struggle for Evidence in Physical and Rehabilitation Medicine

Publication Rate of Randomized Controlled Trials and Systematic Reviews Is Growing More Than in Other Therapeutic Fields

Negrini, Stefano, MD; Levack, William, PT, PhD; Gimigliano, Francesca, MD, PhD; Arienti, Chiara, MSc, DO, PhD(s); Villafañe, Jorge Hugo, PT, PhD; Kiekens, Carlotte, MD

American Journal of Physical Medicine & Rehabilitation: April 2019 - Volume 98 - Issue 4 - p 258–265
doi: 10.1097/PHM.0000000000001058
Original Research Articles
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Objective The aim of the study was to evaluate the rate of publication of randomized controlled trials, systematic reviews, and meta-analysis in physical and rehabilitation medicine and its variation over time.

Design We performed a bibliometric study and searched PubMed from inception to 2017, using National Library of Medicine 3rd level MeSH terms (“rehabilitation,” “physical therapy modalities,” and “drug therapy”) and filters (“randomized controlled trial,” “systematic reviews,” and “meta-analysis”). We used descriptive statistics, and we calculated the best-fitting regression model for all data considered.

Results The absolute number of articles is growing in rehabilitation as much as in other treatment fields such as drug therapy. Whereas the rate of growth of publications for all studies relative to PubMed is bigger for drug therapies than for rehabilitation and physical therapy, the rate of growth of randomized controlled trials, systematic reviews, and meta-analysis is significantly greater for rehabilitation and physical therapy (P < 0.001). In 2017, 19.3% and 28.2% of the total production of scientific articles for rehabilitation and physical therapy (respectively) were for randomized controlled trials and systematic reviews versus 11.3% for drug therapy.

Conclusions Production of the highest form of research evidence (randomized controlled trials, systematic reviews, and meta-analysis) is continuously increasing in physical and rehabilitation medicine at a higher rate than in other treatment fields such as drug therapy. The quality and results of this evidence should be evaluated in future studies.

From the Clinical and Experimental Sciences Department, University of Brescia, Italy (SN); IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy (SN, CA, JHV); Otago University, Auckland, New Zealand (WL); Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli,” Napoli, Italy (FG); Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium (CK); and Department of Physical and Rehabilitation Medicine, University Hospitals Leuven, Leuven, Belgium (CK).

All correspondence should be addressed to: Chiara Arienti, MSc, DO, PhD(s), IRCCS Fondazione Don Carlo Gnocchi, Largo Paolo VI, 25038 Rovato, Brescia, Italy.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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