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WORK PACKAGE 2. Sybil Farmer Venugopal Durairaj Anand Pandyan September 2010. Where are the Gaps?. A framework for development and evaluation of RCTs for complex interventions to improve health MRC 2000. WP2 Activity. Completion of van Tulder Scoring Meeting re Data Extraction.

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work package 2

WORK PACKAGE 2

Sybil Farmer

VenugopalDurairaj

AnandPandyan

September 2010

where are the gaps
Where are the Gaps?

A framework for development and evaluation of RCTs for complex interventions to improve health MRC 2000

wp2 activity
WP2 Activity

Completion of van Tulder Scoring

Meeting re Data Extraction

data extraction form
Data Extraction Form
  • Ref Works ID
  • Form number
  • Treatment Regime
    • Duration = of course of tx—number FT and unit drop down
    • Session duration
    • Session frequency
  • Joint (listed)—yes /no
  • Technology --select from drop down list
  • TX Comparisons
    • AT/AT,
    • Routine TX/AT,
    • NoTx/AT,
    • Sham/AT, other
  • Time from end of Tx to last assessment
  • Time after Stroke
    • Under 1 month
    • 1-6 months ( inclusive of month 6)
    • Over 6 months
    • Other
  • Odds ratio data
  • Effect size data
  • Study design
effect size
Effect Size

'Effect size' is simply a way of quantifying the size of the difference between two groups.

Odds Ratio

Compares the proportion of those who benefitted from treatment with the proportion of those in the control group who improved

wp2 activity1
WP2 Activity
  • Completion of van Tulder Scoring
  • Meeting re Data Extraction
    • Webform designed
    • Level 4 & 3 papers allocated
    • Data Extracted
  • Meeting re Extracted Data
selecting papers
Selecting Papers

Gold

Standard

Van Tulder Questions

  • Randomisation
  • Similar Prognosis
  • Assessor Blinded
outcome measures
Outcome Measures
  • Fugl Myer
  • ARAT
  • WMFT
  • FIM
  • BPI
  • Ashworth
  • Bartel
  • 9 Hole Peg Test
  • MAL
  • Stroke Impact Score
  • Jebson Taylor Hand Function
  • Force
  • Distance
  • ROM
    • Active
    • Passive
  • Movement Time
  • Repetition
  • Drawing
  • Tracking
where are the gaps1
Where are the Gaps?

A framework for development and evaluation of RCTs for complex interventions to improve health MRC 2000

timing of intervention
Timing of Intervention

Over 6 months ----- mean range 15 -98 months

wp2 activity2
WP2 Activity
  • Completion of van Tulder Scoring
  • Meeting re Data Extraction
    • Webform designed
    • Level 4 & 3 papers allocated
    • Data Extracted
  • Meeting re Extracted Data
  • Papers Cross-checked with Cochrane Reviews
cochrane reviews
Cochrane Reviews

Electromechanical and robot-assisted arm training for improving arm function and activities of daily living after stroke

Electrostimulation for promoting recovery of movement or functional ability after stroke

Electrical stimulation for preventing and treating post-stroke shoulder pain

Supportive devices for preventing and treating subluxation of the shoulder after stroke

Constraint-induced movement therapy for upper extremities in stroke patients

EMG biofeedback for the recovery of motor function after stroke

Interventions for sensory impairment in the upper limb after stroke

Orthotic devices after stroke and other non-progressive brain lesions -Withdrawn

cochrane protocols
Cochrane Protocols

Virtual reality for stroke rehabilitation

Botulinum toxin for adult spasticity after stroke or non-progressive brain lesion

Home-based therapy programmes for upper limb functional recovery following stroke

Hands-on therapy interventions for upper limb motor dysfunction following stroke

Mental practice for treating upper extremity deficits in individuals with hemiparesis after stroke

Mirror therapy for improving motor function after stroke

Interventions for maintaining soft tissue length in the stroke –affected shoulder

wp2 activity3
WP2 Activity
  • Completion of van Tulder Scoring
  • Meeting re Data Extraction
    • Webform designed
    • Level 4 & 3 papers allocated
    • Data Extracted
  • Meeting re Extracted Data
  • Papers Cross-checked with Cochrane Reviews
  • Contact with NIHR re development of website
next stage
Next Stage
  • Write up
    • Systematic Review Method
  • Refine and Test
    • Quality Assessment Method
  • Update
    • All searches
  • Contact Cochrane Stroke Team
  • Further data exploration and Analysis
slide22

Further Questions?

  • Improvement maintained at Follow-up?
  • How long after 6 Months?

More data exploration

For Discussion