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“It’s Not You, It’s Us…”: Heterogeneity of Treatment Effects as a Challenge to Effectiveness Trials.
By: Damian L Keter, PT, DPT, PhD Background: Comparative effectiveness studies are the cornerstone of medicine and health sciences research. They have a goal of finding ‘the best’ treatment for each associated condition. In comparative effectiveness studies, statistical models are able to provide ‘average’ treatment effects, which are often used to establish standardized mean difference […]
Is Myofascial Pain Syndrome a Legitimate Primary Diagnosis?
By: Chad E Cook, Damian Keter, Ken Learman Background: Myofascial Pain Syndrome (MPS) is hypothesized to be both a primary and/or a secondary chronic pain disorder that can refer symptoms to other parts of the body. MPS is relatively common, affecting millions of people worldwide, particularly those who have experienced muscle overuse, trauma, or stress […]
Risk of Bias Measures can be Biased
By: Chad E Cook, Damian Keter, Ken Learman Navigating the Literature: Navigating the ever-growing, healthcare literature can be challenging [1]. The sheer amount of new research, articles, and guidelines published regularly can be overwhelming. The number of biomedical publications has been steadily increasing over the years. As of 2022, there were approximately 3.3 million scientific […]
Why Isn’t Everyone Using Stepped Care for Musculoskeletal Injuries?
By: Chad E. Cook PT, PhD, FAPTA Resource efficiency models Musculoskeletal (MSK) outcomes have shown some concerning trends over the last decade. Conditions like low back pain, neck pain, and joint pain have become more prevalent, contributing to the overall burden of a MSK disorder [1]. According to a report analyzing medical claims data from […]
Three Ways That Recruitment in Randomized Controlled Trials May Not Reflect Real Life
By: Chad Cook, Amy McDevitt, Derek Clewley, Bryan O’Halloran As we wind up a year of recruitment on the SS-MECH trial [1], we are compelled to reflect on our recruitment strategies and study participants. Our study has included four recruitment sites and we’ve enrolled over 110 participants, which is nearly 85% of our targeted sample. […]
Pros and Cons of Paying Peer Reviewers
By: Juliana Ancalmo, Chad E Cook PT, PhD, FAPTA, Ciara Roche Background: Critical appraisal is a hallmark of peer reviewed publishing. Critical appraisal provides analytical evaluations of whether the results of the study can be believed, and can be transferred appropriately into other environments, for use in policy, education, or clinical practice [1]. Historically, critical […]
Yes, Peer Review is Broken, but It’s Probably Worse than You Think
By: Chad E. Cook PT, PhD, FAPTA We have problems: There are countless publications, editorials, and blogs indicating we have a notable problem with the peer review system used in scientific publications [1-4]. Concerns have included its inconsistency, its slow process, and the biases associated with reviewers (especially reviewer two) who have an axe to […]
On Mastery
By: Seth Peterson, PT, DPT, OCS, FAAOMPT “I don’t know how they can sleep at night.” I was getting chewed out in a hallway in my first year of residency training. My mentor was speaking in general terms, but it was painfully clear that “they” meant me. I had just seen an 11-year-old girl with […]
An Exercise in Interpreting Clinical Results
By: Chad E Cook PT, PhD, FAPTA Randomized Controlled Trials In clinical research, treatment efficacy (the extent to which a specific intervention, such as a drug or therapy, produces a beneficial result under ideal conditions) and effectiveness (the degree to which an intervention achieves its intended outcomes in real-world settings) are studied using randomized controlled […]
Disentangling the Truth about Manual Therapy
By: Chad E Cook PT, PhD, FAPTA The “Facts” Please Perhaps you’ve heard the following “facts”? The Great Wall of China is visible from space. If you touch a baby bird that is in its nest, the mother will abandon it. If you flush a toilet in the Southern Hemisphere, water rotates in the opposite […]
