By Erin Macri, MPT, MSc, PhD Candidate
Systematic reviews are the current gold standard method for synthesizing and critically appraising clinically-relevant literature. So among a collection of publications all employing a criterion methodology for reviewing the literature, how does one go about determining the ‘best’ systematic review?
The criteria for BJSM’s systematic reviews are:
- Topic that is highly relevant to BJSM’s readers, and will have the potential to influence how clinicians tackle important clinical challenges.
- The article will introduce the topic accurately, be structurally sound but also engaging.
- Scientifically, the methods will be carefully designed and executed, ideally following internationally recommended reporting guidelines (PRISMA).
- The authors will skillfully analyse and interpret their results and synthesize them into a discussion that links nicely to the study’s objectives, and mixes meaningfully with the existing knowledge / literature.
- The conclusions will be: i) plausible, accurately reflecting the study findings while also considering study limitations; ii) succinct and concrete, creating a take home message that can be feasibly incorporated into clinical practice.
With these components in mind, we evaluated BJSM’s systematic reviews from the July 2012 to June 2013 issues.
Through an iterative process we narrowed our evaluation down to five papers:
- Barton CJ et al. (2013) Gluteal muscle activity and patellofemoral pain syndrome: a systematic review. 47: 207-214
- Freckleton G et al. (2013) Risk factors for hamstring muscle strain injury in sport: a systematic review and meta-analysis. 47: 351-358
- Hegedus EJ et al. (2012) Which physical examination tests provide clinicians with the most value when examining the shoulder? Update of a systematic review with meta-analysis of individual tests. 46: 964-978
- Kemp JL et al. (2012) Hip arthroscopy for intra-articular pathology: a systematic review of outcomes with and without femoral osteoplasty. 46: 632-643
- O’Sullivan K. et al. (2012) The effects of eccentric training on lower limb flexibility: a systematic review. 46: 838-845
We then very carefully assessed these five papers on the merits described above, using the PRISMA reporting checklist to evaluate scientific rigour in study design and reporting.
The highest ranked paper was by Ms. Joanne Kemp (PhD Candidate), a physical therapist from Tasmania, Australia who recently submitted her PhD thesis at the University of Queensland under the supervision of coauthor Associate Professor Kay Crossley.
Kemp and colleagues’ review investigated the outcomes of pain and physical function following hip arthroscopy with and without femoral osteoplasty in individuals with intra-articular hip pathology. The study question was developed in light of recent advances in surgical techniques as well as a shift in perspective to acknowledge that hip pathologies often co-exist. They argue that surgical outcomes should therefore be evaluated in an inclusive way: by surgical technique or procedure rather than by isolated hip pathology.
Kemp and colleagues’ study contributes to the literature by concluding that 10-year follow-up data on procedures without osteoplasty show good results; effect sizes are similar with and without osteoplasty; and the presence of chondropathy at the time of surgery results in smaller (though still some beneficial) effect sizes compared to those with normal cartilage.
When notified of the award of 1000 pounds, Ms Kemp stated, “We are thrilled to receive this recognition. A lot of effort and teamwork went into this review, and I would like to acknowledge my fantastic co-authors. We also look forward to investing the award funds into future research examining factors that influence outcomes in people with hip pathology, and developing effective interventions targeted to reduce the symptoms associated with hip pathology.”
BJSM congratulates the soon to be Dr Kemp and her co-authors on their review of hip arthroscopy outcomes. This will inspire future authors to design, execute and disseminate exemplary systematic reviews. Importantly, this work will guide clinicians and influence patient management