Abstract
Objectives
To assess the credibility of subgroup claims in back pain randomized controlled trials.
Study Design and Setting
A sample of reports of back pain trials from 2000 to 2015 that provided a subgroup
claim were included (n=38). Two reviewers independently assessed risk of bias and credibility of subgroup
claims as well as the strength of the author's claim. The credibility of subgroup
claims was assessed using a 10-criteria tool, and strength of the subgroup claims
was assessed based on seven criteria to categorize claims into a reasonably strong
claim of a definitive subgroup effect or a more cautious claim of a possible effect.
Results
A total of 91 claims of a subgroup effect were reported in the 38 included trials,
of which 28 were considered strong claims of a definitive effect, and 63 were cautious
claims of a possible effect. None of the subgroup claims met all 10 credibility criteria,
and only 24% (22 claims) satisfied at least five criteria. The only criteria satisfied
by more than 50% of the claims were if the subgroup variable was a characteristic
measured at baseline, and whether the test of interaction was significant. All other
criteria were satisfied by less than 30% of the claims. There was no association between
the credibility of subgroup claims and the journal impact factor, risk of bias, sample
size, or year of publication.
Conclusion
The credibility of subgroup claims in back pain trials is usually low, irrespective
of the strength of the authors' claim.
Keywords
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Article info
Publication history
Published online: June 10, 2016
Accepted:
June 3,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
