BackgroundExercise interventions are frequently recommended for patients with rotator cuff disease, but poor content reporting in clinical trials of exercise limits interpretation and replication of trials and clinicians’ ability to deliver effective exercise protocols. The Consensus on Exercise Reporting Template (CERT) was developed to address this problem.ObjectiveTo assess completeness of content reporting of exercise interventions in randomised controlled trials for patients with rotator cuff disease and the inter-rater reliability of the CERT.DesignCritical appraisal.MethodsIndependent pairs of reviewers applied the CERT to all 34 exercise trials from the most recent Cochrane Review evaluating the effect of manual therapy and exercise for patients with rotator cuff disease. We used the CERT Explanation and Elaboration Statement to guide assessment of whether each of the 19-item criteria were clearly described (score 0–19; higher scores indicate better reporting). Percentage agreement and the prevalence and bias adjusted kappa (PABAK) coefficient were used to measure inter-rater reliability.ResultsThe median CERT score was 5 (range 0–16). Percentage agreement was high for 15 items and acceptable for 4 items. The PABAK coefficient indicated excellent (5 items), substantial (11 items) and moderate (3 items) inter-rater agreement.ConclusionThe description of exercise interventions for patients with rotator cuff disease in published trials is poorly reported. Overall, the inter-rater reliability of the CERT is high/acceptable. We strongly encourage journals to mandate use of the CERT for papers reporting trial protocols and results investigating exercise interventions.

ObjectivesTo investigate (1) self-reported societal comprehension of common and usually non-serious terms found in lumbar spine imaging reports and (2) its relationship to perceived seriousness, likely persistence of low back pain (LBP), fear of movement, back beliefs and history and intensity of LBP.DesignCross-sectional online survey of the general public.SettingFive English-speaking countries: UK, USA, Canada, New Zealand and Australia.ParticipantsAdults (age >18 years) with or without a history of LBP recruited in April 2019 with quotas for country, age and gender.Primary and secondary outcome measuresSelf-reported understanding of 14 terms (annular fissure, disc bulge, disc degeneration, disc extrusion, disc height loss, disc protrusion, disc signal loss, facet joint degeneration, high intensity zone, mild canal stenosis, Modic changes, nerve root contact, spondylolisthesis and spondylosis) commonly found in lumbar spine imaging reports. For each term, we also elicited worry about its seriousness, and whether its presence would indicate pain persistence and prompt fear of movement.ResultsFrom 774 responses, we included 677 (87.5%) with complete and valid responses. 577 (85%) participants had a current or past history of LBP of whom 251 (44%) had received lumbar spine imaging. Self-reported understanding of all terms was poor. At best, 235 (35%) reported understanding the term ‘disc degeneration’, while only 71 (10.5%) reported understanding the term ‘Modic changes’. For all terms, a moderate to large proportion of participants (range 59%–71%), considered they indicated a serious back problem, that pain might persist (range 52%–71%) and they would be fearful of movement (range 42%–57%).ConclusionCommon and usually non-serious terms in lumbar spine imaging reports are poorly understood by the general population and may contribute to the burden of LBP.Trial registration numberACTRN12619000545167.

Imaging reports are the primary method of communicating diagnostic imaging findings between the radiologist and the referring clinician. Guidelines produced by professional bodies provide guidance on content and format of imaging reports, but the extent to which they consider comprehensibility for referring clinicians and their patients is unclear. The objective of this review was to determine the extent to which radiology reporting guidelines consider comprehensibility of imaging reports for referring clinicians and patients. We performed a scoping review of English-language diagnostic imaging reporting guidelines. We searched electronic databases (OVID MEDLINE, Embase) and websites of radiological professional organisations to identify guidelines. The extent to which the guidelines recommended essential report features such as technical information, content, format and language, as well as features to enhance comprehensibility, such as lay language summaries, was recorded. Six guidelines from professional bodies representing radiologists from the USA, Canada, Australia and New Zealand, Hong Kong, the UK and Europe were identified from the search. Inconsistencies exist between guidelines in their recommendations, and they rarely consider that patients may read the report. No guideline made recommendations about the reporting of results considering the clinical context, and none recommended features preferred by patients such as lay language summaries. This review identifies an opportunity for future radiology reporting guidelines to give greater consideration to referring clinician and patient preferences.