Functional impact of multidisciplinary outpatient program on patients with chronic complete spinal cord injury

Derakhshanrad, Nazi; Vosoughi, Fardis; Yekaninejad, Mir Saeed; Moshayedi, Pouria; Saberi, Hooshang

doi:10.1038/sc.2015.136

Cited by 19 publications

(13 citation statements)

References 17 publications

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“…

Previous reports of male/female ratio in Iran for traumatic SCI range from 2.55 (95% CI 2.29-2.94) [2] to 3.5 (95% CI 2.88-4.6) [3] to 3.7/1 (95% CI 3.15-4.59) [4] . These numbers are concordant with the global average of 3.8 [5] .

…”

mentioning

confidence: 99%

Epidemiology of Spinal Cord Injury in Iran: Discrepancy with International and Previous Institutional Reports

Saberi

Derakhshanrad²,

Yekaninejad³

et al. 2015

Neuroepidemiology

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“…

…”

mentioning

confidence: 99%

Epidemiology of Spinal Cord Injury in Iran: Discrepancy with International and Previous Institutional Reports

Saberi

Derakhshanrad²,

Yekaninejad³

et al. 2015

Neuroepidemiology

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“…The median number of individuals with SCI was 15 (range: 4‐558, interquartile range: 10‐32), the median total sample size was 18 (range: 4‐582, interquartile range: 10‐34), see Figure . The subset of studies with a total sample size >100 (n = 12) comprised multicenter as well as single‐center trials . We found that 167 out of 207 (81%) eligible studies met our definition of a small‐sample size study.…”

Section: Resultsmentioning

confidence: 97%

“…The subset of studies with a total sample size >100 (n = 12) comprised multicenter [26][27][28] as well as single-center trials. [29][30][31][32][33][34][35] We found that 167 out of 207 (81%) eligible studies met our definition of a small-sample size study.…”

Section: Sample Sizesmentioning

confidence: 98%

Sample sizes and statistical methods in interventional studies on individuals with spinal cord injury: A systematic review

Zimmermann

Bolter

Sluka

et al. 2019

J Evidence Based Medicine

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Aim Prevalence and incidence of spinal cord injury (SCI) are low. However, sample sizes have not been systematically examined yet, although this might represent useful information for study planning and power considerations. Therefore, our objective was to determine the median sample size in clinical trials on SCI individuals. Moreover, within small‐sample size studies, statistical methods and awareness of potential problems regarding small samples were examined. Methods We systematically reviewed all studies on human SCI individuals published between 2014 and 2015, where the effect of an intervention on one or more health‐related outcomes was assessed by means of a hypothesis test. If at least one group had a size <20, the study was classified as a small sample size study. PubMed was searched for eligible studies; subsequently, data on sample sizes and statistical methods were extracted and summarized descriptively. Results Out of 8897 studies 207 were included. Median total sample size was 18 (range 4‐582). Small sample sizes were found in 167/207 (81%) studies, resulting limitations and implications for statistical analyses were mentioned in 109/167 (65%) studies. Conclusions Although most recent SCI trials have been conducted with small samples, the consequences on statistical analysis methods and the validity of the results are rarely acknowledged.

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“…where δ denotes the desired effect size, e.g., the MCID. 6 Take as a paradigmatic example for direction misalignment a study by Derakhshanrad et al 2015. Their research hypothesis is clearly directional: "The objective of this study was to determine whether an integrated and an intensive outpatient program would result in functional improvement of spinal cord injury (SCI) patients [...]."…”

Section: Prevailing Misalignments Between Research Hypotheses and Smentioning

confidence: 99%

Misalignment Between Research Hypotheses and Statistical Hypotheses: A Threat to Evidence-Based Medicine?

Lawler

Zimmermann

2019

Topoi

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Evidence-based medicine frequently uses statistical hypothesis testing. In this paradigm, data can only disconfirm a research hypothesis' competitors: One tests the negation of a statistical hypothesis that is supposed to correspond to the research hypothesis. In practice, these hypotheses are often misaligned. For instance, directional research hypotheses are often paired with non-directional statistical hypotheses. Prima facie, one cannot gain proper evidence for one's research hypothesis employing a misaligned statistical hypothesis. This paper sheds lights on the nature of and the reasons for such misalignments and it provides a thorough analysis of whether they pose a threat to evidence-based medicine. The upshots are that the misalignments are often hidden for clinicians and that although some cases of misalignments can be partially counterbalanced, the overall threat is non-negligible. The counterbalances either lead to methodological inadequacy (in addition to the misalignment), loss of statistical power, or involve a (potential) lack of information that could be crucial for decision making. This result casts doubt on various findings of medical studies in addition to issues associated with under-powered studies or the replication crisis. AcknowledgementsWe thank Arne Bathke, Robyn Bluhm, Charlotte Werndl, the audiences in Genoa, Paris, and Munich, the editors of the special issue Fabrizio Macagno and Carlo Martini, as well as two anonymous reviewers for their constructive criticisms and suggestions. 1 We briefly discuss the normative issue of whether directional research hypotheses should be used in evidence-based medicine at all in sect. 4.4. 2 Cho and Abe (2013) claim that this issue also prevails in business research, and given the reasons provided in sect. 4, it is likely to be also found in other disciplines, e.g., psychology.

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Functional impact of multidisciplinary outpatient program on patients with chronic complete spinal cord injury

Cited by 19 publications

References 17 publications

Epidemiology of Spinal Cord Injury in Iran: Discrepancy with International and Previous Institutional Reports

Epidemiology of Spinal Cord Injury in Iran: Discrepancy with International and Previous Institutional Reports

Sample sizes and statistical methods in interventional studies on individuals with spinal cord injury: A systematic review

Misalignment Between Research Hypotheses and Statistical Hypotheses: A Threat to Evidence-Based Medicine?

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