American Institutes for Research

KT Update

An e-newsletter from the Center on Knowledge Translation for Disability and Rehabilitation Research

Vol. 4, No. 4 - April 2016


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The contents of this newsletter were developed under grant number 90DP0027 from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this newsletter do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.

Copyright © 2016 by American Institutes for Research

Introducing: Scoping Review Methods
Online Workshop

Join us for a live, online, two-part workshop that introduces disability and rehabilitation researchers to the methodology of Scoping Reviews. The first session will provide an overview on current approaches for conducting a Scoping Review and participants will learn how to apply them to the literature in disability and rehabilitation. The second session expands on the first to give an in-depth presentation of the steps of conducting a scoping review.

Dates: April 27 & May 25, 2016
Time: 3-4:30 PM ET
Register here:

NARRTC Conference Presentation:
Exploring the Transition from an In-person to
an Online Conference as a KT Strategy

Join us in Alexandria, VA on May 5th for a presentation at the annual NARRTC Conference where Steven Boydston will present, "Exploring the Transition from an In-person to an Online Conference as a KT Strategy". This presentation will describe the process and outcomes of the transition from an in-person to online-only conference framed in a knowledge translation context.

Where: Hilton Alexandria, VA.
When: May 5th, 2016
Time: 3:15-3:30 PM ET (Salon C)
More information:

Community of Practice (CoP) for Vocational Rehabilitation Professionals (CoP-VR)

KTDRR invites vocational rehabilitation (VR) professionals to participate in a new Community of Practice (CoP). The Community of Practice for Vocational Rehabilitation Professionals (CoP-VR) is a forum to facilitate the sharing of ideas and resources among its members, through email, teleconferencing and webcasts.

The CoP will initiate activities with a teleconference that will provide information about research on best practices in the VR field and allow VR professionals to learn from one another how these practices are being used effectively in the field. Attendees will have an opportunity to provide input for future KTDRR webcasts related to best practices in VR.

You have the option of participating on one of two dates: Tuesday, May 10 or Tuesday, June 7 (Time: 2:00-3:00 PM Eastern). We have requested pre-approval from the CRCC for participants to receive 1 CRC-CEU for participating and completing the evaluation of the CoP activity. Please let us know if you are interested and if so, which date would work best for you. If you are not able to make either call, we would still like to have you participate in future CoP activities.
Please contact Cindy Cai if you have specific questions.

Webcast on Plain Language Strategies
May 11, 2016

Learn about the importance of creating materials in plain language from Kelly Warmington, program manager of Knowledge Translation at the Hospital for Sick Children in Toronto. She shares concrete tips and tools for writing websites, research briefs, consent forms, and other educational materials in plain language. This webcast has been pre-approved for 1 CRC-CEU, through 5-10-17.

Date: May 11, 2016
Time: 3 - 4:00 PM ET / 2 - 3:00 PM CT
Registration (no cost):
More information:

Archived Webcast Available!
Campbell Collaboration (C2) Seeks Peer Reviewers

Dr. Carlton Fong of the Campbell Collaboration (C2) discussed the need for peer reviewers in C2's systematic review process. He also described how NIDILRR grantees and other researchers can apply to serve as peer reviewers in their content areas for Campbell's Disability Subgroup, as well as other review areas.
More information:

What Works Global Summit

KTDRR will be represented at the What Works Global Summit: Putting Evidence to Work (London, Sept. 26-28, 2016). The WWGS will share experience from around the world and across sectors on measuring policy impact, experiences in the use of evidence, promoting policy uptake, knowledge translation, and critical appraisal of evidence, as well as discussions of new evidence and study methods.

2016 Online KT Conference: Oct. 24-26-28, 2016

The Center on KTDRR sponsors an annual Online KT Conference for NIDILRR-funded grantees and others, by invitation. This conference is designed to address strategies in the planning and implementation of effective and efficient KT approaches. The 4th Online Conference will take place on October 24, 26, and 28, 2016. Check back to the 2016 Conference Home Page for themes, speakers, and registration information.

Listing of Recent Systematic Reviews in Disability and Rehabilitation

Bañas, B. B., & Gorgon, E. J. (2014). Clinimetric properties of sitting balance measures for children with cerebral palsy: a systematic review. Physical & Occupational Therapy in Pediatrics, 34(3), 313-334. doi:10.3109/01942638.2014.881952
Reviews nine articles with information on seven clinical measures, of which four (PRT, SACND, SATCo, TCMS) demonstrate acceptable overall applicability and are recommended for use in practice.
PMID: 24490854

Bonnechere, B., Jansen, B., Omelina, L., Degelaen, M., Wermenbol, V., Rooze, M., & Van Sint Jan, S. (2014). Can serious games be incorporated with conventional treatment of children with cerebral palsy? A review. Research in Developmental Disabilities, 35(8), 1899-1913. doi:10.1016/j.ridd.2014.04.016
Claims that it is difficult to compare the results of 31 studies using “serious games” (SG, or virtual reality) that were found, with more traditional interventions for CP children. This is said to be due to the lack of standardization in CP patient rehabilitation strategy, the use of various clinical scales and scores and non-standardization in patient follow-up. Proposes standardization strategies.
PMID: 24794289

Chen, Y. P., Pope, S., Tyler, D., & Warren, G. L. (2014). Effectiveness of constraint-induced movement therapy on upper-extremity function in children with cerebral palsy: a systematic review and meta-analysis of randomized controlled trials. Clinical Rehabilitation, 28(10), 939-953. doi:10.1177/0269215514544982
Meta-analyzes 27 studies that compared constraint-induced movement therapy (CIMT) with another intervention, with a focus on arm function in children with cerebral palsy. Concludes that the literature supports CIMT as an effective intervention to improve arm function.
PMID: 25125440

Craig, J. (2014). Music therapy to reduce agitation in dementia. Nursing Times, 110(32-33), 12-15. Found eight studies showing that music therapy increases emotional well-being in persons with all stages of dementia. The best results appear to be produced when familiar music is played, two-three times a week for 30-50 minutes.
PMID: 25188964

Frost, J., Garside, R., Cooper, C., & Britten, N. (2014). A qualitative synthesis of diabetes self-management strategies for long term medical outcomes and quality of life in the UK. BMC Health Services Research, 14, 348-6963-14-348. doi:10.1186/1472-6963-14-348
Synthesizes the findings of four qualitative studies, conducted in the UK, of self-management strategies of patients with Type 2 Diabetes Mellitus. Concludes that for self-management strategies to be sustainable in the long term, patients need to have a sense of having a stake in their self-management, timely information and support, and an overall sense of empowerment.
PMID: 25127714
PMCID: PMC4158039

Hall, A. M., Kamper, S. J., Hernon, M., Hughes, K., Kelly, G., Lonsdale, C., … Ostelo, R. (2015). Measurement tools for adherence to non-pharmacologic self-management treatment for chronic musculoskeletal conditions: a systematic review. Archives of Physical Medicine and Rehabilitation, 96(3), 552-562. doi: 10.1016/j.apmr.2014.07.405
Reviews “self-invented” (unnamed, unreferenced) measures of adherence to self-management used in studies of musculoskeletal samples. Diaries (n=31), multi-item questionnaires (n=11) and single-item scales (n=7) are not well supported in terms of clinimetric data, and the authors suggest that the construct of self-management adherence itself is ill-defined.
PMID: 25108098

Hansen, D., Marinus, N., Remans, M., Courtois, I., Cools, F., Calsius, J., … Takken, T. (2014). Exercise tolerance in obese vs. lean adolescents: a systematic review and meta-analysis. Obesity Reviews : An Official Journal of the International Association for the Study of Obesity, 15(11), 894-904. doi:10.1111/obr.12202
Reviews nine studies that evaluated the exercise tolerance (cardiopulmonary responses to maximal exercise testing) of obese and lean adolescents. Found that there was little difference, except for a reduced VO2 peak in obese children.
PMID: 25132188

Kutlubaev, M. A., & Hackett, M. L. (2014). Part II: predictors of depression after stroke and impact of depression on stroke outcome: an updated systematic review of observational studies. International Journal of Stroke, 9(8), 1026-1036. doi:10.1111/ijs.12356
Updates and expands a 2005 systematic review on factors associated with development of depression in people with stroke. Finds that post-stroke depression is associated with prestroke depression, more severe neurological deficit and physical disability in the acute phase and later after stroke. There was no consistent relationship between depression and demographic parameters or stroke features.
PMID: 25156411

Liebherz, S., & Rabung, S. (2014). Do patients' symptoms and interpersonal problems improve in psychotherapeutic hospital treatment in Germany? A systematic review and meta-analysis. PloS One, 9(8), e105329. doi:10.1371/journal.pone.0105329
Reviews randomized controlled trials as well as longitudinal uncontrolled studies on the effect of psychotherapy on patients hospitalized with “higher-severity” common mental problems. Finds medium within-group effect sizes at discharge and follow-up for symptom change, and small to medium effects for interpersonal problems changes. PMID: 25141289
PMCID: PMC4139348

Maïano C., Normand, C. L., Aimé, A., Bégarie, J. (2014). Lifestyle interventions targeting changes in body weight and composition among youth with an intellectual disability: A systematic review. Research in Developmental Disabilities, 35(8), 1914-1926. doi:10.1016/j.ridd.2014.04.014
Reviews nine studies investigating changes in body weight and composition, healthy lifestyle, and secondary health conditions among young people with an intellectual disability. Concludes that these studies suggest success in changing weight, body mass index and fat mass, but that intervention effects on healthy lifestyle and secondary health conditions are scarce and inconclusive.
PMID: 24830882

Murray, E., McCabe, P., & Ballard, K. J. (2014). A systematic review of treatment outcomes for children with childhood apraxia of speech. American Journal of Speech-Language Pathology / American Speech-Language-Hearing Association, 23(3), 486-504. doi:10.1044/2014_AJSLP-13-0035
Notes that of the 13 approaches used in the 23 single subject design articles, treatments were primarily for speech motor skills (n = 6), linguistic skills (n = 5), and augmentative and alternative communication (n = 2). Most participants responded positively to treatment, but for only seven of 13 maintenance and/or generalization of treatment effects were reported.
PMID: 24686844

Noonan, V. K., Wolfe, D. L., Thorogood, N. P., Park, S. E., Hsieh, J. T., Eng, J. J., & SCIRE Research Team. (2014). Knowledge translation and implementation in spinal cord injury: a systematic review. Spinal Cord, 52(8), 578-587. doi:10.1038/sc.2014.62
Reviews ten studies evaluating knowledge translation (KT) interventions such as developing and implementing patient care protocols, providing clinician education and incorporating outcome measures into clinical practice, Concludes that the field of KT in spinal cord injury is in its infancy, with few relevant publications, mostly of poor quality. Notes, however, that there is some evidence that KT interventions may change clinician behavior and improve patient outcomes. PMID: 24796445
PMCID: PMC4492721

O'Grady, M. G., & Dusing, S. C. (2015). Reliability and validity of play-based assessments of motor and cognitive skills for infants and young children: a systematic review. Physical Therapy, 95(1), 25-38. doi:10.2522/ptj.20140111
Evaluates the clinimetric information available for four play-based assessments for children from 0 to 36 months of age. Finds that they have potential, more so for assessing the child's motor development than for evaluating cognitive development.
PMID: 25169918

Panagioti, M., Richardson, G., Small, N., Murray, E., Rogers, A., Kennedy, A., … Bower, P. (2014). Self-management support interventions to reduce health care utilisation without compromising outcomes: a systematic review and meta-analysis. BMC Health Services Research, 14, 356-6963-14-356. doi:10.1186/1472-6963-14-356
Investigates which models of self-management for patients with long-term conditions are associated with reductions in health services utilization, without reducing level of outcomes. Finds that in a few instances among 184 studies health outcomes were compromised, but in a few other cases they were improved. Reduction in utilization differed by condition.
PMID: 25164529
PMCID: PMC4177163

Pfortmueller, C. A., Lindner, G., & Exadaktylos, A. K. (2014). Reducing fall risk in the elderly: risk factors and fall prevention, a systematic review. Minerva Medica, 105(4), 275-281. doi:R10Y9999N00A140012 [pii]
Reviews risk factors for falling in the elderly (sarcopenia/frailty, polypharmacy, multimorbidity, vitamin D status and home hazards) as well as fall prevention approaches targeting a single fall risk factor or multiple risk factors. Stresses that for prevention to be effective, a match between risk factor(s) and intervention needs to be achieved.
PMID: 24867188

Pilutti, L. A., Platta, M. E., Motl, R. W., & Latimer-Cheung, A. E. (2014). The safety of exercise training in multiple sclerosis: a systematic review. Journal of the Neurological Sciences, 343(1-2), 3-7. doi:10.1016/j.jns.2014.05.016
Notes that there are many reviews documenting the benefits of exercise for people with MS, but none of the risks. Finds that across 26 studies comparing exercise and control, exercise was not associated with an increased risk of disease relapse, and the risk of adverse events was estimated not to be higher than in healthy populations.
PMID: 24880538

Prince, S. A., Saunders, T. J., Gresty, K., & Reid, R. D. (2014). A comparison of the effectiveness of physical activity and sedentary behaviour interventions in reducing sedentary time in adults: a systematic review and meta-analysis of controlled trials. Obesity Reviews, 15(11), 905-919. doi:10.1111/obr.12215
Synthesizes, qualitatively and quantitatively, the findings of controlled studies aiming to change sedentary behavior (SB) and/or physical activity (PA). Finds inconsistent and generally moderate changes in PA, but consistent evidence that large reductions in SB can be achieved using interventions with a focus on reducing SB.
PMID: 25112481
PMCID: PMC4233995

Ramond-Roquin, A., Bouton, C., Gobin-Tempereau, A. S., Airagnes, G., Richard, I., Roquelaure, Y., & Huez, J. F. (2014). Interventions focusing on psychosocial risk factors for patients with non-chronic low back pain in primary care--a systematic review. Family Practice, 31(4), 379-388. doi:10.1093/fampra/cmu008
Summarizes the effectiveness of interventions focusing on psychosocial risk factors for patients with non-chronic low back pain (LBP) in primary care, because these factors are important for the transition from acute to chronic LBP. The authors conclude that among the range of psychosocial risk factors, research has focused mainly on pain beliefs and coping skills, with disappointing results. They claim that “extended theoretical models integrating several psychosocial factors and multicomponent interventions are probably required to meet the challenge of LBP”.
PMID: 24632524

Thiebaud, R. S., Funk, M. D., & Abe, T. (2014). Home-based resistance training for older adults: a systematic review. Geriatrics & Gerontology International, 14(4), 750-757. doi:10.1111/ggi.12326
Systematically reviews the effectiveness of home-based resistance exercise on strength and functional ability of older adults. Concludes that this exercise can improve strength as well as functional ability, but that the improvements are generally small, possibly due to insufficient progression in intensity, as a result of insufficient supervision and/or a lack of motivation.
PMID: 25109883

Listing of Recent Papers on Methodology of
Systematic Reviewing and Meta-Analysis

Brangan, J., Quinn, S., & Spirtos, M. (2015). Impact of an evidence-based practice course on occupational therapist's confidence levels and goals. Occupational Therapy in Health Care, 29(1), 27-38. doi:10.3109/07380577.2014.968943
Evaluates the changes on the “Evidence Based Practice Confidence Scale” for 136 OTs, and finds a significant improvement after an EBP training course. Analyses the therapists' goals to integrate EBP into their practice. As is the Case for most such studies, does not investigate whether actual practice changes occurred.
PMID: 25337671

Collins, G. S., Reitsma, J. B., Altman, D. G., & Moons, K. G. (2015). Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis (TRIPOD): the TRIPOD statement. Diabetic Medicine: A Journal of the British Diabetic Association, 32(2), 146-154. doi:10.1111/dme.12654
Presents a set of recommendations for reporting a prediction model, either diagnostic or prognostic. The TRIPOD checklist contains 22 items deemed essential by the participating experts in reporting prediction model studies.
PMID: 25600898

Galipeau, J., Moher, D., Campbell, C., Hendry, P., Cameron, D. W., Palepu, A., & Hebert, P. C. (2015). A systematic review highlights a knowledge gap regarding the effectiveness of health-related training programs in journalology. Journal of Clinical Epidemiology, 68(3), 257-265. doi:10.1016/j.jclinepi.2014.09.024
Investigates whether training programs make for better scholarly authorship, peer review or editorship. Finds 17 studies (12 writing; 5 peer reviewing; 0 editing) that are generally small and inconclusive, of questionable validity and due to their risk of bias susceptible to misinterpretation.
PMID: 25510373

Gebel, K., Ding, D., Foster, C., Bauman, A. E., & Sallis, J. F. (2015). Improving current practice in reviews of the built environment and physical activity. Sports Medicine (Auckland, N.Z.), 45(3), 297-302. doi:10.1007/s40279-014-0273-8
Reviews published systematic reviews of studies of the link between nature of the built environment and physical activity. Comments that these reviews are generally done poorly, and do not follow the QUOROM or PRISMA statements.
PMID: 25315457

Griffith, L. E., van den Heuvel, E., Fortier, I., Sohel, N., Hofer, S. M., Payette, H., … Raina, P. (2015). Statistical approaches to harmonize data on cognitive measures in systematic reviews are rarely reported. Journal of Clinical Epidemiology, 68(2), 154-162. doi:10.1016/j.jclinepi.2014.09.003
Analyzes 33 meta-analyses combining cognition outcomes, and evaluates how they deal with harmonization, i.e. achieving comparability of previously collected data reported in summary form. Finds that none of these studies reported their harmonization steps. Additionally, reports on three statistical harmonization methods described in (other) literature: (1) standardization methods, (2) latent variable models, and (3) multiple imputation models, and notes that these have not been well compared.
PMID: 25497980
PMCID: PMC4685455

Koroshetz, W. (2015). A core set of trial outcomes for every medical discipline? BMJ (Clinical Research Ed.), 350, h85. doi:10.1136/bmj.h85
Comments on the conclusion in a report in the same issue (Ioannidis, J. P. A., Horbar, J. D., Ovelman, C. M., Brosseau, Y., Thorlund, K., Buus-Frank, M. E., et al. Completeness of main outcomes across randomized trials in entire discipline: survey of chronic lung disease outcomes in preterm infants. BMJ 2015;350:h72.) that the majority of trials included in 174 systematic reviews of interventions on preterm infants are missing information on one of the most common serious outcomes in this population, chronic lung disease. Discusses advantages and feasibility of the suggestion made there, that consideration should be given to the development of standardized clinical outcomes that would have to be collected and reported, by default, in all trials in a given specialty area.
PMID: 25623113

Li, T., Vedula, S. S., Hadar, N., Parkin, C., Lau, J., & Dickersin, K. (2015). Innovations in data collection, management, and archiving for systematic reviews. Annals of Internal Medicine, 162(4), 287-294. doi:10.7326/M14-1603
Provides a step-by-step tutorial for selecting data collection tools; constructing data collection forms; and abstracting, managing, and archiving data for systematic reviews. Argues that if it is done well, data collection for systematic reviews only needs to be done by 1 team and data extractions can be placed into a publicly accessible database for future public use.
PMID: 25686168

Papageorgiou, S. N., Tsiranidou, E., Antonoglou, G. N., Deschner, J., & Jager, A. (2015). Choice of effect measure for meta-analyses of dichotomous outcomes influenced the identified heterogeneity and direction of small-study effects. Journal of Clinical Epidemiology, 68(5), 534-541. doi:10.1016/j.jclinepi.2015.01.004
By means of reanalysis of data in 235 meta-analyses, compares the impact on results of using the odds ratio (OR), risk ratio (RR), and risk difference (RD), respectively, in meta-analyses of dichotomous outcomes, in terms of finding (1) statistical significance, (2) heterogeneity, and (3) publication bias. Finds that conclusions in terms of significance rarely changed. Notes that use of OR resulted in the lowest I2 values (RR and RD), the Egger's test for publication bias was most often significant with RR, and that substitution of RR for OR led to a change of the observed effects in 3%, change of between-study heterogeneity in 6% to 24%, and change in Egger's test results in 7% of the cases. Concludes that the choice of metric for meta-analyses of dichotomous outcomes might influence the identified between-study heterogeneity and conclusions on publication bias.
PMID: 25666885

Rethlefsen, M. L., Farrell, A. M., Osterhaus Trzasko, L. C., & Brigham, T. J. (2015). Librarian co-authors correlated with higher quality reported search strategies in general internal medicine systematic reviews. Journal of Clinical Epidemiology, 68(6), 617-626. doi:10.1016/j.jclinepi.2014.11.025 [doi]
Finds, based on the application of two sets of standards (Recommended Standards for the Search Process and Peer Review of Electronic Search Strategies) to systematic reviews published in high-impact general internal medicine journals, that systematic reviews co-authored by librarians or information specialists have higher search reproducibility and satisfy more of the standards. Suggests, not surprisingly, that librarians or information specialists should be part of the systematic review team.
PMID: 25766056

Santesso, N., Rader, T., Nilsen, E. S., Glenton, C., Rosenbaum, S., Ciapponi, A., … Schunemann, H. J. (2015). A summary to communicate evidence from systematic reviews to the public improved understanding and accessibility of information: a randomized controlled trial. Journal of Clinical Epidemiology, 68(2), 182-190. doi:10.1016/j.jclinepi.2014.04.009
Evaluates a new plain language summary (PLS) format against the current Cochrane format. Finds that people in 5 countries understand the benefits and harms and the quality of the evidence better, independent of their education level.
PMID: 25034199

Shamseer, L., Moher, D., Clarke, M., Ghersi, D., Liberati, A., Petticrew, M., … PRISMA-P Group. (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ (Clinical Research Ed.), 349, g7647. doi:10.1136/bmj.g7647
Presents the PRISMA-P, a modification of the PRISMA statement developed by a group of experts to improve the reporting of protocols for systematic reviews and meta-analyses.
PMID: 25555855

Smith, V., Clarke, M., Williamson, P., & Gargon, E. (2015). Survey of new 2007 and 2011 Cochrane reviews found 37% of prespecified outcomes not reported. Journal of Clinical Epidemiology, 68(3), 237-245. doi:10.1016/j.jclinepi.2014.09.022
Reviews 702 Cochrane reviews published in 2007-11, and finds that 37% of outcomes prespecified in their methods sections were not reported. Argues for the development of Core Outcome Sets for use in systematic reviews.
PMID: 25455837

Vale, C. L., Rydzewska, L. H., Rovers, M. M., Emberson, J. R., Gueyffier, F., Stewart, L. A., & Cochrane IPD Meta-analysis Methods Group. (2015). Uptake of systematic reviews and meta-analyses based on individual participant data in clinical practice guidelines: descriptive study. BMJ (Clinical Research Ed.), 350, h1088. doi:10.1136/bmj.h1088
Concludes, based on review of 33 individual participant data (IPD) meta-analyses and 177 matched clinical guidelines, that systematic reviews and meta-analyses based on IPD are being under-utilized.
PMID: 25747860
PMCID: PMC4353308

Zhou, X., Wang, Y., Tsafnat, G., Coiera, E., Bourgeois, F. T., & Dunn, A. G. (2015). Citations alone were enough to predict favorable conclusions in reviews of neuraminidase inhibitors. Journal of Clinical Epidemiology, 68(1), 87-93. doi:10.1016/j.jclinepi.2014.09.014
Claims, based on an analysis of 152 reviews of neuraminidase inhibitors and 4,574 articles they cite, that whether a review draws conclusions favorable to these inhibitors can be predicted based just on the articles cited. Concludes that these results highlight how evidence exclusion shapes conclusions in reviews.
PMID: 25450452

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