Biopsychosocial rehabilitation for inflammatory arthritis and osteoarthritis: Protocol for a systematic review and meta-analysis of randomised trials

Morten Løbner Pedersen, Peter Thinggard, Rinie Geenen, Marianne Uggen Rasmussen, Maarten de Wit, Lyn March, Philip Mease, Ernest Choy, Phillip Conaghan, Simon S.K. Lee, Anne Faber Hansen, Simon Tarp, Carsten Bogh Juhl, Sabrina Mai Nielsen, Kirstine Amris, Robin Christensen*

*Kontaktforfatter for dette arbejde

Publikation: AndetUdgivelser på nettet - Net-publikationForskningpeer review

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Resumé

Introduction
Inflammatory arthritis (IA) and osteoarthritis (OA) have a detrimental effect on function and
quality of life, primarily due to pain and physical limitations, resulting in a large global
socioeconomic burden. International guidelines and the European League Against
Rheumatism (EULAR) recommend the use of biopsychosocial approaches for nonpharmacological rehabilitation. The ability to weigh benefits and harms will support decisions
for treatment in clinical practice.

Objective
To assess the benefits and harms of biopsychosocial rehabilitation for patients with IA or OA.
Methods and analysis
Eligible studies will be located through a systematic search of MEDLINE (via Pubmed),
EMBASE (via Ovid), CENTRAL (via Cochrane Library), PsycINFO (via Ovid) and CINAHL (via
Ebsco), ClinicalTrials.gov, Web of Science, the abstract archives of American College of
Rheumatology (ACR) and European League Against Rheumatism (EULAR). Hand searching of
trials and relevant reviews will be performed. Randomised and quasi-randomised controlled
trials examining the benefits and/or harms of biopsychosocial rehabilitation compared to any
other control therapy for IA or OA will be included. Trials will be restricted to English, German
and Scandinavian languages. No restrictions will be imposed regarding age, gender, trial
duration, setting, publication date or publication status. Risk of bias will be assessed using the
Cochrane Risk of Bias tool. There is currently no consensus on a generic core outcome
measurement set that would apply across all rheumatic and musculoskeletal diseases and for
all types of biopsychosocial rehabilitation. However, pain, physical function and mental wellbeing remains constructs of major importance to all (rheumatology) stakeholders. Metaanalyses of outcome measures will be performed using a restricted maximum likelihood
(REML) based model (i.e. random-effects). Subgroup analyses will be conducted by stratifying
for type of musculoskeletal condition, treatment modality/component, approach in care (i.e.
multidisciplinary rehabilitation, interdisciplinary rehabilitation or others), supervision of
intervention (e.g. group or individual), extent of intervention (measured in hours per week),
length of intervention, trial duration and comparator/control group. GRADE (Grading of
Recommendations Assessment, Development and Evaluation) will be used to rate the overall
certainty of the evidence for risk of bias, publication bias, imprecision, inconsistency,
indirectness, and magnitude of effect. This results in ratings of high-, moderate-, low-, or very
low–, quality of evidence reflecting the extent to which we are confident that the effect
estimates are correct.

Perspectives and dissemination
We anticipate that the findings of this study will be useful in clinical recommendations for the
management of IA and OA. The results will be disseminated as at least one scientific article in
at least one peer-reviewed research journal. Also, we expect that our systematic review will
facilitate evidence-based research; i.e. identifying key areas for future trial research and
provide a framework for conducting the trials urgently needed.

PROSPERO Registration number: CRD42019127670
OriginalsprogEngelsk
Publikationsdatoapr. 2019
UdgiverPROSPERO International prospective register of systematic reviews.
Antal sider27
StatusUdgivet - apr. 2019

Fingeraftryk

Meta-Analysis
Publications
Research
Musculoskeletal Diseases
Publication Bias
Rheumatology
Rheumatic Diseases
PubMed
MEDLINE
Libraries
Consensus
Language
Outcome Assessment (Health Care)
Guidelines
Control Groups

Bibliografisk note

PROSPERO protokol: PROSPERO Registration number: CRD42019127670

Citer dette

Pedersen, M. L., Thinggard, P., Geenen, R., Rasmussen, M. U., de Wit, M., March, L., ... Christensen, R. (2019, apr). Biopsychosocial rehabilitation for inflammatory arthritis and osteoarthritis: Protocol for a systematic review and meta-analysis of randomised trials. PROSPERO International prospective register of systematic reviews.
Pedersen, Morten Løbner ; Thinggard, Peter ; Geenen, Rinie ; Rasmussen, Marianne Uggen ; de Wit, Maarten ; March, Lyn ; Mease, Philip ; Choy, Ernest ; Conaghan, Phillip ; Lee, Simon S.K. ; Hansen, Anne Faber ; Tarp, Simon ; Juhl, Carsten Bogh ; Mai Nielsen, Sabrina ; Amris, Kirstine ; Christensen, Robin. / Biopsychosocial rehabilitation for inflammatory arthritis and osteoarthritis : Protocol for a systematic review and meta-analysis of randomised trials. 2019. PROSPERO International prospective register of systematic reviews. 27 s.
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title = "Biopsychosocial rehabilitation for inflammatory arthritis and osteoarthritis: Protocol for a systematic review and meta-analysis of randomised trials",
abstract = "IntroductionInflammatory arthritis (IA) and osteoarthritis (OA) have a detrimental effect on function andquality of life, primarily due to pain and physical limitations, resulting in a large globalsocioeconomic burden. International guidelines and the European League AgainstRheumatism (EULAR) recommend the use of biopsychosocial approaches for nonpharmacological rehabilitation. The ability to weigh benefits and harms will support decisionsfor treatment in clinical practice.ObjectiveTo assess the benefits and harms of biopsychosocial rehabilitation for patients with IA or OA.Methods and analysisEligible studies will be located through a systematic search of MEDLINE (via Pubmed),EMBASE (via Ovid), CENTRAL (via Cochrane Library), PsycINFO (via Ovid) and CINAHL (viaEbsco), ClinicalTrials.gov, Web of Science, the abstract archives of American College ofRheumatology (ACR) and European League Against Rheumatism (EULAR). Hand searching oftrials and relevant reviews will be performed. Randomised and quasi-randomised controlledtrials examining the benefits and/or harms of biopsychosocial rehabilitation compared to anyother control therapy for IA or OA will be included. Trials will be restricted to English, Germanand Scandinavian languages. No restrictions will be imposed regarding age, gender, trialduration, setting, publication date or publication status. Risk of bias will be assessed using theCochrane Risk of Bias tool. There is currently no consensus on a generic core outcomemeasurement set that would apply across all rheumatic and musculoskeletal diseases and forall types of biopsychosocial rehabilitation. However, pain, physical function and mental wellbeing remains constructs of major importance to all (rheumatology) stakeholders. Metaanalyses of outcome measures will be performed using a restricted maximum likelihood(REML) based model (i.e. random-effects). Subgroup analyses will be conducted by stratifyingfor type of musculoskeletal condition, treatment modality/component, approach in care (i.e.multidisciplinary rehabilitation, interdisciplinary rehabilitation or others), supervision ofintervention (e.g. group or individual), extent of intervention (measured in hours per week),length of intervention, trial duration and comparator/control group. GRADE (Grading ofRecommendations Assessment, Development and Evaluation) will be used to rate the overallcertainty of the evidence for risk of bias, publication bias, imprecision, inconsistency,indirectness, and magnitude of effect. This results in ratings of high-, moderate-, low-, or verylow–, quality of evidence reflecting the extent to which we are confident that the effectestimates are correct.Perspectives and disseminationWe anticipate that the findings of this study will be useful in clinical recommendations for themanagement of IA and OA. The results will be disseminated as at least one scientific article inat least one peer-reviewed research journal. Also, we expect that our systematic review willfacilitate evidence-based research; i.e. identifying key areas for future trial research andprovide a framework for conducting the trials urgently needed.PROSPERO Registration number: CRD42019127670",
author = "Pedersen, {Morten L{\o}bner} and Peter Thinggard and Rinie Geenen and Rasmussen, {Marianne Uggen} and {de Wit}, Maarten and Lyn March and Philip Mease and Ernest Choy and Phillip Conaghan and Lee, {Simon S.K.} and Hansen, {Anne Faber} and Simon Tarp and Juhl, {Carsten Bogh} and {Mai Nielsen}, Sabrina and Kirstine Amris and Robin Christensen",
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Pedersen, ML, Thinggard, P, Geenen, R, Rasmussen, MU, de Wit, M, March, L, Mease, P, Choy, E, Conaghan, P, Lee, SSK, Hansen, AF, Tarp, S, Juhl, CB, Mai Nielsen, S, Amris, K & Christensen, R 2019, Biopsychosocial rehabilitation for inflammatory arthritis and osteoarthritis: Protocol for a systematic review and meta-analysis of randomised trials. PROSPERO International prospective register of systematic reviews..

Biopsychosocial rehabilitation for inflammatory arthritis and osteoarthritis : Protocol for a systematic review and meta-analysis of randomised trials. / Pedersen, Morten Løbner; Thinggard, Peter; Geenen, Rinie; Rasmussen, Marianne Uggen; de Wit, Maarten; March, Lyn; Mease, Philip; Choy, Ernest; Conaghan, Phillip; Lee, Simon S.K.; Hansen, Anne Faber; Tarp, Simon; Juhl, Carsten Bogh; Mai Nielsen, Sabrina; Amris, Kirstine; Christensen, Robin.

27 s. PROSPERO International prospective register of systematic reviews.. 2019, Protocol.

Publikation: AndetUdgivelser på nettet - Net-publikationForskningpeer review

TY - ICOMM

T1 - Biopsychosocial rehabilitation for inflammatory arthritis and osteoarthritis

T2 - Protocol for a systematic review and meta-analysis of randomised trials

AU - Pedersen, Morten Løbner

AU - Thinggard, Peter

AU - Geenen, Rinie

AU - Rasmussen, Marianne Uggen

AU - de Wit, Maarten

AU - March, Lyn

AU - Mease, Philip

AU - Choy, Ernest

AU - Conaghan, Phillip

AU - Lee, Simon S.K.

AU - Hansen, Anne Faber

AU - Tarp, Simon

AU - Juhl, Carsten Bogh

AU - Mai Nielsen, Sabrina

AU - Amris, Kirstine

AU - Christensen, Robin

N1 - PROSPERO protokol: PROSPERO Registration number: CRD42019127670

PY - 2019/4

Y1 - 2019/4

N2 - IntroductionInflammatory arthritis (IA) and osteoarthritis (OA) have a detrimental effect on function andquality of life, primarily due to pain and physical limitations, resulting in a large globalsocioeconomic burden. International guidelines and the European League AgainstRheumatism (EULAR) recommend the use of biopsychosocial approaches for nonpharmacological rehabilitation. The ability to weigh benefits and harms will support decisionsfor treatment in clinical practice.ObjectiveTo assess the benefits and harms of biopsychosocial rehabilitation for patients with IA or OA.Methods and analysisEligible studies will be located through a systematic search of MEDLINE (via Pubmed),EMBASE (via Ovid), CENTRAL (via Cochrane Library), PsycINFO (via Ovid) and CINAHL (viaEbsco), ClinicalTrials.gov, Web of Science, the abstract archives of American College ofRheumatology (ACR) and European League Against Rheumatism (EULAR). Hand searching oftrials and relevant reviews will be performed. Randomised and quasi-randomised controlledtrials examining the benefits and/or harms of biopsychosocial rehabilitation compared to anyother control therapy for IA or OA will be included. Trials will be restricted to English, Germanand Scandinavian languages. No restrictions will be imposed regarding age, gender, trialduration, setting, publication date or publication status. Risk of bias will be assessed using theCochrane Risk of Bias tool. There is currently no consensus on a generic core outcomemeasurement set that would apply across all rheumatic and musculoskeletal diseases and forall types of biopsychosocial rehabilitation. However, pain, physical function and mental wellbeing remains constructs of major importance to all (rheumatology) stakeholders. Metaanalyses of outcome measures will be performed using a restricted maximum likelihood(REML) based model (i.e. random-effects). Subgroup analyses will be conducted by stratifyingfor type of musculoskeletal condition, treatment modality/component, approach in care (i.e.multidisciplinary rehabilitation, interdisciplinary rehabilitation or others), supervision ofintervention (e.g. group or individual), extent of intervention (measured in hours per week),length of intervention, trial duration and comparator/control group. GRADE (Grading ofRecommendations Assessment, Development and Evaluation) will be used to rate the overallcertainty of the evidence for risk of bias, publication bias, imprecision, inconsistency,indirectness, and magnitude of effect. This results in ratings of high-, moderate-, low-, or verylow–, quality of evidence reflecting the extent to which we are confident that the effectestimates are correct.Perspectives and disseminationWe anticipate that the findings of this study will be useful in clinical recommendations for themanagement of IA and OA. The results will be disseminated as at least one scientific article inat least one peer-reviewed research journal. Also, we expect that our systematic review willfacilitate evidence-based research; i.e. identifying key areas for future trial research andprovide a framework for conducting the trials urgently needed.PROSPERO Registration number: CRD42019127670

AB - IntroductionInflammatory arthritis (IA) and osteoarthritis (OA) have a detrimental effect on function andquality of life, primarily due to pain and physical limitations, resulting in a large globalsocioeconomic burden. International guidelines and the European League AgainstRheumatism (EULAR) recommend the use of biopsychosocial approaches for nonpharmacological rehabilitation. The ability to weigh benefits and harms will support decisionsfor treatment in clinical practice.ObjectiveTo assess the benefits and harms of biopsychosocial rehabilitation for patients with IA or OA.Methods and analysisEligible studies will be located through a systematic search of MEDLINE (via Pubmed),EMBASE (via Ovid), CENTRAL (via Cochrane Library), PsycINFO (via Ovid) and CINAHL (viaEbsco), ClinicalTrials.gov, Web of Science, the abstract archives of American College ofRheumatology (ACR) and European League Against Rheumatism (EULAR). Hand searching oftrials and relevant reviews will be performed. Randomised and quasi-randomised controlledtrials examining the benefits and/or harms of biopsychosocial rehabilitation compared to anyother control therapy for IA or OA will be included. Trials will be restricted to English, Germanand Scandinavian languages. No restrictions will be imposed regarding age, gender, trialduration, setting, publication date or publication status. Risk of bias will be assessed using theCochrane Risk of Bias tool. There is currently no consensus on a generic core outcomemeasurement set that would apply across all rheumatic and musculoskeletal diseases and forall types of biopsychosocial rehabilitation. However, pain, physical function and mental wellbeing remains constructs of major importance to all (rheumatology) stakeholders. Metaanalyses of outcome measures will be performed using a restricted maximum likelihood(REML) based model (i.e. random-effects). Subgroup analyses will be conducted by stratifyingfor type of musculoskeletal condition, treatment modality/component, approach in care (i.e.multidisciplinary rehabilitation, interdisciplinary rehabilitation or others), supervision ofintervention (e.g. group or individual), extent of intervention (measured in hours per week),length of intervention, trial duration and comparator/control group. GRADE (Grading ofRecommendations Assessment, Development and Evaluation) will be used to rate the overallcertainty of the evidence for risk of bias, publication bias, imprecision, inconsistency,indirectness, and magnitude of effect. This results in ratings of high-, moderate-, low-, or verylow–, quality of evidence reflecting the extent to which we are confident that the effectestimates are correct.Perspectives and disseminationWe anticipate that the findings of this study will be useful in clinical recommendations for themanagement of IA and OA. The results will be disseminated as at least one scientific article inat least one peer-reviewed research journal. Also, we expect that our systematic review willfacilitate evidence-based research; i.e. identifying key areas for future trial research andprovide a framework for conducting the trials urgently needed.PROSPERO Registration number: CRD42019127670

M3 - Net publication - Internet publication

PB - PROSPERO International prospective register of systematic reviews.

ER -