Opening the rehabilitation “black box” to improve reporting and evidence synthesis. The Guideline for Intervention Description in Rehabilitation (GUIDE-Rehab)

Article type
Authors
Negrini S1, Arienti C2, Armijo-Olivo S3, Armijo-Olivo S4, Côté P5, Heinemann A6, Kiekens C7, Kumbhare D8, Levack W9, Meyer-Feil T10, Whyte J11
1Università "La Statale", Milan, Milan, Italy
2IRCCS Fondazione Don Gnocchi, Milan, Italy
3University of Applied Sciences Osnabrück, Faculty of Economics and Social Sciences , Osnabrück, Germany
4Faculties of Rehabilitation Medicine and Medicine and Dentistry, University of Alberta, Edmonton, Canada
5Institute for Disability and Rehabilitation Research and Faculty of Health Sciences, Ontario Tech University, Oshawa, Ontario, Canada
6Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine and Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois, USA
7IRCCS Ospedale Galeazzi S. Ambrogio, Milan, Italy
8Department of Medicine, Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, Canada
9Department of Medicine, University of Otago, Wellington, New Zealand
10Institute for Rehabilitation Medicine, Medical Faculty, Martin-Luther-University Halle-WittenbergHalle (Saale), Germany
11Moss Rehabilitation Research Institute, Albert Einstein Healthcare Network, Elkins Park, Pennsylvania, USA
Abstract
Background
The May 2023 resolution to strengthen rehabilitation in health systems unanimously adopted by the World Health Assembly calls for improved research in the field. The CONSORT statement experience demonstrates the importance of reporting guidelines in improving research conduct. General reporting guidelines include rehabilitation among non-pharmacological or behavioural interventions. Nevertheless, rehabilitation is a complex biopsychosocial approach with different issues from mostly biomedical (e.g. surgical) or behavioural (e.g. psychological) interventions. The Template for Intervention Description and Replication (TIDieR) focuses on accurate reporting of health interventions, but unfortunately, it was found to be suboptimal for the rehabilitation field. Still, the quality of reporting on interventions in rehabilitation remains incomplete and the expression “black box” is frequently used in the field.
Objectives
We aimed to develop a reporting guideline for the description of interventions for all study designs in the rehabilitation field.
Methods
We followed the EQUATOR Network’s guidance and registered the project on the EQUATOR website. The preparatory phase included 21 papers produced in three years, with one specifically focused on rehabilitation intervention reporting. The starting point of the GUIdeline for Intervention Description in Rehabilitation (GUIDE-Rehab) included 1) the TIDieR guideline, 2) the American Congress of Rehabilitation Medicine’s Rehabilitation Treatment Specification Networking Group work, and 3) the rehabilitation definition for research purposes. We included 75 experts: 1) methodologists, 2) chief editors of rehabilitation journals, 3) rehabilitation researchers, and 4) Cochrane members and authors. During the 4th Cochrane Rehabilitation Methodological Meeting, participants drafted the first version of GUIDE-Rehab through group work after the presentation and discussion of the preparatory material. A Delphi survey found a minimum of 80% agreement for all items. We piloted with 22 chief editors of 18 journals, and 7 research groups of the Horizon-funded PREPARE project. The final GUIDE-Rehab included different versions: complete, short-form (SF), for uncontrolled studies, and graphical.
Results
Figure 1 reports the GUIDE-rehab items.
Conclusions
The current GUIDE-Rehab is the first version and will evolve. Improving the quality of reporting of interventions in rehabilitation studies will increase not only research but also clinical replicability, with a consequent significant impact on patients.