A guide to interpretation of studies investigating subgroups of responders to physical therapy interventions.
Many researchers and clinicians believe the effectiveness of existing physical therapy interventions can be improved by targeting the provision of specific interventions at patients who respond best to that treatment. Although this approach has the potential to improve outcomes for some patients, it needs to be implemented carefully because some methods used to identify subgroups can produce biased or misleading results. The aim of this article is to assist readers in assessing the validity and generalizability of studies designed to identify subgroups of responders to physical therapy interventions. The key messages are that subgroups should be identified using high-quality randomized controlled trials, the investigation should be limited to a relatively small number of potential subgroups for which there is a plausible rationale, subgroup effects should be investigated by formally analyzing statistical interactions, and findings of subgroups should be subject to external validation.
Hancock
Mark
M
Back Pain Research Group, The University of Sydney, Sydney, New South Wales, Australia. M.Hancock@usyd.edu.au
Herbert
Robert D
RD
Maher
Christopher G
CG
D035061:Control Groups; D003627:Data Interpretation, Statistical; D006801:Humans; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D026741:Physical Therapy Modalities / Q000458:organization & administration*; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D015203:Reproducibility of Results; D012107:Research Design