title: Distal biceps brachii tendon repair: a systematic review of patient outcome determination using modified Coleman methodology score criteria.
abstract: OBJECTIVE
  This systematic literature review evaluated the methodological research design quality of studies that evaluated patient outcomes following distal biceps brachii tendon repair and developed evidence-based recommendations for future patient clinical outcomes research.
  
  
  METHODS
  Following the preferred reporting items for systematic reviews and meta-analyses criteria, and using "biceps brachii", "tendon", "repair" and "outcome assessment" search terms, the CINAHL, Academic Search Premier and MEDLINE databases were searched from January 1960-October 2015. The modified Coleman methodology score (MCMS) served as the primary outcome measure. Descriptive statistical analysis was performed for composite and component MCMS and for patient outcome assessment methodology use frequency.
  
  
  RESULTS
  A total of 93 studies were evaluated. Overall MCMS was low (57.1 ± 14). Only 12 (12.9 %) had prospective cohort or randomized controlled trial designs. There was a moderate relationship between publication year and MCMS (r = 0.53, P < 0.0001). Although 61 studies (65.6 %) had adequate surgical descriptions, only 3 (3.2 %) had well-described rehabilitation. Of 2253 subjects, only 39 (1.7 %) were women. Studies published after 2008 had higher MCMS scores than studies published earlier (61.3 ± 10 versus 52.9 ± 16, P = 0.003).
  
  
  CONCLUSIONS
  Although overall research study methodological scores improved on average since 2008, generally low MCMS scores, retrospective designs, lack of eccentric elbow flexor or supinator strength testing, and poorly described surgical and rehabilitation descriptions remain commonplace. These findings decrease clinical study validity and generalizability.
  
  
  METHODS
  III.
authors.affiliation: Athletic Training Program, Kosair Charities College of Health and Natural Sciences, Spalding University, 901 South 4th Street, Louisville, KY, 40203-2188, USA. jnyland@spalding.edu.|Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA. jnyland@spalding.edu.
authors.forename: John
authors.initials: J
authors.lastname: Nyland
authors.affiliation: Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA.
authors.forename: Brandon
authors.initials: B
authors.lastname: Causey
authors.affiliation: Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA.
authors.forename: Jeff
authors.initials: J
authors.lastname: Wera
authors.affiliation: Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Krupp
authors.affiliation: Louisville Arm and Hand, Norton Healthcare Pavilion, Suite 195, 315 E. Broadway, Louisville, KY, 40202, USA.
authors.forename: David
authors.initials: D
authors.lastname: Tate
authors.affiliation: Louisville Arm and Hand, Norton Healthcare Pavilion, Suite 195, 315 E. Broadway, Louisville, KY, 40202, USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
mesh_terms: D001132:Arm / Q000601:surgery; D006801:Humans; D017063:Outcome Assessment, Health Care; D012107:Research Design / Q000592:standards*; D013710:Tendons / Q000601:surgery*
keywords: Muscle test; Patient outcome; Rehabilitation; Surgery; Upper extremity