title: The Power of Low Back Pain Trials: A Systematic Review of Power, Sample Size, and Reporting of Sample Size Calculations Over Time, in Trials Published Between 1980 and 2012.
abstract: METHODS
  A systematic review of nonspecific low back pain trials published between 1980 and 2012.
  
  
  OBJECTIVE
  To explore what proportion of trials have been powered to detect different bands of effect size; whether there is evidence that sample size in low back pain trials has been increasing; what proportion of trial reports include a sample size calculation; and whether likelihood of reporting sample size calculations has increased.
  
  
  BACKGROUND
  Clinical trials should have a sample size sufficient to detect a minimally important difference for a given power and type I error rate. An underpowered trial is one within which probability of type II error is too high. Meta-analyses do not mitigate underpowered trials.
  
  
  METHODS
  Reviewers independently abstracted data on sample size at point of analysis, whether a sample size calculation was reported, and year of publication. Descriptive analyses were used to explore ability to detect effect sizes, and regression analyses to explore the relationship between sample size, or reporting sample size calculations, and time.
  
  
  RESULTS
  We included 383 trials. One-third were powered to detect a standardized mean difference of less than 0.5, and 5% were powered to detect less than 0.3. The average sample size was 153 people, which increased only slightly (∼4 people/yr) from 1980 to 2000, and declined slightly (∼4.5 people/yr) from 2005 to 2011 (P < 0.00005). Sample size calculations were reported in 41% of trials. The odds of reporting a sample size calculation (compared to not reporting one) increased until 2005 and then declined (Equation is included in full-text article.).
  
  
  CONCLUSIONS
  Sample sizes in back pain trials and the reporting of sample size calculations may need to be increased. It may be justifiable to power a trial to detect only large effects in the case of novel interventions.
  
  
  METHODS
  3.
authors: Department of Health Sciences, Kristiania University College, Oslo, Norway.|Warwick Medical School, University of Warwick, Coventry, UK.
authors: Robert
authors: R
authors: Froud
authors: Department of Health Sciences, Kristiania University College, Oslo, Norway.|European School of Osteopathy, Maidstone, Kent, UK.
authors: Dévan
authors: D
authors: Rajendran
authors: Warwick Medical School, University of Warwick, Coventry, UK.
authors: Shilpa
authors: S
authors: Patel
authors: European School of Osteopathy, Maidstone, Kent, UK.
authors: Philip
authors: P
authors: Bright
authors: Department of Health Sciences, Kristiania University College, Oslo, Norway.
authors: Tom
authors: T
authors: Bjørkli
authors: Monash Department of Clinical Epidemiology, Cabrini Institute and Department of Epidemiology and Preventive Medicine, Monash University, Cabrini Medical Centre, Malvern, Melbourne, Victoria, Australia.
authors: Sandra
authors: S
authors: Eldridge
authors: Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Whitechapel, London, UK.
authors: Rachelle
authors: R
authors: Buchbinder
authors: Warwick Medical School, University of Warwick, Coventry, UK.
authors: Martin
authors: M
authors: Underwood
mesh_terms: D002986:Clinical Trials as Topic; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D012107:Research Design; D018401:Sample Size