Assessing the reporting quality of physical activity programs in randomized controlled trials for the management of juvenile idiopathic arthritis using three standardized assessment tools

Abstract

Background: The reporting quality of physical activity (PA) programs in randomized controlled trials (RCTs) for the management of juvenile idiopathic arthritis (JIA) remains unknown. This study aimed to assess and compare the reporting quality of PA programs in RCTs for the management of JIA using three difference standardized assessment tools, and to describe the elements that were similar and different between these tools.

Methods: A systematic search was conducted for moderate-to high-quality RCTs of PA programs in JIA, published up until January 2019. Two reviewers independently included 10 RCTs and scored the reporting quality of PA programs using the following tools: Consensus on Exercise Reporting Template (CERT) checklist, Consensus on Therapeutic Exercise Training (CONTENT) scale, and Template for Intervention Description and Replication (TIDieR) checklist.

Results: Results showed that reporting of PA programs in 10 moderate- to high-quality RCTs for JIA management remains incomplete. The average reporting quality (± standard deviation) for all RCTs combined was moderate for the three standardized assessment tools with 70.8 (±14.3)% for the TIDieR checklist, 53.2 (±20.2)% for the CERT checklist, and 70.0 (±18.9)% for the CONTENT scale. Despite some overlap, the three standardized assessment tools (TIDieR, CERT, CONTENT) included different elements resulting in different scores. All tools assess elements linked to PA programs (provider, location, timing, personalization and adherence), but the CERT checklist includes other essential elements (e.g., additional resources, motivational strategies, adverse events).

Conclusions: The lack of complete reporting of PA programs in RCTs for the management of JIA and the variation in scores and assessed elements among standardized assessment tools show the need to improve reporting. Using the most comprehensive standardized tool (i.e., the CERT) and providing accessible supplemental information on PA programs may improve the reporting quality of PA programs in RCTs and help reproduce PA programs in research and clinical practice.

Keywords: Juvenile idiopathic arthritis; Physical activity programs; Randomized controlled trials; Reporting quality.

Fig. 1

Study flow diagram (Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA)) for selected RCTs. This PRISMA flow chart is developed using the “PRISMA Statement” referenced in: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6 (7): e1000097.10.1371/journal.pmed.1000097

Fig. 2

Percentage of RCTs (n = 10) which reported each TIDieR checklist item (see Appendix 2: item descriptions)

Fig. 3

Percentage of RCTs (n = 10) which reported each CERT checklist item (see Appendix 2: item descriptions)

Fig. 4

Percentage of RCTs (n = 10) which reported each CONTENT scale item (see Appendix 2: item descriptions)

Fig. 5

Overlap of items between the CERT and TIDieR checklists (see Appendix 2 for item descriptions). Legend: Black (overlap); Grey (uncertain overlap); White (no overlap)

Fig. 6

Overlap of items between CONTENT scale and TIDieR checklist (see Appendix 2 for item descriptions). Legend: Black (overlap); Grey (uncertain overlap); White (no overlap)

Fig. 7

Overlap of items between CERT checklist and CONTENT scale (see Appendix 2 for item descriptions). Legend: Black (overlap); Grey (uncertain overlap); White (no overlap)