Questions
The following is a list of frequently asked questions about OTseeker.
If you can't find the answer to your question in this list, please go to the 'Contacts'
page for details of how to contact the OTseeker Project
Manager.
How were the trials contained in OTseeker located?
1) The trials in OTseeker were located by conducting systematic searches of the
following databases: Medline, CINAHL, ERIC, EMBASE Rehabilitation and Physical Medicine,
AMED, PsycINFO, the Cochrane Library, CancerLit, and Ageline.
2) Auto-alert strategies are in place for Medline, CINAHL, EMBASE, AMED and PsycINFO
and the OTseeker team is notified as new trials are added to these databases. Relevant
journals that are not indexed by these databases are hand-searched.
3) The staff of PEDro and the Rehabilitation and Related Field of the Cochrane Collaboration
kindly allowed the OTseeker team to search their respective databases for trials
that were appropriate to include in OTseeker.
4) The reference lists of systematic reviews in OTseeker are checked for trials
that could meet the OTseeker inclusion criteria.
5) Members of the OTseeker project team provided details of trials contained within
their personal collections.
What are the criteria for deciding if a trial becomes included on
OTseeker?
Clinical Trials
To be included in OTseeker, a trial must meet all of the following criteria:
§ Must involve comparison of at least two interventions
(either two interventions or one intervention and one no treatment / sham treatment
control). Crossover trials (where each participant receives more than one intervention)
included if other criteria are met.
§ The interventions could include (but need not
be limited to) treatments, prevention strategies, equipment, management or education
strategies.
§ At least one of the interventions must be currently
part of occupational therapy practice or could become part of occupational therapy
practice. It is not necessary for occupational therapists to have been involved
in the study.
§ The interventions should be applied to a) participants
who are representative of those to whom the intervention might be applied in the
course of occupational therapy practice or b) participants whose involvement helps
to establish the validity of the intervention.
§ The trial must have involved human participants.
§ The trial should involve random allocation
or intended-to-be random allocation of participants to interventions. Intended-to-be
random allocation refers to methods of allocation such as alternation (e.g. every
second patient), or allocation by odd and even birth dates or hospital record numbers.
§ Must be a full paper (not an abstract) in a
peer-reviewed journal.
Systematic Reviews
§ Systematic reviews of clinical trials are included
if they contain a Methods section and review at least one trial which satisfies
all of the above criteria for clinical trials.
What rating scale is used to rate the trials contained in OTseeker?
The PEDro scale (partitioned) is used to rate the trials
in OTseeker. The PEDro scale is used by PEDro, the Physiotherapy Evidence Database.
The PEDro scale is scored out of a total of 10. Although the same scale items are
used in the PEDro scale (partitioned), 2 subscores are presented instead of a total
score.
The PEDro scale (partitioned) considers two aspects of trial quality, namely the
"internal validity" (or "believability") of the trial and whether
the trial contains sufficient statistical information to make it interpretable ("statistical
reporting"). It does not rate the "meaningfulness" (or "generalisability"
or "external validity") of the trial, or the size of the treatment effect.
To assess internal validity we look for unambiguous confirmation of a number
of criteria, including random allocation, concealment of allocation, comparability
of groups at baseline, blinding of patients, therapists and assessors, analysis
by intention to treat and adequacy of follow-up. This gives a total of 8 items for
this aspect of the scale.
To assess statistical reporting we look for between-group statistical comparisons
and reports of both point estimates and measures of variability. This gives a total
of 2 for this aspect of the scale.
Trials are rated on the basis of what they report - if a trial does not report that
a particular criterion was met, it is scored as if the criterion was not met ('guilty
till proven innocent').
All but two of the PEDro scale (partitioned) items are based on the Delphi list,
developed by Verhagen and colleagues. The Delphi list is a list of trial characteristics
that was thought to be related to trial "quality" by a group of clinical
trial experts (for details see Verhagen et al, Journal of Clinical Epidemiology
51: 1235-41, 1998). The PEDro scale (partitioned) contains additional items on adequacy
of follow-up and between-group statistical comparisons. One item on the Delphi list
(the item on eligibility criteria) is related to external validity, so it does not
reflect the dimensions of quality assessed by the PEDro scale (partitioned). This
item is not used to calculate the scores that are displayed in the search results.
This item has, nevertheless, been retained so that all Delphi list items are represented
on the PEDro scale (partitioned).
Each trial is rated by two raters. If the ratings of the two raters differ, a third
rater rates the trial and resolves any disagreements. On the Detailed Search Results
page, the rating status of the trial will display 'This rating has not yet been
confirmed' if 1) only one rater has rated the trial so far or 2) there was disagreement
between the two raters and a third rater is yet to rate the trial. Once rating consensus
has been achieved, the rating status of the trial will display 'This rating has
been confirmed'.
Systematic reviews are not rated and N/A (meaning 'not applicable') is displayed
in the score columns on the search results page.
One of the trial raters is one of the two OTseeker project managers, based at the
University of Queensland. The other rater is based at the University of Western
Sydney and is an occupational therapist employed by the OTseeker team. A member
of the OTseeker project team performs the third rating of a trial when this is required.
All raters have undergone training in the use of PEDro scale (partitioned).
A study that examines the reliability of the PEDro scale (partitioned) is being
planned and will be conducted in 2003.
What happens if I disagree with the rating of a trial?
If you disagree with the rating of a trial that is contained in OTseeker, please
send the OTseeker Project Manager details of the trial (author/s, title, journal
title, volume, issue and page numbers) in question, along with details about the
aspect of the rating you disagree with and the reason why. We will reassess all
trials that have a disputed rating.
What can I do if I know of a trial or systematic review that is not
in OTseeker?
If you know of a trial or systematic review that is not currently in OTseeker please
contact us. Before you do so though, please check that the trial meets the OTseeker
criteria (these are listed towards the top of this page). If the trial does meet
these criteria, please send us either a copy of the trial or details about the trial
(author/s, title, journal title, volume, issue, page numbers) so that we can locate
it.
If you are the author of a trial or systematic review that you believe should be
in OTseeker, we would appreciate a reprint of the trial. Contact details are located
on the Contacts page of this website.
What can I do if I find an indexing error in a trial or systematic
error in OTseeker?
If you find an indexing error (such as incorrect page numbers, volume number or
spelling errors) in a trial contained in OTseeker please let us know. The easiest
way for you to do this is to copy and paste the complete record from the 'Detailed
Search Results' page into the email message and send it to us. Go to the
Contacts page to send us an email.
Why aren't the abstracts of all trials displayed?
We are unable to display the abstract of a trial or systematic review until the
journal that it is published in, or the publisher of the journal, grants us copyright
permission to do so. As OTseeker was only launched in 2003, there are many journals
and publishers that we are yet to contact to request copyright permission. Therefore,
the number of trials and systematic reviews for which we are able to display the
abstracts will increase over time as we establish agreements with more journals
and publishers.
How often is the OTseeker database updated?
The OTseeker database is continually updated as new trials are located. New trials
are added approximately every week. The staff of OTseeker are currently retrieving
and rating a large backlog of trials and the number of trials in the OTseeker database
will increase substantially over the next few months. The date on which the database
was last updated is displayed at the bottom of the search page.
How were the definitions for the categories in the 'Intervention'
search option decided?
The following sources were consulted when deciding the categories of interventions
and subdisciplines to be used as search terms for the OTseeker search page: Medical
Subject Headings (MeSH), major databases relevant to occupational therapy, the Wilma
L West Library, seminal textbooks, and consultation with academics and clinicians.
Terms were chosen if they enhanced search functionality and were representative
of key terms relevant to occupational therapy.
The definitions were decided after discussion by members of the OTseeker team. They
are not intended to be perceived as definitive. They are simply provided to assist
with conducting searches in OTseeker.
While we believe that occupation is at the centre of occupational therapy philosophy,
in order to enable targeted searching, we have incorporated performance areas into
our intervention search categories.
Why are there only randomised controlled trials and Systematic Reviews
on this database?
The OTseeker team has decided to initially provide a comprehensive database of research
that most commonly (but not always) provides evidence about the effectiveness or
ineffectiveness of interventions. The methodology of systematic reviews and randomised
controlled trials (RCTs) minimises the potential for bias and in many cases has
stronger internal validity than other research methodologies. For more information
about this see the tutorial. However, just because a
study is an RCT, doesn't mean the conclusions are believable, hence the benefit
of a rating scale to act as a guide for how certain you can be that an intervention
is effective. We recognise some of the limitations of RCTs in occupational therapy
and will seek to add other types of research at a later date, funding permitting.
This database is simply a tool to enable fast access to high quality research to
inform treatment decisions and assist your clinical reasoning.
Why are there some articles contained in OTseeker that don't seem
to be directly relevant to the roles an occupational therapist may perform?
The OTseeker team has sought to be inclusive when deciding what articles should
be contained in the database. This is for two reasons. Firstly, occupational therapists
working in remote regions may be required to adopt roles broader than those of their
metropolitan colleagues. Secondly, as therapists anywhere in the world may access
OTseeker we acknowledge that occupational therapy may have a different scope or
emphasis depending on where they work. We have consulted widely about the decision
to include or exclude entries in the database, but we acknowledge that sometimes
these decisions are arbitrary.
This page was last updated in March 2003.