OTseeker - Occupational Therapy Systematic Evaluation of Evidence

Frequently Asked 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.
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What are the criteria for deciding if a trial becomes included on OTseeker?

Randomised Controlled 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 randomised controlled  trials.

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What rating scale is used to rate the trials contained in OTseeker?

The PEDro scale (partitioned) has been used to rate the trials in OTseeker up until the end of June 2013. The PEDro scale was developed by members of the team who developed PEDro - the Physiotherapy Evidence Database. The PEDro scale includes 10 items. OTseeker has separated the PEDro scale into two concepts:  1) internal validity (8 items) and 2) statistical reporting (2 items), due to the different natures of these concepts. The scale used in OTseeker is therefore referred to as the PEDro scale (partitioned). 

The PEDro scale (partitioned) considers two aspects of each trial, namely the "internal validity" (or "risk of bias") 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 8 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. For each trial, OTseeker indicates which of these criteria have been met. The best interpretation of the information provided is to consider the potential impact the presence or absence of these features might have on the trial, rather than relying on the number of items met.

To assess statistical reporting we look for 2 criteria including between-group statistical comparisons and reports of both point estimates and measures of variability.

These criteria 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. This item is reported on separately to the PEDro scale (partitioned) in OTseeker.

The criteria for each trial are rated by two raters independently of each other. 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'. Some trials on OTseeker have not been rated and this is indicated by ‘rating not available’.

Ratings are undertaken by members of the OTseeker team and/or research research assistants. All raters have undergone training in the use of PEDro scale (partitioned). A study that examines the reliability of the PEDro scale (partitioned) found good inter-rater reliability.

Tooth, L., Bennett, S., McCluskey, A., Hoffmann, T., McKenna, K., & Lovarini, M. (2005). Appraising the quality of randomized controlled trials: Inter-rater reliability for the OTseeker evidence database. Journal of Evaluation in Clinical Practice, 11, 547-555.

Systematic reviews are not rated as such but need to meet minimum criteria to be included. Systematic reviews of clinical trials are included if they contain a Methods section and review at least one randomised controlled trial (which meets the criteria for inclusion in OTseeker).

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Why are ratings of randomised controlled trials published up to June 2013 available?

In 2003 when OTseeker was first launched there were only 1,400 articles indexed in OTseeker. By 2013 there were 10,000. Given the rapid increase in the number of randomised controlled trials being published relevant to occupational therapy, in the future it will not be possible for the OTseeker team to rate all new trials that are entered into the database. However, we will seek to provide enhanced resources for therapists to be able to rate trials themselves and provide ratings for some trials where possible.

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What happens if I disagree with the rating of criteria of a trial?

If you disagree with the rating of criteria 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.

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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.

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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.

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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.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.

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How often is the OTseeker database updated?

The OTseeker database is continually updated as new trials and systematic reviews are located. New content is added approximately every month. The date on which the database was last updated is displayed at the bottom of the search page.

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How were the descriptions for the categories in the 'Intervention' search option derived?

Each article indexed in OTseeker is coded according to intervention categories relevant to occupational therapy as well as diagnostic categories. 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.

Descriptions of interventions can be found by clicking here. They 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.

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What type of research is contained in OTseeker?

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 you can believe the results of a trial. 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.

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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. OTseeker therefore contains research relevant to occupational therapy rather than just research specifically involving occupational therapy.

This page was last updated in June 2013.