Contribution of the new rehabilitation definition to possibly improve related Cochrane Systematic Reviews

Session Type
Understanding and using evidence
BATTEL I1, Arienti C2, Levack W3, Kiekens C4, Negrini S1
1University of Milan, Italy
2IRCCS Fondazione Don Carlo Gnocchi, Italy
3University of Otago, New Zealand
4Cochrane Rehabilitation, Italy

Background: Cochrane Rehabilitation (CR) developed with all global relevant stakeholders a new rehabilitation definition (Table 1). The next step in the project was to understand its value in discerning rehabilitation studies from those that were not specifically rehabilitative.
Objectives: The aims were: 1) to assess if CSRs previously tagged as “rehabilitative” met the criteria outlined in the new definition of rehabilitation; to identify 2) major gaps in rehabilitation-relevant CSRs, and 3) in the definition itself
Methods: We analysed a sample of 124 CSRs tagged in the CR evidence database. The sample size was calculated with estimation of proportion. We planned a coding to identify the presence of each element of the definition using a nominal scale: Absence, Presence and Unclear. Two independent reviewers (senior and basic expertise) rated the sample of CSRs.
Results: The disagreement among raters was 33.8%. Most disagreements concerned the rating of "processs" (27%), "multimodal" (9%) and "person with disability" (15%) criteria. Eight (6.5%) CSRs met all criteria, and they were the ones that included all the contents of the "Intervention-General" macro-criterion of the definition. Three (2.4%) CSRs did not meet any of the criteria. Overall, "Intervention-General" had the highest prevalence of absence (74.2%) and unclear reporting (19.4%). "Person-centered," "multimodal," "process," "activity/participation," and "contextual factors" were the least reported and mostly unclear criteria of the sample (Table 2). We did not find information that could require updates of the current rehabilitation definition.
Conclusions: This study revealed that the framework of the new rehabilitation definition was a useful tool in identifying rehabilitative CSRs, although there were gaps, mostly in the reporting of "Intervention General". It seemed that CSRs regarding rehabilitation required specific criteria and a framework in order to address all the components of rehabilitation interventions.
Patient, public and/or healthcare consumer involvement:

Table 1.pdf