Understand the Evidence About Your Musculoskeletal Condition

With the ever-expanding internet, we can now learn much more about the condition or pain we are experiencing. It is far easier than going to a library with a specific question and searching through textbooks for the answer. Now, several well-chosen words, such as ‘frozen shoulder’ or ‘ACL’, will pull up loads of information. The quality of this information is the problem. There is no limitation on anyone, whether qualified or unqualified, to speak on the chosen topic, or to post, blog, or share articles and pictures on the subject you are searching for. One of the better sources of information is published literature. Because it has undergone the rigorous analysis required for publication, it is often a better source of information than blogs or web pages, where the writer's general thoughts prevail. Be careful when taking facts from an internet site. Check what their qualifications are and ensure that what you are reading comes from a source you hope to rely on.

How to Search the Internet for Information

It is helpful to limit where you search the internet for information. You can do this in any search engine, such as Google, by limiting your search to specific types of information.

A good example is to limit it to Google Scholar so you search only published literature, not the general internet. It can also be helpful to use specific search words to search for the correct topic you want to find out about. If you are not familiar with this, public libraries can help you learn how to perform this type of search. Once you know how, it will be easy next time.

Here Are Some of the Things to Look Out for When Reading Literature and Articles

1) Randomised Controlled Trials (RCTs): These are published trials that use a vigorous and thorough process during the research method to ensure that they try to limit the answer more specifically to the question they are trying to answer. They have to use methods that exclude the risk of bias in their research to ensure the answer they get is indeed what they set out to find. Unfortunately, there are several pitfalls to this type of data; some state they follow this design, but in cleverly worded answers, they have not. Another problem is that an RCT does not readily address some of the questions we want answered. Much physiotherapy research is challenging to fit into an RCT because of the nature of the question, so good research cannot always support what we think we know.

2) Systematic Reviews: These are published articles that look to analyse the outcome of many different published articles. They will ask a question, such as ‘What is the best graft for ACL repair?’, and then conduct a thorough search of all articles on this topic. A systematic review will then analyse the quality of this research, how it was conducted, the answers it found, and the risk of bias. It will then give you a proposed overview and answer to the question. This is a good way to gather a more rounded view of the topic. Look for systematic reviews first when checking for literature on your topic. Type a systematic review in with your few valid words, and this will generally bring up some answers.

3) Case studies: these come lower down then list of reliable evidence as they rely on just one patient or persons experience of the condition they are talking about. this is still useful when you have a base knowledge of the topic as you can pick up one or two things to look at further, for example, they may have mentioned a different assessment technique that you had not chosen to use yourself before that you would then consider. Overall, it is best not to place too much emphasis on any single scenario, as every individual is different. Until the bias has been removed and it has been shown that the same result would be found in many other people, it is hard to be confident in the result.

The Best Thing to Do When Reading Anything on the Internet Is to Think Carefully About Several Questions

1) Who wrote it? Do you believe their qualifications justify their ability to speak on the topic?

2) Can the statements or opinions be backed up with a quick literature search for published data?

3) How good is the published data?

The last thing to do is to look at well-established websites for the answer, where experienced and qualified clinicians have done the critiquing for you and posted the answers. Sites such as NICE and Cochrane. Always read with an element of suspicion, and think about what you are reading.

Should you be concerned about how you’re moving and walking, contact us now to help and get you going again – call +65 8088 1876

Written by

Leanne Plenge

Specialist MSK Physiotherapist