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MRC
Health Services
Research Collaboration, Department of Social Medicine, University of
Bristol
Correspondence to: Mr Jiri Chard, MRCHealth Services Research Collaboration,
Department of Social Medicine, University of Bristol, Whiteladies Road,
Bristol BS8 2PR, UK
Email: j.a.chard{at}bristol.ac.uk
Accepted for publication 10 January 2000
OBJECTIVETo assess
the published research base for interventions for osteoarthritis of
the knee, and to identify areas in need of further research.
METHODSLiterature
searches were conducted on electronic databases (Medline, Embase, ISI,
and Cochrane library), bibliographies of existing review articles were
hand searched, and a postal questionnaire was sent to members of the
Osteoarthritis Research Society International. All relevant articles
were copied and searched for treatment type, study methodology,
statistical results, conclusions, funding source, researcher
affiliations, and year of publication, using a predetermined data
extraction form.
RESULTSThere
have been marked changes in the literature over the period studied
(1950-98), with a recent rise in trials of physical therapy,
educational interventions, and complementary treatments. However,
overall, most research was either drug (59.1%) or surgically (25.6%)
related. Most of the studies reported positive results (94%). Research
on oral drugs was significantly more likely to provide a positive
result than research on any other intervention (p<0.001 by
2 test). Commercially funded studies were significantly
more likely to produce a positive result than non-commercially funded
research (p=0.0027 by 2 test).
CONCLUSIONSAnalysis
of time trends indicates that the research agenda does shadow changes
in consumer demands. However, there are significant gaps in the
research base that need to be considered.
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