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The TIDieR Checklist Will Benefit the Physical Therapy Profession

Tiê Yamato, Chris Maher, Bruno Saragiotto, Anne Moseley, Tammy Hoffmann, Mark Elkins, Alan Jette
DOI: 10.2522/ptj.2016.96.7.930 Published 1 July 2016
Tiê Yamato
T. Yamato, PT, MSc, Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia.
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Chris Maher
C. Maher, PT, PhD, Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia.
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Bruno Saragiotto
B. Saragiotto, PT, MSc, Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia.
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Anne Moseley
A. Moseley, PT, PhD, Musculoskeletal Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Australia.
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Tammy Hoffmann
T. Hoffman, PhD, Centre for Research in Evidence Based Practice, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia.
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Mark Elkins
M. Elkins, PT, PhD, Chair of the International Society of Physiotherapy Journals, and Editor in Chief of the Journal of Physiotherapy.
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Alan Jette
A. Jette, PT, PhD, Editor in Chief of Physical Therapy (PTJ).
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Evidence-based practice involves physical therapists incorporating high-quality clinical research on treatment efficacy into their clinical decision-making.1 However, if clinical interventions are not adequately reported in the literature, physical therapists face an important barrier to using effective interventions for their patients. Previous studies have reported that incomplete description of interventions is a problem in reports of randomized controlled trials in many health areas.2–4 One of these studies examined 133 trials of nonpharmacological interventions.4 The experimental intervention was inadequately described in over 60% of the trials, and descriptions of the control interventions were even worse.

A recent study5 evaluated the completeness of descriptions of the physical therapist interventions in a sample of 200 randomized controlled trials published in 2013. Overall, the interventions were poorly described. For the intervention groups, about one quarter of the trials did not fulfill at least half of the criteria. Reporting for the control groups was even worse, with around three quarters of trials not fulfilling at least half of the criteria. In other words, for the majority of the physical therapy trials, clinicians and researchers would be unable to replicate the interventions that were tested.

Describing a treatment may seem like a simple task, but physical therapist interventions can be very complex. Some interventions are multimodal, involving the use of manual techniques, consumable materials, equipment, education, training, and feedback. Some interventions are tailored to each patient's specific health state, including the patient's immediate response to the application of the treatment. When the intervention involves a course of treatments, the intensity or dose may be progressed over time. The descriptions of physical therapist interventions in trial reports often do not capture all these components of the interventions or detail their complexity.

If researchers fail to comprehensively report all aspects of the interventions, the trial results cannot be incorporated into clinical practice or the intervention could be implemented incorrectly. Incorrect implementation may make the treatment ineffective, wasting the clinician's and patient's time and health care resources. Inadequate reporting of interventions also poses a barrier to incorporating a trial's results into secondary research such as systematic reviews and clinical practice guidelines, as well as the usability of these resources. This means that the resources that were invested in undertaking the trial have been wasted. Such resources are extensive, including direct trial costs (eg, payment of researchers, consumables), use of infrastructure (eg, clinic space, equipment), human resources (eg, ethics committee review, granting body review), and the goodwill of patients who agree to participate. Currently, there is a growing realization that we need strategies to reduce waste in clinical research.6 When the list of resources involved in a single study is considered, improving the reproducibility of interventions through better reporting could markedly reduce waste in research.7

The TIDieR (Template for Intervention Description and Replication) checklist and guide were developed to improve the reporting of interventions in any evaluative study, including randomized trials.8 The checklist contains 12 items and was developed as an extension to the CONSORT 20109 and SPIRIT 201310 statements to provide further guidance for authors on the key information to include in trial reports. TIDieR items include: name of the intervention; intervention rationale for essential elements; intervention materials and details about how to access them; description of the intervention procedures; details of intervention providers; mode of delivery of intervention; location of intervention delivery and key infrastructure; details about the number, duration, intensity and dose of intervention sessions; details of any intervention tailoring; any intervention modifications throughout the study; and details of intervention fidelity assessment, monitoring and level achieved.

The TIDieR checklist will help improve the quality of intervention reporting more if it is used not only by study authors, but also by journal editors, peer reviewers, ethics committees, and funding agencies. A copy of the checklist is available at http://www.equator-network.org/reporting-guidelines/tidier/.

In summary, incomplete reporting of interventions in physical therapy studies is an important problem, and we endorse the use of the TIDieR checklist as a potential solution. The responsibility for improving intervention reporting extends beyond the authors of individual trials to journal editors and others who can mandate the use of the TIDieR checklist to combat this problem. Mandating the use of the TIDieR checklist would guide authors to describe their interventions better and, consequently, help clinicians to use the interventions and researchers to synthesise and replicate the evidence.

At PTJ, the TIDieR statement has already been incorporated into editorial policy. Submitting authors are required to complete the checklist at the time of submission of a manuscript that describes any study that involves the delivery of an intervention. Authors can download a copy of the TIDieR checklist here: http://www.equator-network.org/wp-content/uploads/2014/03/TIDieR-Checklist-PDF.pdf. Reviewers are encouraged to confirm that the items on the checklist are adequately reported. The journal's editorial team also checks that the items on the TIDieR checklist are adequately reported. Submitting authors with questions about the checklist are invited to contact PTJ's editorial team at ptjourn{at}apta.org.

Acknowledgment of Co-Publication

DOI of original article: http://dx.doi.org/10.1016/j.jphys.2016.02.015

The editorial was originally published in 2016 in Journal of Physiotherapy; however, this version contains a modified author list and amendments to the description about PTJ's incorporation of the TIDieR checklist into its manuscript processing. The editorial is republished with the kind permission of the Australian Physiotherapy Association. For citation purposes, please use the original publication details: Yamato T, Maher, C, Saragiotto B, et al. The TIDieR checklist will benefit the physical therapy profession. J Physiother. 2016;62:57–58.

  • © 2016 American Physical Therapy Association

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Vol 96 Issue 7 Table of Contents
Physical Therapy: 96 (7)

Issue highlights

  • The TIDieR Checklist Will Benefit the Physical Therapy Profession
  • The Single-Case Reporting Guideline In BEhavioural Interventions (SCRIBE) 2016 Statement
  • National Profile of Physical Therapists in Critical Care Units of Sri Lanka: Lower Middle-Income Country
  • Raising the Priority of Lifestyle-Related Noncommunicable Diseases in Physical Therapy Curricula
  • Physical Therapy Residency and Fellowship Education: Reflections on the Past, Present, and Future
  • Prognostic Models in Adults Undergoing Physical Therapy for Rotator Cuff Disorders: Systematic Review
  • Disability Trajectories in Patients With Complaints of Arm, Neck, and Shoulder (CANS) in Primary Care: Prospective Cohort Study
  • Locomotor Performance During Rehabilitation of People With Lower Limb Amputation and Prosthetic Nonuse 12 Months After Discharge
  • Physical Therapists' Use of Functional Electrical Stimulation for Clients With Stroke: Frequency, Barriers, and Facilitators
  • Improving Shoulder Kinematics in Individuals With Paraplegia: Comparison Across Circuit Resistance Training Exercises and Modifications in Hand Position
  • Concussion Attitudes and Beliefs, Knowledge, and Clinical Practice: Survey of Physical Therapists
  • Dietary Protein Intake and Lean Muscle Mass in Survivors of Childhood Acute Lymphoblastic Leukemia: Report From the St. Jude Lifetime Cohort Study
  • Problems, Solutions, and Strategies Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews
  • Comparative Associations of Working Memory and Pain Catastrophizing With Chronic Low Back Pain Intensity
  • Treatment-Based Classification System for Low Back Pain: Revision and Update
  • Interdisciplinary Management of Complex Regional Pain Syndrome of the Face
  • Comparison of Self-report and Performance-Based Balance Measures for Predicting Recurrent Falls in People With Parkinson Disease: Cohort Study
  • Therapists' Perceptions of Application and Implementation of AM-PAC “6-Clicks” Functional Measures in Acute Care: Qualitative Study
  • Highlight
  • Alberta Infant Motor Scale (AIMS) Performance of Greek Preterm Infants: Comparisons With Full-Term Infants of the Same Nationality and Impact of Prematurity-Related Morbidity Factors
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The TIDieR Checklist Will Benefit the Physical Therapy Profession
Tiê Yamato, Chris Maher, Bruno Saragiotto, Anne Moseley, Tammy Hoffmann, Mark Elkins, Alan Jette
Physical Therapy Jul 2016, 96 (7) 930-931; DOI: 10.2522/ptj.2016.96.7.930

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The TIDieR Checklist Will Benefit the Physical Therapy Profession
Tiê Yamato, Chris Maher, Bruno Saragiotto, Anne Moseley, Tammy Hoffmann, Mark Elkins, Alan Jette
Physical Therapy Jul 2016, 96 (7) 930-931; DOI: 10.2522/ptj.2016.96.7.930
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