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Letters |

Alexander Technique Lessons or Acupuncture Sessions for Persons With Chronic Neck Pain FREE

Hugh MacPherson, BSc, on behalf of the ATLAS Project Team
[+] Article, Author, and Disclosure Information

From University of York, York, United Kingdom.

Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-0667.


Ann Intern Med. 2016;164(5):376. doi:10.7326/L15-0632
© 2016 American College of Physicians
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IN RESPONSE:

In our trial of Alexander Technique or acupuncture for chronic neck pain, we registered our primary outcome measure, the Northwick Park Neck Pain Questionnaire, and specified that it would be “measured at baseline, 3, 6 and 12 months” (1). Drysdale and colleagues incorrectly state that “3 primary outcomes (1 score at 3 time points) were prespecified.” In our protocol (2), published 2 years before the main trial results, we specified that the 12-month outcome on this questionnaire was our primary outcome end point. Hence, we reported that outcome as the primary end point in our article that provided the main results of our trial. Identifying the primary outcome in advance of analysis of the main trial results is important to avoid “cherry picking” trial outcomes, and this is what we did.

Of the 17 secondary prespecified outcome measures, all have been reported in the article or will be reported in secondary papers that are currently being prepared. These secondary papers will report on the as-yet unpublished outcomes that are part of our prespecified, mediator-based analyses that have been described in detail in our published protocol (2).

Although we support the CONSORT guidelines on best practice in trial reporting (3), we are concerned about the ambiguity of registry entry labelling and the scope for misinterpretation by researchers when entering data at the outset of a trial or by commentators, as has occurred here. For example, we perhaps naively assumed that we correctly completed our registry entry by entering not just the primary measure but also the time points at which we measured it. The registry entry does not ask for a primary end point. We likewise erred on the side of fully reporting all outcomes of secondary measures; however, as set out in our protocol (2), many of those measures were related to mediator-based analyses to be published in secondary papers.

Although we support the principles of COMPare, their Web site needs to provide a means of responding to limitations and inaccuracies in their reporting if their initiative is to succeed. Moreover, given the limited scope of registry entry data, we suggest that COMPare should review a trial's published protocol in tandem with its registry entry as part of their process.

References

The ATLAS neck pain trial. ISRTCN Registry. BioMed Central. 11 March 2015. Accessed at www.controlled-trials.com/ISRCTN15186354 on 25 January 2016.
 
MacPherson H, Tilbrook HE, Richmond SJ, Atkin K, Ballard K, Bland M, et al. Alexander Technique Lessons, Acupuncture Sessions or usual care for patients with chronic neck pain (ATLAS): study protocol for a randomised controlled trial. Trials. 2013; 14:209.
PubMed
CrossRef
 
Schulz KF, Altman DG, Moher D, CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010; 340:c332.
PubMed
CrossRef
 

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References

The ATLAS neck pain trial. ISRTCN Registry. BioMed Central. 11 March 2015. Accessed at www.controlled-trials.com/ISRCTN15186354 on 25 January 2016.
 
MacPherson H, Tilbrook HE, Richmond SJ, Atkin K, Ballard K, Bland M, et al. Alexander Technique Lessons, Acupuncture Sessions or usual care for patients with chronic neck pain (ATLAS): study protocol for a randomised controlled trial. Trials. 2013; 14:209.
PubMed
CrossRef
 
Schulz KF, Altman DG, Moher D, CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010; 340:c332.
PubMed
CrossRef
 

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