[ARTICLE] Asking New Questions with Old Data: The Centralized Open-Access Rehabilitation Database for Stroke

Abstract

Background: This paper introduces a tool for streamlining data integration in rehabilitation science, the Centralized Open-Access Rehabilitation database for Stroke (SCOAR), which allows researchers to quickly visualize relationships among variables, efficiently share data, generate hypotheses, and enhance clinical trial design. Methods: Bibliographic databases were searched according to inclusion criteria leaving 2,892 titles that were further screened to 514 manuscripts to be screened by full text, leaving 215 randomized controlled trials in the database (489 independent groups representing 12,847 patients). Demographic, methodological, and statistical data were extracted by independent coders and entered into SCOAR. Results: Trial data came from 114 locations in 27 different countries and represented patients with a wide range of ages, 62 yr [41; 85], (shown as median [range]) and at various stages of recovery following their stroke, 141 d [1; 3372]. There was considerable variation in the dose of therapy that patients received, 20 h [0; 221], over interventions of different durations, 28 d [10; 365]. There was also a lack of common data elements (CDEs) across trials, but this lack of CDEs was most pronounced for baseline assessments of patient impairment and severity of stroke. Conclusions: Data integration across hundreds of RCTs allows clinicians and researchers to quickly visualize data from the history of the field and lays the foundation for making SCOAR a living database to which researchers can upload new data as trial results are published. SCOAR is a useful tool for clinicians and researchers that will facilitate data visualization, data sharing, the finding of relevant past studies, and the design of clinical trials by enabling more accurate and comprehensive power analyses. Furthermore, these data speak to the need for CDEs specific to stroke rehabilitation in randomized controlled trials.

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Figure 1. PRISMA Flow diagram showing the manuscript screening process. At the eligibility assessment, manuscripts were excluded if the population was not stroke, there was no random assignment to at least two different groups, if the intervention did not meet our population, intervention, control, and outcome criteria, if the outcomes were not a clinical measure of function/impairment, if no full text of manuscript was available (e.g., restricted access or the text only existed in abstract form), if the data in the manuscript came from a larger study/reanalysis of a study that was already in the database, if the manuscript was a review, commentary, or a trial protocol (rather than a trial itself), or if it was not clear how the study related to an existing study in the database (i.e., possibly the same patients being analyzed twice; coded as “other”).