Risk of bias in chiropractic mixed methods research: a secondary analysis of a meta-epidemiological review

Peter C Emary; Kent J Stuber; Lawrence Mbuagbaw; Mark Oremus; Paul S Nolet; Jennifer V Nash; Craig A Bauman; Carla Ciraco; Rachel J Couban; Jason W Busse

Risk of bias in chiropractic mixed methods research: a secondary analysis of a meta-epidemiological review

J Can Chiropr Assoc. 2022 Apr;66(1):7-20.

Authors

Peter C Emary^{1

2

3}, Kent J Stuber⁴, Lawrence Mbuagbaw^{1

5

6

7}, Mark Oremus^{1

8}, Paul S Nolet^{4

9}, Jennifer V Nash¹⁰, Craig A Bauman^{11

12}, Carla Ciraco², Rachel J Couban¹³, Jason W Busse^{1

10

13

14}

Affiliations

¹ Department of Health Research Methods, Evidence and Impact, McMaster University.
² Chiropractic Department, D'Youville University.
³ Private Practice.
⁴ Department of Graduate Education and Research, Canadian Memorial Chiropractic College.
⁵ Biostatistics Unit, Father Sean O'Sullivan Research Centre, St. Joseph's Healthcare-Hamilton.
⁶ Centre for the Development of Best Practices in Health, Yaundé, Cameroon.
⁷ Division of Global Health, Stellenbosch University, South Africa.
⁸ School of Public Health Sciences, University of Waterloo.
⁹ Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands.
¹⁰ Department of Anesthesia, McMaster University.
¹¹ Department of Family Medicine, McMaster University.
¹² The Centre for Family Medicine Family Health Team, Kitchener, Ontario.
¹³ Michael G. DeGroote National Pain Centre, McMaster University, Hamilton, Ontario, Canada.
¹⁴ Chronic Pain Centre of Excellence for Canadian Veterans, Hamilton, Ontario, Canada.

PMID: 35655699
PMCID: PMC9103633

Abstract
in English, French

Objective: To examine the risk of bias in chiropractic mixed methods research.

Methods: We performed a secondary analysis of a meta-epidemiological review of chiropractic mixed methods studies. We assessed risk of bias with the Mixed Methods Appraisal Tool (MMAT) and used generalized estimating equations to explore factors associated with risk of bias.

Results: Among 55 eligible studies, a mean of 62% (6.8 [2.3]/11) of MMAT items were fulfilled. In our adjusted analysis, studies published since 2010 versus pre-2010 (adjusted odds ratio [aOR] = 2.26; 95% confidence interval [CI], 1.39 to 3.68) and those published in journals with an impact factor versus no impact factor (aOR = 2.21; 95% CI, 1.33 to 3.68) were associated with lower risk of bias.

Conclusion: Our findings suggest opportunities for improvement in the quality of conduct among published chiropractic mixed methods studies. Author compliance with the MMAT criteria may reduce methodological bias in future mixed methods research.

Objectif: examiner le risque de biais dans la recherche sur les méthodes mixtes chiropratiques.

Méthodologie: nous avons effectué une analyse secondaire d’un examen méta-épidémiologique d’études de méthodes mixtes chiropratiques. Nous avons examiné le risque de biais avec The Mixed Methods Appraisal Tool, MMAT (l’outil d’évaluation des méthodes mixtes), et utilisé des équations d’estimation généralisées pour explorer les facteurs associés au risque de biais.

Résultats: parmi 55 études admissibles, une moyenne de 62 % (6,8 [2,3]/11) des items du MMAT ont été remplis. Dans notre analyse ajustée, les études publiées depuis 2010 versus celles d’avant 2010 (rapport de cotes [aOR] ajusté = 2,26; intervalle de confiance [IC] à 95 %, 1,39 à 3,68), et celles publiées dans des revues avec un indice de citations versus aucun indice de citations (aOR = 2,21; IC à 95 %, 1,33 à 3,68) étaient associées à un risque de biais plus faible.

Conclusion: nos résultats suggèrent des opportunités d’amélioration de la qualité de la conduite parmi les études publiées sur les méthodes mixtes chiropratiques. La conformité des auteurs aux critères MMAT peut réduire les biais méthodologiques dans les futures recherches sur les méthodes mixtes.

Keywords: chiropractic; methodological review; mixed methods research; risk of bias.

Abstract in English, French

Abstract
in English, French