Due to the ever expanding internet we are now able to find out so much more about a condition or pain that we are experiencing. it is far easier than the days of having to go to a library with a specific question and searching through text books for the answer. Now, several well chosen words such as ‘frozen shoulder’ or ‘ACL’ will pull up loads of information. the quality of this information is the problem. There is no limitation on anyone, however qualified or unqualified to speak on the chosen topic, putting up posts, blogs, articles and pictures on the topic you are searching. Often one of the better sources of information are published literature. The very fact that it has gone through the rigorous analysis needed in order to gain publication means that often it is a better source of information than blogs or internet pages where it is the general thought of the writer. Be careful when taking fact from an internet site. check what their qualifications are and ensure that what you are reading comes from a source you hope to rely on.
How to search the internet for information:
It is useful to limit where you search the internet for information. You can do this in any search engine such as google by choosing only to search in certain types of information.
A good example is to limit it to google scholar so that you only search published literature articles and not the general internet. It can also be useful to use specific search words to search for the correct topic you want to find out about. If you are not familiar with this then public libraries can help you to learn how to perform this type of search and once you know how it is easy for the next time.
Here are some of the things to look out for when reading literature and articles:
1) Randomised Controlled Trials (RCT’s): These are published trials that use a vigorous and thorough process during the research method in order to ensure that they try to limit the answer more specifically to the question they are trying to answer. they have to use methods that exclude the risk of bias in their research to ensure the answer they get is indeed what they set out to find. unfortunately, there are several pitfalls to this type of data; some state they follow this design but in cleverly worded answers they have not. another problem is that some questions that we want the answer to are not easily answered with an RCT design. lots of physiotherapy research is tricky to fit into an RCT due to the nature of the question and so good research cannot always back up what we think we know.
2) Systematic Reviews: these are published articles that look to analyse the outcome of many different published articles. they will ask a question such as ‘what is the best graft for ACL repair?’ and then do a through search to look for all the articles published on this topic. a Systematic review will then analyse the quality of this research and how it was put together, the answers they found and risk of bias. it will then give you a proposed overview and answer to the question. this is a good way of gathering a more rounded view on the topic. look for systematic reviews first when checking for literature on your topic. type systematic review in with your few useful words and this will normally bring up some answers.
3) Case studies: these come lower down then list of reliable evidence as they rely on just one patient or persons experience of the condition they are talking about. this is still useful when you have a base knowledge of the topic as you can pick up one or two things to look at further, for example, they may have mentioned a different assessment technique that you had not chosen to use yourself before that you would then consider. on the whole it is best not to put too much emphasis on single scenarios such as this as every individual is different and until the bias has been removed and it has been shown that the same result would be found in many other people, it is hard to be confident in the result.
The best thing to do when reading anything on the internet is to think carefully about several questions:
1) Who wrote it? do you believe their qualifications justify their ability to speak on the topic?
2) Can the statements or opinions be backed up with a quick literature search for published data?
3) How good is the published data?
The last thing to do is to look on well established websites for the answer, where experienced and qualified clinicians have done the critiquing for you and put up the answers. Sites such as NICE and Cochrane. Always read with an element of suspicion, thin about what you are reading.
Should you be concerned about how you’re moving and walking, contact us now help and get you going again – call 0207 884 0474
Written by Leanne Plenge
Specialist MSK Physiotherapist