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Editorials
Growth in the Physiotherapy Evidence Database (PEDro) and use of the PEDro scale
  1. Mark R Elkins,
  2. Anne M Moseley,
  3. Catherine Sherrington,
  4. Robert D Herbert,
  5. Christopher G Maher
  1. The Centre for Evidence-Based Physiotherapy, The George Institute for Global Health, Sydney, New South Wales, Australia
  1. Correspondence to Dr Anne M Moseley, The Centre for Evidence-Based Physiotherapy, The George Institute for Global Health, PO Box M201, Missenden Road, Sydney, NSW 2050, Australia; pedro{at}georgeinstitute.org.au

https://doi.org/10.1136/bjsports-2012-091804

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    Physiotherapy Evidence Database

    In 2010, the British Journal of Sports Medicine (BJSM) published an editorial1 about the Physiotherapy Evidence Database (PEDro, www.pedro.org.au). The editorial described how this freely available bibliographic database directs users to high-quality evidence about the effects of physiotherapy interventions. The growth of PEDro to that time was also described; it was shown that the number of records on the database had doubled every 3.5 years. This exponential growth has continued, and PEDro now indexes reports of over 18 000 randomised trials and 3500 systematic reviews. Since that editorial, growth has occurred in other aspects of PEDro as well.

    Growth in accessibility of evidence

    For each article retrieved by a search of PEDro, users can access the title, abstract, citation details and, where available, a link to a full-text copy of the article. The range of links to full text has recently been expanded and PEDro now links to full-text versions of papers via PubMed Central, the Maastricht Centre for Evidence Based Physiotherapy, the digital object identifier, PubMed and the publisher. This expansion in the range of links to possible sources of the full-text article improves the likelihood that users can access the evidence they identify when searching PEDro. Access to full text through these links is often free of charge.

    Anyone who wishes to keep abreast of new evidence can now elect to receive a monthly update of the new records that have been added to PEDro. Updates can be limited to a particular subdiscipline. For example, BJSM readers may consider receiving updates of the new evidence available in the sports subdiscipline, which considers interventions as diverse as new exercise modalities in healthy and patient populations,2 ,3 injury treatment and prevention,4 ,5 interventions to promote recovery after exercise6 and educational interventions for athletes.7 Any of nine other subdisciplines can also be selected, including the newly created subdiscipline of oncology. This new subdiscipline may be of interest to readers of this journal because among the 623 oncology records, 259 investigate fitness training and 179 investigate strength training. In addition to updates within a particular subdiscipline, updates are available in the cross-discipline areas of chronic pain, neurotrauma and whiplash. There are four ways to be notified when these updates of PEDro occur: subscribe to really simple syndication feeds, subscribe to the PEDro email list or follow PEDro on Twitter or Facebook. These options are all free and links to activating them can be found on the Updates page of the PEDro website (www.pedro.org.au/english/updates).

    Growth in the use of PEDro: nearly 5000 queries per day

    There has also been growth in the use of PEDro. In 2008–2009, PEDro was used to answer an average of 2454 clinical questions each day (ie, a new search every 35 s). In 2011, PEDro was used to answer an average of 4858 clinical questions each day (ie, a new search every 18 s).

    In 2011, PEDro was used by people from 165 countries. The five countries with the highest usage were the USA (17%), Australia (14%), Brazil (12%), the Netherlands (5%) and Italy (4%). To facilitate greater international usage the website has now been made available in eight languages: Chinese, English, French, German, Italian, Japanese, Portuguese and Spanish. The homepage is currently being translated into Korean.

    PEDro is often searched as a source of trials for inclusion in systematic reviews. The number of systematic reviews indexed on the Cochrane Library that included a search of the PEDro database has increased exponentially over the past decade (figure 1).

    Figure 1
    Figure 1

    Cumulative number of systematic reviews indexed on the Cochrane Library that searched PEDro for eligible trials. List of systematic reviews downloaded on 1 August 2012.

    Many websites from around the world now link to PEDro. These websites include those of academic institutions, national physiotherapy associations, libraries and other databases, among many others. The number of links has grown to 26 825.

    Growth in use of the PEDro scale

    When reports of randomised trials are indexed on PEDro, their methodological quality is rated using the PEDro scale.8 When trial reports are retrieved by a search of PEDro, they are ordered by the number of criteria on the PEDro scale that they satisfy. Users can therefore readily identify those trials that are likely to provide the most valid estimates of the effects of an intervention.

    In the past few years the PEDro scale has undergone substantial psychometric validation8–15 and many systematic reviews use it to rate the quality of the trials they include. We have previously reported the proportion of systematic reviews of physiotherapy interventions that use the PEDro scale to rate trial quality.16 However, the PEDro scale is now also being used in systematic reviews of interventions in other areas including medicine,17 ,18 nutrition19 and speech pathology.20 Therefore, an analysis of growth in the use of the PEDro scale must now include other disciplines. Figure 2 shows the cumulative number of systematic reviews indexed on the Cochrane Library that use the PEDro scale to rate trial quality.

    Figure 2
    Figure 2

    Cumulative number of systematic reviews indexed on the Cochrane Library that used the PEDro scale to rate the quality of the included trials. List of systematic reviews downloaded on 16 July 2012.

    A training programme is available for people interested in learning to use the PEDro scale. To facilitate further use of the PEDro scale, the scale has been translated into five languages (Chinese, English, French, German and Portuguese) and the training programme has been translated into four languages (Chinese, English, German and Portuguese).

    In summary, improvements in the usability of PEDro and the accessibility of evidence that is identified by searching PEDro have occurred over the past decade. The use of PEDro continues to increase exponentially. The use of the PEDro scale has also increased. Usability of the PEDro scale has been improved by translations and psychometric validation. Clinicians and researchers may wish to take advantage of some of these improvements.

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    View Abstract

    Footnotes

    • Contributors All authors contributed to devising the content, AM and ME analysed the data, ME wrote the first draft and all authors revised the manuscript.

    • Funding PEDro is funded by the Motor Accidents Authority of New South Wales, the American Physical Therapy Association, the Australian Physiotherapy Association, the Motor Accident Insurance Commission (Queensland), the Victorian Transport Accident Commission (Australia), WorkCoverSA (Australia), the Norwegian Electronic Health Library, and the physiotherapy associations in the UK, Afghanistan, Austria, Bahamas, Belgium, Canada, Chile, Denmark, Fiji, Finland, Germany, Guatemala, Hong Kong, Ireland, Israel, Italy, Latvia, Lebanon, Lithuania, Luxembourg, Macau, Mexico, Namibia, Nepal, Netherlands, New Zealand, Norway, Pakistan, Philippines, Portugal, Saudi Arabia, Serbia, Singapore, Slovenia, Spain, Sri Lanka, Sweden, Switzerland, Taiwan and Thailand. CGM, CS and RH's research fellowships are funded by the National Health and Medical Research Council.

    • Competing interests None.

    • Provenance and peer review Commissioned; internally peer reviewed.

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