Joanna Diong

This is the first study to estimate the effect of proprioception on upper-limb function across the lifespan within an explicitly defined causal framework. Specifically, we investigated whether deficits in low-level proprioceptive judgements (made within a single frame of reference) or high-level proprioceptive judgements (made between frames of reference) impair upper-limb function across the lifespan. We provide novel evidence that imprecise high-level proprioceptive judgements impair an everyday upper-limb functional task, with this relationship strengthening with age.

Spinal cord stimulation is an emerging treatment in spinal cord injury and chronic low back pain. This scoping review aimed to identify and consolidate key criteria for rigor, transparency and reproducibility across reporting guidelines for research on spinal cord stimulation, and ensure all relevant criteria are captured, as a first step to identify and evaluate broader strategies for good research practices. Findings were used to to refine mechanisms for rigor, transparency and reproducibility in a causal graph. Four databases were searched from inception to 12 September 2024, and monitored through weekly article alerts up till 29 November 2024. Reviewers independently assessed articles for inclusion if they were (1) standards, guidelines, recommendations, or statements for research on humans, (2) on rigor, transparency and reproducibility, in stimulation or neuromodulation, and (3) written in English. The following data were extracted and synthesized: stimulation type, clinical area, type of responsible practice, and article text on responsible practice. Differences between reviewers were resolved by consensus, and findings used to refine the causal graph. Eleven articles of the following types were included: formal reporting guidelines, standards or checklists (n = 6), general recommendations (n = 4) or systematic review (n = 1). Data were synthesized and used to refine the initial causal graph. The nodes Reporting of experimental conditions , Protocol registration , and Open science practices were unchanged. The node Reporting study design to minimize bias was refined as Reporting study, participant, and investigator characteristics ; the node Reporting stimulation parameters was refined as Reporting stimulation configuration and parameters; and the new node Reporting adverse events was added. The responsible reporting of spinal cord stimulation research should also explicitly include study, participant and investigator characteristics, stimulation configuration and parameters, and adverse events.

The relationship between proprioceptive ability and physical function is commonly assessed in people with stroke, Parkinson’s disease, and multiple sclerosis to investigate the etiology of functional deficits. The primary aim of this systematic review was to evaluate the magnitude of this association. We also investigated whether the magnitude of these associations was influenced by 1) study sample size, 2) the pairing of body regions targeted by assessments of proprioceptive ability and physical function, 3) the proprioceptive sense assessed, and 4) the type of proprioceptive assessment (low-level proprioception; high-level proprioception). A total of 56 studies reporting 438 measures of association were included. The magnitude of the associations ranged from −0.31 to 0.93 ( r and ρ), with 92% being positive (better proprioceptive ability associated with better physical function). Study sample size, pairing of assessments, and type of low-level proprioceptive assessment (detect, discriminate, match) did not systematically influence the direction or magnitude of the associations. Ninety-seven percent of assessments focused on low-level proprioception and kinesthesia (position and movement sense). When studies discussed their measures of association, 50% used language that implied causality. Despite a detailed breakdown of measures of association, no clear pattern emerged regarding the link between proprioceptive ability and physical function. Future studies in people with stroke, Parkinson’s disease, and multiple sclerosis should 1) move away from simple measures of association to infer causation given that several interrelated and potentially confounding deficits coexist, and 2) assess various aspects of proprioception, including high-level proprioception, as they differentially contribute to physical function.

Randomised controlled trials are the gold standard design to obtain knowledge of causal effects of treatments. However, not all causal questions can be answered by randomised trials for practical or ethical reasons. Target trial emulation is a conceptual framework and set of analysis methods to obtain knowledge of causal effects of treatments using observational data, and is particularly valuable when randomised trials are not feasible. In this Perspective, we outline the concepts and application of target trial emulation, showing how it can be used to minimise bias due to confounding at baseline and over the course of sustained treatments, and how causal per-protocol analysis can be performed to provide informative yet unbiased estimates of treatment effects. We summarise a recent target trial emulation that examined the effects of intensity of early rehabilitation for hip fracture on performance in activities of daily living as a worked example. We encourage investigators to explore the target trial framework, and apply it to answer causal questions when using observational data.

Sound reporting of research results is fundamental to good science. Unfortunately, poor reporting is common and does not improve with editorial educational strategies. We investigated whether publicly highlighting poor reporting at a journal can lead to improved reporting practices. We also investigated whether reporting practices that are required or strongly encouraged in journal Information for Authors are enforced by journal editors and staff. A 2016 audit highlighted poor reporting practices in the Journal of Neurophysiology. In August 2016 and 2018, the American Physiological Society updated the Information for Authors, which included the introduction of several required or strongly encouraged reporting practices. We audited Journal of Neurophysiology papers published in 2019 and 2020 (downloaded through the library of the University of New South Wales) on reporting items selected from the 2016 audit, the newly introduced reporting practices, and items from previous audits. Summary statistics (means, counts) were used to summarize audit results. In total, 580 papers were audited. Compared to results from the 2016 audit, several reporting practices remained unchanged or worsened. For example, 60% of papers erroneously reported standard errors of the mean, 23% of papers included undefined measures of variability, 40% of papers failed to define a statistical threshold for their tests, and when present, 64% of papers with p-values between 0.05 and 0.1 misinterpreted them as statistical trends. As for the newly introduced reporting practices, required practices were consistently adhered to by 34 to 37% of papers, while strongly encouraged practices were consistently adhered to by 9 to 26% of papers. Adherence to the other audited reporting practices was comparable to our previous audits. Publicly highlighting poor reporting practices did little to improve research reporting. Similarly, requiring or strongly encouraging reporting practices was only partly effective. Although the present audit focused on a single journal, this is likely not an isolated case. Stronger, more strategic measures are required to improve poor research reporting.

Background: This study aimed to investigate how strongly Australian university codes of research conduct endorse responsible research practices.Methods: Codes of research conduct from 25 Australian universities active in health and medical research were obtained from public websites, and audited against 19 questions to assess how strongly they (1) defined research integrity, research quality, and research misconduct, (2) required research to be approved by an appropriate ethics committee, (3) endorsed 9 responsible research practices, and (4) discouraged 5 questionable research practices.Results: Overall, a median of 10 (IQR 9 to 12) of 19 practices covered in the questions were mentioned, weakly endorsed, or strongly endorsed. Five to 8 of 9 responsible research practices were mentioned, weakly, or strongly endorsed, and 3 questionable research practices were discouraged. Results are stratified by Group of Eight (n = 8) and other (n = 17) universities. Specifically, (1) 6 (75%) Group of Eight and 11 (65%) other codes of research conduct defined research integrity, 4 (50%) and 8 (47%) defined research quality, and 7 (88%) and 16 (94%) defined research misconduct. (2) All codes required ethics approval for human and animal research. (3) All codes required conflicts of interest to be declared, but there was variability in how strongly other research practices were endorsed. The most commonly endorsed practices were ensuring researcher training in research integrity [8 (100%) and 16 (94%)] and making study data publicly available [6 (75%) and 12 (71%)]. The least commonly endorsed practices were making analysis code publicly available [0 (0%) and 0 (0%)] and registering analysis protocols [0 (0%) and 1 (6%)]. (4) Most codes discouraged fabricating data [5 (63%) and 15 (88%)], selectively deleting or modifying data [5 (63%) and 15 (88%)], and selective reporting of results [3 (38%) and 15 (88%)]. No codes discouraged p-hacking or hypothesising after results are known.Conclusions: Responsible research practices could be more strongly endorsed by Australian university codes of research conduct. Our findings may not be generalisable to smaller universities, or those not active in health and medical research.

Journals can substantially influence the quality of research reports by including responsible reporting practices in their Instructions to Authors. We assessed the extent to which 100 journals in neuroscience and physiology required authors to report methods and results in a rigorous and transparent way. For each journal, Instructions to Authors and any referenced reporting guideline or checklist were downloaded from journal websites. Twenty-two questions were developed to assess how journal Instructions to Authors address fundamental aspects of rigor and transparency in five key reporting areas. Journal Instructions to Authors and all referenced external guidelines and checklists were audited against these 22 questions. Of the full sample of 100 Instructions to Authors, 34 did not reference any external reporting guideline or checklist. Reporting whether clinical trial protocols were pre-registered was required by 49 journals and encouraged by 7 others. Making data publicly available was encouraged by 64 journals; making (processing or statistical) code publicly available was encouraged by ∼30 of the journals. Other responsible reporting practices were mentioned by less than 20 of the journals. Journals can improve the quality of research reports by mandating, or at least encouraging, the responsible reporting practices highlighted here.

Introduction: This study aimed to estimate the causal effect of face-to-face learning on student performance in anatomy, compared to online learning, by analysing examination marks under a causal structure. Methods: We specified a causal graph to indicate how the mode of learning affected student performance. We sampled purposively to obtain end-semester examination marks of undergraduate and postgraduate students who learned using face-to-face (pre-COVID, 2019) or online modes (post-COVID, 2020). The analysis was informed by the causal graph. Marks were compared using linear regression, and sensitivity analyses were conducted to assess if effects were robust to unmeasured confounding. Results: On average, face-to-face learning improved student performance in the end-semester examination in undergraduate students (gain of mean 8.3%, 95% CI 3.3 to 13.4%; E-value 2.77, lower limit of 95% CI 1.80) but lowered performance in postgraduate students (loss of 8.1%, 95% CI 3.6 to 12.6%; E-value 2.89, lower limit of 95% CI 1.88), compared to online learning. Discussion: Under the assumed causal graph, we found that compared to online learning, face-to-face learning improved student performance in the end-semester examination in undergraduate students, but worsened student performance in postgraduate students. These findings suggest that different modes of learning may suit different types of students. Importantly, this is the first attempt to estimate causal effects of the mode of learning on student performance under a causal structure. This approach makes our assumptions transparent, informs data analysis, and is recommended when using observational data to make causal inferences.