Could performance bias have influenced the prevention of pressure ulcers obtained with neuromuscular electrical stimulation in critically ill patients?

Authors

DOI:

https://doi.org/10.17267/2675-021Xevidence.2025.e6005

Keywords:

Pressure Ulcer, ICU, Bias

Abstract

This article aims to describe and reflect on a possible performance bias found in the randomized clinical trial by Baron et al, on the effectiveness of neuromuscular electrical stimulation for the prevention of pressure ulcers in critically ill patients. 

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Author Biography

  • Bruno Prata Martinez, Universidade Federal da Bahia (Salvador). Bahia, Brazil.

    Programa de Pós-Graduação em Medicina e Saúde Pública(PPgMS), Universidade Federal da Bahia(UFBA).

References

(1) Baron MV, Silva PE, Koepp J, Urbanetto JS, Santamaria AFM, Santos MP, et al. Efficacy and safety of neuromuscular electrical stimulation in the prevention of pressure injuries in critically ill patients: a randomized controlled trial. Annals of Intensive Care. 2022;12(53):1-13. https://doi.org/10.1186/s13613-022-01029-1

(2) Barcot O, Dosenovic S, Boric M, Pericic TL, Cavar M, Kadic AJ, , Puljak L. Assessing the risk of performance and detection bias in Cochrane reviews. Journal of Comparative Effectiveness Research. 2020;9(8). https://doi.org/10.2217/cer-2019-0181

(3) Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. https://doi.org/10.1136/bmj.l4898

(4) Shi C, Dumville JC, Cullum N, Rhodes S, McInnes E, Goh EL, et al. Beds, overlays and mattresses for preventing and treating pressure ulcers: an overview of Cochrane Reviews and network meta-analysis. Cochrane Database of Systematic Reviews. 2021, Issue 8. Art. No.: CD013761. https://doi.org/10.1002/14651858.cd013761.pub2

(5) Nakanishi N, Yoshihiro S, Kawamura Y, Aikawa G, Shida H, Shimizu M, et al. Effect of Neuromuscular Electrical Stimulation in Patients With Critical Illness: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials. Crit Care Med. 2023;1;51(10):1386-1396. https://doi.org/10.1097/ccm.0000000000005941

(6) Yoshikawa Y, Shimooka M, Yoshikawa M, Maeshige N, Uemura M, Yamaguchi A, et al. Evaluation of the Effect of Gluteus Maximus Contraction by Electrical Stimulation on Interfacial Pressure in Supine Bed Positions. Prog Rehabil Med. 2024;9:20240035. https://doi.org/10.2490/prm.20240035

(7) Fremmelevholm A; Soegaard K. Pressure ulcer prevention in hospitals: a successful nurse-led clinical quality improvement intervention. British Journal of Nursing. 2019;28(6):S6-S11. https://doi.org/10.12968/bjon.2019.28.6.s6

(8) Cullum N, Buckley H, Dumville J, Hall J, Lamb K, Madden M, et al. Wounds Research for Patient Benefit: A 5-year Programme of Research. Programme Grants Appl Res 2016;4(13). https://doi.org/10.3310/pgfar04130

(9) Gray TA, Rhodes S, Atkinson RA, Rothwell K, Wilson P, Dumville JC, et al. Opportunities for better value wound care: a multiservice, cross-sectional survey of complex wounds and their care in a UK community population. BMJ Open 2018;8(3):e019440. https://doi.org/10.1136/bmjopen-2017-019440

(10) Teixeira AO, Brinati LM, Toledo LV, Neto JFS, Teixeria DLP, Januário CF et al. Factors associated with the incidence of pressure wounds in critical patients: a cohort study. Rev Bras Enferm. 2022;75(6):1-7. https://doi.org/10.1590/0034-7167-2021-0267pt

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Published

03/31/2025

Issue

Section

Critical Appraisal of Evidence

How to Cite

1.
Martinez BP, Alves IGN, Neto MG. Could performance bias have influenced the prevention of pressure ulcers obtained with neuromuscular electrical stimulation in critically ill patients?. Evidence [Internet]. 2025 Mar. 31 [cited 2025 Apr. 3];7:e6005. Available from: https://www5.bahiana.edu.br/index.php/evidence/article/view/6005

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