Provision of knee bracing for knee osteoarthritis (PROP OA): multicentre, parallel group, superiority, statistician blinded, randomised controlled trial.
Holden MA, Nicholls E, Abdali Z, Birrell F, Borrelli B, Callaghan M, Dziedzic K, Felson D, Foster NE, Halliday N, Ingram C, Jinks C, Jowett S, Peat G, PROP OA trial team
Paper source
Provision of knee bracing for knee osteoarthritis (PROP OA): multicentre, parallel group, superiority, statistician blinded, randomised controlled trial.
This rigor review was examined and confirmed by Adcurare Editorial · July 7, 2026
How this rating was calculated▸
Started at 5★ — no deductions. Nothing the checks ran surfaced a material problem.
No specific rigor problems surfaced by the checks that ran.
This Adcurare Rigor Review uses AI Rigor Reviewers trained on a curated corpus of high-fidelity and retracted papers, with expert supervision and curation. It can still make mistakes; verify each finding against the source before relying on it.
The manuscript is a well-designed pragmatic RCT with strong methodology in most dimensions. It scores well on scientific premise, study design, biological variables, ethics, key resources, and statistical analysis, with only minor gaps in data code availability (code in supplementary files not a permanent repository) and reporting transparency (no explicit CONSORT mention or dedicated limitations section).
Three independent reviewer evaluations using a prespecified eight-dimension checklist were synthesised. The statistics verification component checked 5 tests (all consistent) but coverage is limited to tests with a test statistic and degrees of freedom, or an effect estimate with a 95% CI; threshold-only p-values and resampling-based methods could not be verified. The citation check found no retracted or missing references. The copyedit pass flagged 4 minor issues (formatting, consistency).
9 major claims checked against the paper's own evidence: all adequately supported.
Recomputed 5 tests: 5 consistent, 0 inconsistent, 5 via agent-written checks.
4 copyedit issues flagged: mostly consistency, other, clarity.
Checked 35 references: 30 verified — 5 not checked.
2 data/code links checked; 2 live.
Registered (1 ID: ISRCTN). No reporting guideline cited.
The manuscript is ready for submission after addressing a short list of pre-submission actions: moving the analysis code to a persistent repository, adding a CONSORT reporting guideline reference, adding a dedicated limitations section, and making minor copyedit fixes. No critical methodological problems were identified.
- 1.HIGHdata codeUpload the analysis code to a version-controlled public repository (e.g., GitHub, Zenodo, or the same institutional repository that hosts the data) and update the Data Availability Statement to include the repository link and persistent identifier.Code in supplementary files is not independently citable or version-controlled; a persistent repository ensures long-term access and reproducibility.
- 2.HIGHreportingAdd an explicit statement in the Methods section that the trial report follows CONSORT guidelines, and provide the completed CONSORT checklist as a supplementary file.Journals and readers expect reference to the applicable reporting guideline; its absence may trigger a reviewer request and delays.
- 3.HIGHreportingAdd a dedicated 'Strengths and Limitations' subsection to the Discussion that transparently addresses potential biases (e.g., open-label design, contamination in the AIE group who received motivational interviewing), generalisability, and the impact of COVID-19 adaptations.A dedicated limitations section is a standard element of a complete clinical trial report and helps readers interpret the findings appropriately.
- 4.MEDIUMreportingReport exact p-values (e.g., p=0.006) alongside the 95% confidence intervals for all primary and key secondary outcomes in the Results and Tables 4–5.While confidence intervals are sufficient for inference, some meta-analysts and funders require exact p-values; their absence may be noted during peer review.
- 5.MEDIUMreportingAdd the Bristol Online Tool or another validated adherence measurement instrument reference to complement the description of the adherence intervention (motivational interviewing).This would strengthen the methodology description and allow others to replicate the adherence component.
- 6.MEDIUMreportingIn the Abstract, consider adding a brief statement of the study's limitations to balance the conclusions.Abstracts are frequently read in isolation; a limitations sentence helps prevent overinterpretation.
- 7.MEDIUMcopyeditIn the Methods: Randomisation and masking section, rephrase 'Although masking participants or physiotherapists to treatment allocation was not possible ...' to 'Masking of participants and physiotherapists was not feasible due to the nature of the intervention; however, the trial statistician was blinded to treatment allocation.'Improves clarity and flow of a key methodological statement.
- 8.LOWcopyeditStandardise the formatting of confidence intervals throughout: use en dash or 'to' consistently (e.g., '0.96 to 5.82' in text, ensure tables match).Minor formatting consistency improves readability and avoids copyeditor queries.
- 9.LOWcopyeditIn Table 2 and Table 4, standardise the display of subscale names (e.g., remove extra colon in 'KOOS-4: (0-100):').Minor formatting issue that can be caught with a final proofread.
- 10.LOWcopyeditIn Table 1 footnote, clarify whether the reported intraclass correlation coefficient (0.94, 95% CI 0.90 to 0.96) refers to intra-rater or inter-rater reliability, as the model described ('two-way random effects model with absolute agreement') is typically used for inter-rater reliability.Resolves a potential confusion for readers about the type of reliability assessed.
- 11.LOWreportingConsider providing the brace adherence data as a supplementary dataset with a DOI to enhance the reproducibility of the complier average causal effect (CACE) analysis.Would strengthen the transparency and reusability of the trial data.
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