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Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials
Open accessAbstract
OBJECTIVES: To determine whether trials of physical activity promotion based in primary care show sustained effects on physical activity or fitness in sedentary adults, and whether exercise referral interventions are more effective than other interventions. DESIGN: Systematic review and meta-analysis of randomised controlled trials. DATA SOURCES: Medline, CINAHL, PsycINFO, EMBASE, SPORTDiscus, Centre for Reviews and Dissemination, the Cochrane Library, and article reference lists. REVIEW METHODS: Review of randomised controlled trials of physical activity promotion in sedentary adults recruited in primary care, with minimum follow-up of 12 months, reporting physical activity or fitness (or both) as outcomes, and using intention to treat analyses. Two reviewers independently assessed studies for inclusion, appraised risk of bias, and extracted data. Pooled effect sizes were calculated using a random effects model. RESULTS: We included 15 trials (n=8745). Most interventions took place in primary care, included health professionals in delivery, and involved advice or counselling given face to face or by phone (or both) on multiple occasions. Only three trials investigated exercise referral. In 13 trials presenting self reported physical activity, we saw small to medium positive intervention effects at 12 months (odds ratio 1.42, 95% confidence interval 1.17 to 1.73; standardised mean difference 0.25, 0.11 to 0.38). The number needed to treat with an intervention for one additional sedentary adult to meet internationally recommended levels of activity at 12 months was 12 (7 to 33). In four trials reporting cardiorespiratory fitness, a medium positive effect at 12 months was non-significant (standardised mean difference 0.51, -0.18 to 1.20). Three trials of exercise referral found small non-significant effects on self reported physical activity at 12 months (odds ratio 1.38; 0.98 to 1.95; standardised mean difference 0.20, -0.21 to 0.61). CONCLUSIONS: Promotion of physical activity to sedentary adults recruited in primary care significantly increases physical activity levels at 12 months, as measured by self report. We found insufficient evidence to recommend exercise referral schemes over advice or counselling interventions. Primary care commissioners should consider these findings while awaiting further trial evaluation of exercise referral schemes and other primary care interventions, with longer follow-up and use of objective measures of outcome.
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TL;DR
Physical activity promotion based in primary care for sedentary adults produced small to medium improvements in self-reported physical activity at 12 months, with a number needed to treat of 12 for one additional adult to meet recommended activity levels. Evidence was insufficient to show that exercise referral schemes are more effective than advice or counselling.
Key findings
- In 15 trials (n=8745), pooled analysis of 13 trials reporting self-reported physical activity at 12 months found small to medium positive effects: odds ratio 1.42 (95% CI 1.17 to 1.73); standardised mean difference 0.25 (0.11 to 0.38); number needed to treat 12 (7 to 33).
- Four trials reporting cardiorespiratory fitness found a medium but non-significant pooled effect at 12 months: standardised mean difference 0.51 (−0.18 to 1.20); only one study reported objective physical activity and found no significant effect (−0.04, −0.16 to 0.08).
- Three exercise referral trials found small non-significant effects on self-reported physical activity at 12 months: odds ratio 1.38 (0.98 to 1.95); standardised mean difference 0.20 (−0.21 to 0.61).
- Subgroup analysis found larger effects in trials with no-intervention controls (OR 1.74, 1.39 to 2.18; SMD 0.36, 0.28 to 0.43) than with comparator controls (OR 1.18, 0.95 to 1.48; SMD −0.03, −0.17 to 0.11), with significant differences between these sets.
Methods
- Systematic review and meta-analysis of randomised controlled trials of physical activity promotion in sedentary adults aged 16 years or over recruited through primary care, with minimum 12 months’ follow-up, reporting physical activity or fitness, and using intention-to-treat analyses.
- Searched Medline, CINAHL, PsycINFO, EMBASE, SPORTDiscus, Centre for Reviews and Dissemination, and the Cochrane Library (May 2009; repeated May 2010), plus reference lists and expert check; two reviewers independently assessed inclusion, risk of bias, and extracted data.
- Pooled effect sizes used a random effects model; odds ratios and standardised mean differences with 95% confidence intervals were calculated, with I² used to assess heterogeneity and a formula used to calculate number needed to treat.
Limitations
- The paper states that most included trials used self-reported physical activity as the main outcome, which is susceptible to differential social desirability bias and lacks precision; few trials used objective measures.
- The paper states that intervention content was often poorly reported, participants were mostly white with socioeconomic characteristics poorly reported, no unpublished trials were identified, only one reviewer screened titles and abstracts, and follow-up was limited to 12 months so clinical outcomes could not be assessed.
- Evident from the text: all but two studies were judged at high risk of bias in at least one domain, including lack of blinding, inadequate management of incomplete outcome data in six studies, and selective outcome reporting in one study; some pooled estimates had high heterogeneity (I²=70% for continuous self-reported physical activity; I²=97% for fitness).
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Claims the paper makes
41 Not checked yet · 36 Own result · 22 Own interpretation · 13 Own method · 8 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 13 trials presenting self reported physical activity, we saw small to medium positive intervention effects at 12 months (odds ratio 1.42, 95% confidence interval 1.17 to 1.73; standardised mean difference 0.25, 0.11 to 0.38).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The number needed to treat with an intervention for one additional sedentary adult to meet internationally recommended levels of activity at 12 months was 12 (7 to 33).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Three trials of exercise referral found small non-significant effects on self reported physical activity at 12 months (odds ratio 1.38; 0.98 to 1.95; standardised mean difference 0.20, −0.21 to 0.61).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In 13 trials presenting self reported physical activity, we saw small to medium positive intervention effects at 12 months (odds ratio 1.42, 95% confidence interval 1.17 to 1.73; standardised mean difference 0.25, 0.11 to 0.38).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“In nine studies, dichotomous outcome measures related to whether participants had achieved a specified target level of physical activity in keeping with accepted guidelines (most commonly the achievement of at least 30 minutes of moderate intensity activity each day for at least five days per week).18 19 20 21 22 23 28 29 36”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Self reported physical activity
What the sources say
- Not checked yetcites [18] Van Sluijs EM, van Poppel MN, Twisk JW, Chin APM, Calfas KJ, van MW. Effect of a tailored physical activity intervention delivered in general practice settings: results of a randomized controlled trial. Am J Public Health 2005; 9510: 1825-31. PMC1449443 16186461
- Not checked yetcites [19] Jimmy G, Martin BW. Implementation and effectiveness of a primary care based physical activity counselling scheme. Patient Educ Couns 2005; 56: 323-31. 15721975
- Not checked yetcites [20] Harrison RA, Roberts C, Elton PJ. Does primary care referral to an exercise programme increase physical activity one year later? A randomized controlled trial. J Public Health 2004; 271: 25-32. 15564275
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Three trials of exercise referral found small non-significant effects on self reported physical activity at 12 months (odds ratio 1.38; 0.98 to 1.95; standardised mean difference 0.20, −0.21 to 0.61).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Abstract
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most interventions took place in primary care, included health professionals in delivery, and involved advice or counselling given face to face or by phone (or both) on multiple occasions.”
- Also stated in: § Intervention characteristics · plain
“Most interventions included written materials and two or more sessions of advice or counselling on physical activity, delivered face to face.”
- Also stated in: § Intervention characteristics · plain
“In nine studies, supplementary advice or counselling was delivered by telephone, and in one trial, the intervention was delivered exclusively by telephone.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Abstract
plainn = 8,745- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Intervention characteristics · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most interventions took place in primary care, included health professionals in delivery, and involved advice or counselling given face to face or by phone (or both) on multiple occasions.”
- Also stated in: § Intervention characteristics · plain
“Physical activity promotion was delivered in primary care in 10 studies, in primary care and a sports facility in one study, and at home or by telephone only in two studies.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Intervention characteristics · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“continuous data (standardised mean difference 0.25 (0.11 to 0.38); I2=70% (27% to 83%); fig 4)”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects on self reported physical activity
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the seven studies that compared interventions with comparator interventions, we did not see a significant effect on self reported physical activity at 12 months (odds ratio 1.18 (0.95 to 1.48), I2=9% (0% to 64%); standardised mean difference −0.03 (−0.17 to 0.11), I2=0% (0% to 73%)).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Subgroup and sensitivity analyses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“after removal of data from three studies presenting non-parametric data and from one study with supplied means based on skewed data,18 21 35 36 the pooled effect estimates increased (odds ratio 1.50 (1.22 to 1.84), I2=16% (0% to 63%); standardised mean difference 0.28 (0.12 to 0.44), I2=57% (0% to 82%)).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Subgroup and sensitivity analyses
What the sources say
- Not checked yetcites [18] Van Sluijs EM, van Poppel MN, Twisk JW, Chin APM, Calfas KJ, van MW. Effect of a tailored physical activity intervention delivered in general practice settings: results of a randomized controlled trial. Am J Public Health 2005; 9510: 1825-31. PMC1449443 16186461
- Not checked yetcites [21] Lawton BA, Rose SB, Elley CR, Dowell AC, Fenton A, Moyes SA. Exercise on prescription for women aged 40-74 recruited through primary care: two year randomised controlled trial. BMJ 2008; 337: a2509. 19074218 PMC2769033
- Not checked yetcites [35] Halbert JA, Silagy CA, Finucane PM, Withers RT, Hamdorf PA. Physical activity and cardiovascular risk factors: effect of advice from an exercise specialist in Australian general practice. Med J Aust 2000; 173: 84-7. 10937036
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Five of six trials reporting adverse events identified no increase associated with physical activity promotion.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Pooled analysis showed small, non-significant effects on self reported physical activity at 12 months (odds ratio 1.38 (95% confidence interval 0.98 to 1.95), I2=0% (0% to 73%); standardised mean difference 0.20 (−0.21 to 0.61), I2=76%) (figs 6 and 7).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects of exercise referral interventions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The mean intervention effect for this measure (after adjustment for baseline measurement and minimisation stratifiers) was not significant at 12 month follow-up (−0.04 (95% confidence interval −0.16 to 0.08)).”
- Also stated in: § Summary and interpretation of findings · plain
“One study reported objective physical activity and also found no significant effect.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects on objective physical activity
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Summary and interpretation of findings · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Adverse events varied substantially among the six trials that reported them.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Adverse events
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Only one study reported an objective measure of physical activity in all participants.32”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects on objective physical activity
What the sources say
- Not checked yetcites [32] Kinmonth AL, Wareham NJ, Hardeman W, Sutton S, Prevost AT, Fanshawe T, et al. Efficacy of a theory-based behavioural intervention to increase physical activity in an at-risk group in primary care (ProActive UK): a randomised trial. Lancet 2008; 371: 41-8. 18177774
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Only one study showed a significant intervention effect.31”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects on cardiorespiratory fitness
What the sources say
- Not checked yetcites [31] Petrella RJ, Koval JJ, Cunningham DA, Paterson DH. Can primary care doctors prescribe exercise to improve fitness?: The step test exercise prescription (STEP) project. Am J Prev Med 2003; 24: 316-22. 12726869
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Pooled analysis of 13 studies showed small to medium effects for dichotomous data (odds ratio 1.42 (95% confidence interval 1.17 to 1.73); I2=43% (0% to 70%); fig 3)”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects on self reported physical activity
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The increase seen in participants randomly assigned to receive a comparator intervention was almost as large as that seen in participants assigned to receive an intervention.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Change in physical activity over time
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“One study also reported no effect on cardiorespiratory fitness at 12 months.36”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects of exercise referral interventions
What the sources say
- Not checked yetcites [36] Lamb SE, Bartlett HP, Ashley A, Bird W. Can lay-led walking programmes increase physical activity in middle aged adults? A randomised controlled trial. J Epidemiol Community Health 2002; 56: 246-52. 11896130 PMC1732126
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No study found a significant effect on self reported physical activity at 12 months.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects of exercise referral interventions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Pooled analysis showed small, non-significant effects on self reported physical activity at 12 months (odds ratio 1.38 (95% confidence interval 0.98 to 1.95), I2=0% (0% to 73%); standardised mean difference 0.20 (−0.21 to 0.61), I2=76%) (figs 6 and 7).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects of exercise referral interventions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A second study compared exercise referral with written information about physical activity and found small non-significant effects on self reported activity at 12 months.20”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
What the sources say
- Not checked yetcites [20] Harrison RA, Roberts C, Elton PJ. Does primary care referral to an exercise programme increase physical activity one year later? A randomized controlled trial. J Public Health 2004; 271: 25-32. 15564275
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“This study found no significant intervention effect on self reported physical activity at 12 months.30”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects on self reported physical activity
What the sources say
- Not checked yetcites [30] Hillsdon M, Thorogood M, White I, Foster C. Advising people to take more exercise is ineffective: a randomized controlled trial of physical activity promotion in primary care. Int J Epidemiol 2002; 31: 808-15. 12177026
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The intervention used in this study was unique in including prescription of an exercise training heart rate.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We saw a much smaller increase in participants allocated to receive no intervention, than in those allocated to receive an intervention.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Change in physical activity over time
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“The number needed to treat with an intervention of physical activity promotion, compared with any control, for one additional sedentary adult to report meeting recommended levels of physical activity at 12 months was 12 (95% confidence interval 7 to 33), based on the pooled odds ratio for the nine studies that reported this outcome.”
- Also stated in: § Summary and interpretation of findings · hedged
“The best estimate of the number needed to treat for one additional sedentary adult to report recommended levels of activity at 12 months is 12.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects on self reported physical activity
What the sources say
- Not checked yetcites [18] Van Sluijs EM, van Poppel MN, Twisk JW, Chin APM, Calfas KJ, van MW. Effect of a tailored physical activity intervention delivered in general practice settings: results of a randomized controlled trial. Am J Public Health 2005; 9510: 1825-31. PMC1449443 16186461
- Not checked yetcites [19] Jimmy G, Martin BW. Implementation and effectiveness of a primary care based physical activity counselling scheme. Patient Educ Couns 2005; 56: 323-31. 15721975
- Not checked yetcites [20] Harrison RA, Roberts C, Elton PJ. Does primary care referral to an exercise programme increase physical activity one year later? A randomized controlled trial. J Public Health 2004; 271: 25-32. 15564275
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Summary and interpretation of findings · hedged
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Most studied interventions were delivered in primary care by health professionals.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Reporting of the content of interventions was often poor, especially in relation to intensity and fidelity of intervention delivery.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Few published trials exist of exercise referral schemes with at least 12 months of follow-up”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Conclusions and implications for policy, practice, and research
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Our review is affected by several limitations at the study level including, most importantly, the use of self reported measures of physical activity as the main outcome measure in most included trials.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Self reported measures of physical activity lack precision.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The strength of our conclusions was reduced further by other trial factors that might have introduced bias in two thirds of studies.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, since follow-up was limited to 12 months in most trials, we could not assess the effect of interventions on clinical outcomes, such as incidence of diabetes mellitus, cardiovascular events, or mortality.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We found insufficient evidence to recommend exercise referral schemes over advice or counselling interventions.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“None of the studies was judged to be at high risk of selection bias.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Risk of bias
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“One study reported outcomes selectively (a planned analysis of cardiorespiratory fitness was not reported owing to concerns over inaccuracies in study data).21”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Risk of bias
What the sources say
- Not checked yetcites [21] Lawton BA, Rose SB, Elley CR, Dowell AC, Fenton A, Moyes SA. Exercise on prescription for women aged 40-74 recruited through primary care: two year randomised controlled trial. BMJ 2008; 337: a2509. 19074218 PMC2769033
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Trial personnel or outcome assessors were not blinded to allocation in five studies, and management of incomplete outcome data led to high risk of bias in six studies.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Risk of bias
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Risk of bias was judged to be unclear in at least one domain for nine studies.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Risk of bias
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Trial personnel or outcome assessors were not blinded to allocation in five studies, and management of incomplete outcome data led to high risk of bias in six studies.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Risk of bias
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Funnel plots did not display overt asymmetry that would suggest publication bias (fig 2).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Study selection
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“All studies but two were judged to be at high risk of bias in at least one domain (table 3).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Risk of bias
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Promotion of physical activity to sedentary adults recruited in primary care significantly increases physical activity levels at 12 months, as measured by self report.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Abstract
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Evidence to support physical activity promotion in primary care is less robust.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Introduction
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“However, these findings might not be directly generalisable to the primary care setting, since half of the included studies recruited participants from alternative sources.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Introduction
What the sources say
- Not checked yetcites [17] Hillsdon M, Foster C, Thorogood M. Interventions for promoting physical activity. Cochrane Database Syst Rev 2005; 1: CD003180. 15674903 PMC4164373
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These findings suggest that briefer interventions, as used in the comparator groups, might achieve effects that are similar to those of more intensive interventions.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In this systematic review, we found that promotion of physical activity to sedentary adults identified through primary care leads to a small to medium improvement in self reported physical activity at 12 months (odds ratio 1.42 (95% confidence interval 1.17 to 1.73); standardised mean difference 0.25 (0.11 to 0.38)).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In developed countries, 70-80% of adults visit their general practitioner at least once a year,6 and patients are interested in discussing health promotion issues with primary care health professionals.7”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Introduction
What the sources say
- Not checked yetcites [6] Van Doorslaer E, Masseria C, Koolman X, for the OECD Health Equity Research Group. Inequalities in access to medical care by income in developed countries. CMAJ 2006; 174: 177-83. 16415462 PMC1329455
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Furthermore, several large trials of physical activity promotion based in primary care have reported outcomes with at least 12 months’ follow-up since this systematic review was undertaken.18 19 20 21 22 23”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Introduction
What the sources say
- Not checked yetcites [18] Van Sluijs EM, van Poppel MN, Twisk JW, Chin APM, Calfas KJ, van MW. Effect of a tailored physical activity intervention delivered in general practice settings: results of a randomized controlled trial. Am J Public Health 2005; 9510: 1825-31. PMC1449443 16186461
- Not checked yetcites [19] Jimmy G, Martin BW. Implementation and effectiveness of a primary care based physical activity counselling scheme. Patient Educ Couns 2005; 56: 323-31. 15721975
- Not checked yetcites [20] Harrison RA, Roberts C, Elton PJ. Does primary care referral to an exercise programme increase physical activity one year later? A randomized controlled trial. J Public Health 2004; 271: 25-32. 15564275
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Previous reviews have been limited by the inclusion of non-randomised trials and trials with short follow-up duration.12 13 14 15”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Introduction
What the sources say
- Not checked yetcites [12] Eaton CB, Menard LM. A systematic review of physical activity promotion in primary care office settings. Br J Sports Med 1998; 32: 11-6. 9562157 PMC1756060
- Not checked yetcites [13] Riddoch C, Puig-Ribera A, Cooper A. Effectiveness of physical activity promotion schemes in primary care: a review. Health Education Authority, 1998.
- Not checked yetcites [14] Eakin EG, Glasgow RE, Riley KM. Review of primary care-based physical activity intervention studies: effectiveness and implications for practice and future research. J Fam Pract 2000; 49: 158-68. 10718694
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Primary care is well placed to promote physical activity among sedentary adults.4 5”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Introduction
What the sources say
- Not checked yetcites [4] Craig A, Dinan S, Smith A, Taylor A, Webborn N. The National Quality Assurance Framework for Exercise Referral Systems. Department of Health, 2001.
- Not checked yetcites [5] Williams NH. “The wise, for cure, on exercise depend”: physical activity interventions in primary care in Wales. Br J Sports Med 2009; 43: 106-8. 18669546
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A further exploratory analysis suggested that a possible reason why results differed according to control type used was that comparator interventions themselves affected self reported physical activity.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our review shows the effectiveness over at least 12 months of interventions to promote physical activity based in primary care.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Conclusions and implications for policy, practice, and research
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, these projections of potential benefit of such physical activity promotion must be interpreted with caution, owing to the limitations of self reported measurement of physical activity.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Conclusions and implications for policy, practice, and research
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Self reported measures of physical activity lack precision.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Physical activity promotion based in primary care increases self reported physical activity over at least 12 months”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Conclusions and implications for policy, practice, and research
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Based on the findings of a meta-analysis of cohort studies including almost one million individuals, achievement of these activity levels in populations with low levels of activity could reduce mortality by about one fifth.2”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Conclusions and implications for policy, practice, and research
What the sources say
- Not checked yetcites [2] Woodcock J, Franco OH, Orsini N, Roberts I. Non-vigorous physical activity and all-cause mortality: systematic review and meta-analysis of cohort studies. Int J Epidemiol 2011; 40: 121-38. 20630992
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our review highlights the continuing paucity of evidence on the medium to long term effectiveness of exercise referral schemes.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Conclusions and implications for policy, practice, and research
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“These findings are consistent with those reported by Pavey and colleagues in their systematic review and meta-analysis of exercise referral schemes.40”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
What the sources say
- Not checked yetcites [40] Pavey TG, Taylor AH, Fox KR, Hillsdon M, Anokye N, Campbell JL, et al. Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: systematic review and meta-analysis. BMJ 2011; 343: d6462. 22058134 PMC3209555
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“A possible exception is incomplete outcome data which could lead to underestimation of the intervention effect in some circumstances (for example, if a proportion of intervention participants leave the study because they have increased their physical activity).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Based on the limited data available, there is no evidence that they are more effective than physical activity advice or counselling.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Conclusions and implications for policy, practice, and research
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Generally, such factors would be expected to lead to bias in the direction of overestimating the effect of the intervention.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Cost per quality adjusted life year has been shown to be higher for exercise referral programmes of supervised exercise classes based in the gym or instructor led walks than for other types of physical activity interventions in primary care.44”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Conclusions and implications for policy, practice, and research
What the sources say
- Not checked yetcites [44] Garrett S, Elley CR, Rose SB, O’Dea D, Lawton BA, Dowell AC. Are physical activity interventions in primary care and the community cost-effective? A systematic review of the evidence. Br J Gen Pract 2011; 61: 125-33. PMC3047345 21375895
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“However, observational evidence suggests that long term improvements in cardiovascular health depend on sustained changes in physical activity16 and the same may be expected to be true for long term improvements in weight and mental health.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
What the sources say
- Not checked yetcites [16] Paffenbarger RS Jr, Wing AL, Hyde RT. Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol 1978; 108: 161-75. 707484
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Five years after NICE recommended that exercise referral interventions should not be commissioned in primary care outside of well designed research studies,45 we found insufficient evidence to challenge this guidance.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Conclusions and implications for policy, practice, and research
What the sources say
- Not checked yetcites [45] National Institute for Health and Clinical Excellence. Four commonly used methods to increase physical activity: brief interventions in primary care, exercise referral schemes, pedometers and community-based exercise programmes for walking and cycling. National Institute for Health and Clinical Excellence, 2006.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The available evidence does not show exercise referral schemes to be significantly more effective at increasing physical activity than other, potentially lower cost, approaches”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Conclusions and implications for policy, practice, and research
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“We reduced risk of bias present in other reviews13 14 42 by including only randomised controlled trials.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
What the sources say
- Not checked yetcites [13] Riddoch C, Puig-Ribera A, Cooper A. Effectiveness of physical activity promotion schemes in primary care: a review. Health Education Authority, 1998.
- Not checked yetcites [14] Eakin EG, Glasgow RE, Riley KM. Review of primary care-based physical activity intervention studies: effectiveness and implications for practice and future research. J Fam Pract 2000; 49: 158-68. 10718694
- Not checked yetcites [42] Lawlor DA, Hanratty B. The effect of physical activity advice given in routine primary care consultations: a systematic review. J Public Health 2001; 23: 219-26. 11585195
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“To our knowledge, it is the first to examine the effect of physical activity promotion over at least 12 months in patients recruited in primary care.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 33
- Probably not a substantial claim. 26
None of the sources cited for this claim have been checked yet.
In the paper
“Most studies selected participants for sedentary behaviour, but the percentage meeting recommended guidelines for physical activity at baseline ranged from 0%19 20 to 44%18 in the nine studies reporting this outcome.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Study and participant characteristics
What the sources say
- Not checked yetcites [18] Van Sluijs EM, van Poppel MN, Twisk JW, Chin APM, Calfas KJ, van MW. Effect of a tailored physical activity intervention delivered in general practice settings: results of a randomized controlled trial. Am J Public Health 2005; 9510: 1825-31. PMC1449443 16186461
- Not checked yetcites [19] Jimmy G, Martin BW. Implementation and effectiveness of a primary care based physical activity counselling scheme. Patient Educ Couns 2005; 56: 323-31. 15721975
- Not checked yetcites [20] Harrison RA, Roberts C, Elton PJ. Does primary care referral to an exercise programme increase physical activity one year later? A randomized controlled trial. J Public Health 2004; 271: 25-32. 15564275
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Data for self reported physical activity were collected in 14 studies using various assessment tools, including questionnaires or logbooks either self administered or administered by an interviewer (table 4).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Self reported physical activity
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In four trials reporting cardiorespiratory fitness, a medium positive effect at 12 months was non-significant (standardised mean difference 0.51, −0.18 to 1.20).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We included 15 trials (n=8745).”
- Also stated in: § Study and participant characteristics · plain
“In 15 trials, 8745 participants aged between 17 and 92 years were randomised.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Abstract
plainn = 8,745- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Study and participant characteristics · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Most interventions took place in primary care, included health professionals in delivery, and involved advice or counselling given face to face or by phone (or both) on multiple occasions.”
- Also stated in: § Intervention characteristics · plain
“Primary care doctors or nurses were involved in eight studies; physiotherapists in two studies; and health visitors, health educators, health counsellors, health promotion specialists, or trained facilitators from a range of health professions in a further five studies.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Intervention characteristics · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Only three trials investigated exercise referral.”
- Also stated in: § Intervention characteristics · plain
“Of the three exercise referral studies, one involved referral to a leisure centre based programme, one to a community walks programme, and one involved small group exercise sessions at an unspecified location.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Also stated in: § Intervention characteristics · plain
None of the sources cited for this claim have been checked yet.
In the paper
“In two studies, they related to whether participants had increased their level of physical activity from baseline.26 27”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Self reported physical activity
What the sources say
- Not checked yetcites [26] Harland J, White M, Drinkwater C, Chinn D, Farr L, Howel D. The Newcastle exercise project: a randomised controlled trial of methods to promote physical activity in primary care. BMJ 1999; 319: 828-32. 10496829 PMC314213
- Not checked yetcites [27] Chambers R, Chambers C, Campbell I. Exercise promotion for patients with significant medical problems. Health Educ J 2000; 59: 90-8.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“All studies reported outcome data at 12 months after randomisation, apart from one19 reporting at 14 months, and another28 reporting at 24 months.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Study and participant characteristics
What the sources say
- Not checked yetcites [19] Jimmy G, Martin BW. Implementation and effectiveness of a primary care based physical activity counselling scheme. Patient Educ Couns 2005; 56: 323-31. 15721975
- Not checked yetcites [28] The Writing Group for the Activity Counseling Trial Research Group. Effects of physical activity counseling in primary care: the activity counseling trial: a randomized controlled trial. JAMA 2001; 286: 677-87. 11495617
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Only one study found a significant intervention effect on adverse events, reporting a relative 11% increase in falls and a 6% increase in injuries among intervention participants between baseline and 12 months’ follow-up, compared with control participants.21”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Adverse events
What the sources say
- Not checked yetcites [21] Lawton BA, Rose SB, Elley CR, Dowell AC, Fenton A, Moyes SA. Exercise on prescription for women aged 40-74 recruited through primary care: two year randomised controlled trial. BMJ 2008; 337: a2509. 19074218 PMC2769033
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the six studies that compared physical activity promotion to no intervention, we saw a medium, positive, and significant intervention effect on self reported physical activity at 12 months (odds ratio 1.74 (95% confidence interval 1.39 to 2.18), I2=21% (0% to 71%); standardised mean difference 0.36 (0.28 to 0.43), I2=0% (I2 0% to 61%)).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Subgroup and sensitivity analyses
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Nine studies reported the proportion of participants meeting recommended levels of physical activity at baseline and 12 months (or at the next available time point, if 12 month data were not available).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Change in physical activity over time
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Eleven studies reported positive intervention effects on self reported physical activity at 12 months; these effects were significant in six studies.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects on self reported physical activity
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“a sensitivity analysis showed that this was attributable to one outlying study with strong positive results,31 without which heterogeneity was low (I2=0%).”
- Also stated in: § Summary and interpretation of findings · hedged
“The effect sizes showed high heterogeneity, and sensitivity analyses suggested that this was attributable to one outlying study with strong positive findings.31”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects on cardiorespiratory fitness
What the sources say
- Not checked yetcites [31] Petrella RJ, Koval JJ, Cunningham DA, Paterson DH. Can primary care doctors prescribe exercise to improve fitness?: The step test exercise prescription (STEP) project. Am J Prev Med 2003; 24: 316-22. 12726869
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Summary and interpretation of findings · hedged
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In the meta-analysis of continuous physical activity data (fig 4), removal of two studies that did not present an outcome measure for total activity reduced the pooled effect estimate but did not affect the direction or significance of the findings (standardised mean difference 0.20 (0.05 to 0.35), I2=72% (18% to 85%)).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Subgroup and sensitivity analyses
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The pooled standardised mean difference had a medium effect size but was non-significant (0.51 (95% confidence interval −0.18 to 1.20); fig 5). Heterogeneity was high (I2=97% (96% to 98%))”
- Also stated in: § Summary and interpretation of findings · plain
“Only four trials reported cardiorespiratory fitness and pooled analysis showed no significant effect.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects on cardiorespiratory fitness
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Summary and interpretation of findings · plain
In the paper
“A third study used a no intervention control, and found small to medium sized positive effects on self reported activity, which were significant for continuous (frequency of exercise sessions) but not dichotomous data (proportion of participants who had become more active from study entry).27”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
What the sources say
- Not checked yetcites [27] Chambers R, Chambers C, Campbell I. Exercise promotion for patients with significant medical problems. Health Educ J 2000; 59: 90-8.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The additional percentage of participants who reported meeting international activity recommendations at 12 months, compared with baseline, was 11-47% in participants allocated to receive an intervention, and 8-47% in those allocated to receive a comparator intervention. The corresponding range for those allocated to receive no intervention was from −2% to +19% (fig 8).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Three studies examined exercise referral interventions.20 27 36”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects of exercise referral interventions
What the sources say
- Not checked yetcites [20] Harrison RA, Roberts C, Elton PJ. Does primary care referral to an exercise programme increase physical activity one year later? A randomized controlled trial. J Public Health 2004; 271: 25-32. 15564275
- Not checked yetcites [27] Chambers R, Chambers C, Campbell I. Exercise promotion for patients with significant medical problems. Health Educ J 2000; 59: 90-8.
- Not checked yetcites [36] Lamb SE, Bartlett HP, Ashley A, Bird W. Can lay-led walking programmes increase physical activity in middle aged adults? A randomised controlled trial. J Epidemiol Community Health 2002; 56: 246-52. 11896130 PMC1732126
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For both dichotomous and continuous data, we found significant differences in effect size between these two sets of studies (dichotomous data, χ²=6.9 df=1, P=0.008; continuous data, χ²=21.7, df=1, P<0.00001).”
- Also stated in: § Summary and interpretation of findings · plain
“A planned subgroup analysis showed significantly larger intervention effects on self reported activity in studies where control participants received no intervention than where they received a comparator intervention.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Subgroup and sensitivity analyses
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § Summary and interpretation of findings · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Four studies reported cardiorespiratory fitness.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects on cardiorespiratory fitness
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At a review level, our search was systematic but we did not identify any unpublished trials.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Although all the interventions in our review are potentially reproducible in real life settings in primary care, most involved multiple contacts over time.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Conclusions and implications for policy, practice, and research
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Trial personnel or outcome assessors were not blinded to allocation in five studies, and management of incomplete outcome data was inadequate in six studies.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, no additional studies were identified by an independent expert on the topic.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The funnel plots did not suggest publication bias, although these plots are difficult to interpret with a small number of studies.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Two reviewers independently assessed studies for inclusion, appraised risk of bias, and extracted data.”
- Also stated in: § Search methods, study selection, and data extraction · plain
“Two reviewers (GO and SSu) assessed retrieved papers independently.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Abstract
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Also stated in: § Search methods, study selection, and data extraction · plain
In the paper
“We adjusted for clustering in two studies18 29 by calculating the effective sample size.37”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Methods > Statistical analysis
What the sources say
- Not checked yetcites [37] Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions version 5.0.2 (updated September 2009). Chapter 16.3.4. Cochrane Collaboration, 2009.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Five prespecified meta-analyses were conducted using a random effects model in RevMan.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Methods > Statistical analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Sensitivity analyses explored effects of decisions about outcome selection and design effects. These analyses were planned after data extraction but before undertaking the meta-analyses.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Methods > Subgroup, sensitivity, and additional analyses
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Blinding of participants to study group allocation was achieved in one study, not achieved in one, not reported in seven, and not possible in six (in which control participants received no intervention).”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Risk of bias
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A third reviewer (ALK) resolved any conflicts.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Methods > Search methods, study selection, and data extraction
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“If a study presented both a trial completers’ analysis and a full intention to treat analysis using imputed values, we used the intention to treat analysis.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Methods > Statistical analysis
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“Assessing the sustainability of impact of interventions is important, because observational research shows that the health benefits of physical activity are lost with reversion to a sedentary lifestyle.16”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Introduction
What the sources say
- Not checked yetcites [16] Paffenbarger RS Jr, Wing AL, Hyde RT. Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol 1978; 108: 161-75. 707484
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Alternatively, social desirability bias could explain why control participants who received an intervention reported more activity at 12 months than those who received no intervention.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Rests on an assumption: It is difficult to conceal the study group from participants in physical activity trials.
In the paper
“Self reported achievement of these activity levels was associated with a 19% reduction in the rate of all cause mortality, compared with sedentary behaviour, in a large meta-analysis of cohort studies.2”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Introduction
What the sources say
- Not checked yetcites [2] Woodcock J, Franco OH, Orsini N, Roberts I. Non-vigorous physical activity and all-cause mortality: systematic review and meta-analysis of cohort studies. Int J Epidemiol 2011; 40: 121-38. 20630992
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The United Kingdom’s chief medical officers recommend that adults undertake at least 150 minutes of moderate intensity activity each week.1”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Introduction
What the sources say
- Not checked yetcites [1] Chief medical officers of England, Scotland, Wales and Northern Island. Start active, stay active: a report on physical activity from the four home countries’ chief medical officers. Department of Health, 2011.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This absence of effect could have been due to the small number of studies recruiting through primary care that reported fitness data, three of which also found no significant effect on self reported physical activity.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“A Cochrane systematic review of interventions to promote physical activity in community dwelling adults showed a moderate effect on self reported physical activity and cardiorespiratory fitness at a minimum of six months of follow-up.17”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Introduction
What the sources say
- Not checked yetcites [17] Hillsdon M, Foster C, Thorogood M. Interventions for promoting physical activity. Cochrane Database Syst Rev 2005; 1: CD003180. 15674903 PMC4164373
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“The UK has seen a marked expansion in exercise referral schemes over the past two decades,24 but there are concerns that these might not produce sustained changes in physical activity beyond the typical programme length of 12 weeks.25”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Introduction
What the sources say
- Not checked yetcites [24] Labour Research Department. Exercise on prescription: a report for the Chartered Society of Physiotherapists. Labour Research Department, 2004.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In developed countries, 70-80% of adults visit their general practitioner at least once a year,6 and patients are interested in discussing health promotion issues with primary care health professionals.7”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Introduction
What the sources say
- Not checked yetcites [7] Stott NC, Pill RM. “Advise yes, dictate no.” Patients’ views on health promotion in the consultation. Fam Pract 1990; 7: 125-31. 2369980
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“We found no effect of interventions on cardiorespiratory fitness at 12 months across four trials, by contrast with the systematic review by Hillsdon and colleagues, which identified a positive effect on fitness at a minimum of six month follow-up.17”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
What the sources say
- Not checked yetcites [17] Hillsdon M, Foster C, Thorogood M. Interventions for promoting physical activity. Cochrane Database Syst Rev 2005; 1: CD003180. 15674903 PMC4164373
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Yet only 39% of men and 29% of women achieved these levels in the 2008 Health Survey for England.3”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Introduction
What the sources say
- Not checked yetcites [3] Joint Health Surveys Unit. Health survey for England 2008. Physical activity and fitness. The Stationery Office, 2009.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The best estimate of the number needed to treat with a physical activity promotion intervention for one additional sedentary adult to report recommended levels of activity at 12 months was 12, which compares favourably to the estimated numbers needed to treat of 50-120 for smoking cessation advice.8”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Conclusions and implications for policy, practice, and research
What the sources say
- Not checked yetcites [8] Stead LF, Bergson G, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev 2008; 2: CD000165. 18425860
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, participants in the included trials could have been more motivated to increase their physical activity than the primary care populations from which they were recruited.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“Cost effectiveness was not assessed in this review, but recent research suggests that most physical activity interventions based in primary care have comparable cost effectiveness to funded pharmaceutical interventions.44”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Conclusions and implications for policy, practice, and research
What the sources say
- Not checked yetcites [44] Garrett S, Elley CR, Rose SB, O’Dea D, Lawton BA, Dowell AC. Are physical activity interventions in primary care and the community cost-effective? A systematic review of the evidence. Br J Gen Pract 2011; 61: 125-33. PMC3047345 21375895
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is difficult to conceal the study group from participants in physical activity trials, and self reported measures are therefore susceptible to differential social desirability bias, which could inflate estimates of intervention effect.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: It is difficult to conceal the study group from participants in physical activity trials.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Removal of these data in a sensitivity analysis led to an increase in the pooled intervention effect on self reported physical activity that retained statistical significance, suggesting that the decision to include these studies in the main analysis led, at worst, to an underestimation of the pooled intervention effect.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Our findings extend the evidence from two previous systematic reviews of community based interventions17 41 in two ways. Firstly, we included only studies recruiting through primary care to more directly inform commissioning in general practice. Secondly, we included studies with longer follow-up to inform sustainability of effect.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
What the sources say
- Not checked yetcites [17] Hillsdon M, Foster C, Thorogood M. Interventions for promoting physical activity. Cochrane Database Syst Rev 2005; 1: CD003180. 15674903 PMC4164373
- Not checked yetcites [41] Muller-Riemenschneider F, Reinhold T, Nocon M, Willich SN. Long-term effectiveness of interventions promoting physical activity: a systematic review. Prev Med 2008; 47: 354-68. 18675845
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When reported, most trial participants were white, and socioeconomic characteristics were poorly reported; therefore, we do not know whether our findings apply to adults with different ethnic, social, and economic characteristics.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Brief interventions have shown effectiveness in the promotion of smoking cessation and alcohol reduction,8 9 and further research is warranted to assess their effectiveness for physical activity promotion.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Conclusions and implications for policy, practice, and research
What the sources say
- Not checked yetcites [8] Stead LF, Bergson G, Lancaster T. Physician advice for smoking cessation. Cochrane Database Syst Rev 2008; 2: CD000165. 18425860
- Not checked yetcites [9] Kaner EF, Beyer F, Dickinson HO, Pienaar E, Campbell F, Schlesinger C, et al. Effectiveness of brief alcohol interventions in primary care populations. Cochrane Database Syst Rev 2007; 2: CD004148. 17443541
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“They found a 16% increase in the relative risk of achieving recommended levels of physical activity at six to 12 months with exercise referral schemes compared with usual care, but no significant difference between exercise referral schemes and alternative physical activity interventions.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
What the sources say
- Not checked yetcites [40] Pavey TG, Taylor AH, Fox KR, Hillsdon M, Anokye N, Campbell JL, et al. Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: systematic review and meta-analysis. BMJ 2011; 343: d6462. 22058134 PMC3209555
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Only one reviewer screened titles and abstracts, and although papers could have been missed at this stage, seven databases were systematically searched on two occasions (May 2009; repeated May 2010), supplemented by hand searching of reference lists.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Two fifths of included studies were conducted in the UK and most of the remaining trials took place in countries with broadly comparable primary care services, enhancing the generalisability of our findings to these settings.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Strengths and limitations
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In summary, although no significant pooled effect was found, in individual studies, the likelihood of meaningful effect was highest in the comparison of exercise referral schemes with no intervention and weakest for the comparison of exercise referral schemes with advice given face to face.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
In 2006, the UK National Institute for Health and Clinical Excellence advised that exercise referral schemes should not be commissioned in primary care outside of well designed research studies.
“In 2006, the UK National Institute for Health and Clinical Excellence (NICE) advised that exercise referral schemes should not be commissioned in primary care outside of well designed research studies.”
The paper relies on this without support.
Exercise referral schemes remain widely used in the UK despite the NICE recommendation.
“Despite this recommendation, the schemes remain widely used”
The paper relies on this without support.
Physical activity promotion in primary care improves self reported physical activity in the short term (3-6 months), but its effect in the longer term is unclear.
“Physical activity promotion in primary care improves self reported physical activity in the short term (3-6 months), but its effect in the longer term is unclear”
The paper relies on this without support.
Exercise referral schemes are popular yet costly, and their effectiveness compared with other types of intervention over the medium to long term is unknown.
“Exercise referral schemes are popular yet costly, and their effectiveness compared with other types of intervention over the medium to long term is unknown”
The paper relies on this without support.
Self reported measures of physical activity lack precision.
“Self reported measures of physical activity also lack precision and our findings would have been strengthened if complemented by greater use of objective measures.”
The paper relies on this without support.
It is difficult to conceal the study group from participants in physical activity trials.
“It is difficult to conceal the study group from participants in physical activity trials, and self reported measures are therefore susceptible to differential social desirability bias, which could inflate estimates of intervention effect.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“primary care-based interventions for increasing physical activity (PA) are effective [4-7]”
From Discriminant content validity of a theoretical domains framework questionnaire for use in implementation research (2014) · cites this paper as [7]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Results > Intervention effects of exercise referral interventions
“No study found a significant effect on self reported physical activity at 12 months.”
§ Effectiveness of physical activity promotion based in primary care: systematic review and meta-analysis of randomised controlled trials > Discussion > Summary and interpretation of findings
“A third study used a no intervention control, and found small to medium sized positive effects on self reported activity, which were significant for continuous (frequency of exercise sessions) but not dichotomous data (proportion of participants who had become more active from study entry).27”
Citations
Cites
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
A taxonomy of behavior change techniques used in interventions
Abraham, C., & Michie, S. (2008) · Health Psychology · doi:10.1037/0278-6133.27.3.379 · Cited by 2,525
PHYSICAL ACTIVITY AS AN INDEX OF HEART ATTACK RISK IN COLLEGE ALUMNI1
PAFFENBARGER, R. S., WING, A. L., & HYDE, R. T. (1978) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a112608 · Cited by 1,980
Physician advice for smoking cessation
Stead, L. F., Buitrago, D., Preciado, N., Sanchez, G., Hartmann-Boyce, J., & Lancaster, T. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd000165.pub4 · Cited by 1,955
Effectiveness of brief alcohol interventions in primary care populations
Kaner, E. F., Beyer, F. R., Muirhead, C., Campbell, F., Pienaar, E. D., Bertholet, N., Daeppen, J. B., Saunders, J. B., & Burnand, B. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004148.pub4 · Cited by 1,665
Inequalities in access to medical care by income in developed countries
van Doorslaer, E. K. A. (2006) · Canadian Medical Association Journal · doi:10.1503/cmaj.050584 · Cited by 976
Effectiveness of brief alcohol interventions in primary care populations
Kaner, E. F. S., Dickinson, H. O., Beyer, F. R., Campbell, F., Schlesinger, C., Heather, N., Saunders, J. B., Burnand, B., & Pienaar, E. D. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004148.pub3 · Cited by 746
Interventions for promoting physical activity
Foster, C., Hillsdon, M., Thorogood, M., Kaur, A., & Wedatilake, T. (2005) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd003180.pub2 · Cited by 692
Elley, C. R., Kerse, N., Arroll, B., & Robinson, E. (2003) · BMJ · doi:10.1136/bmj.326.7393.793 · Cited by 606
Woodcock, J., Franco, O. H., Orsini, N., & Roberts, I. (2010) · International Journal of Epidemiology · doi:10.1093/ije/dyq104 · Cited by 546
Research works printed but not linked: 3
- [33]Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions version 5.0.2 (updated September 2009). Chapter 8. Cochrane Collaboration, 2009.
- [34]Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions version 5.0.2 (updated September 2009). Chapter 7.7.3.8. Cochrane Collaboration, 2009.
- [37]Higgins JPT, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions version 5.0.2 (updated September 2009). Chapter 16.3.4. Cochrane Collaboration, 2009.
Cited by
Sorted by citations
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., et al. (2019) · Circulation · doi:10.1161/cir.0000000000000678 · Cited by 4,536
(2019) · doi:10.1161/cir.0000000000000677 · Cited by 4,501
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., et al. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2019.03.010 · Cited by 1,896
2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary
Arnett, D. K., Blumenthal, R. S., Albert, M. A., Buroker, A. B., Goldberger, Z. D., Hahn, E. J., Himmelfarb, C. D., Khera, A., Lloyd-Jones, D., McEvoy, J. W., et al. (2019) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2019.03.009 · Cited by 1,193
OECD (2019) · OECD health policy studies · doi:10.1787/67450d67-en · Cited by 1,227
Metadata
- Authors
- Orrow, G., Kinmonth, A.-L., Sanderson, S., & Sutton, S.
- Affiliations
- University of Cambridge (GB)
- Corresponding author
- Orrow, G.
- ORCID
- Sutton, S.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2012-03-26
- Volume
- 344
- Issue
- mar26 1
- Pages
- e1389-e1389
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC3312793
- OpenAlex
- W2042918999
- Semantic Scholar
- 0a174ab0223bbd7717ddc5e15780ad7502b72b2d
- Cited by
- 739
- References
- 38
- Citations by year
- 2026: 28 · 2025: 32 · 2024: 54 · 2023: 36 · 2022: 39 · 2021: 60 · 2020: 126 · 2019: 54 · 2018: 49 · 2017: 53 · 2016: 45 · 2015: 51 · 2014: 56 · 2013: 43 · 2012: 13
- FWCI
- 5.61
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- National Institute for Health and Care Research (RP-PG-0608-10079, PB-PG-0110-20199, NF-SI-0507-10182, ACF-2008-14-008)
- University of Cambridge
- NIHR School for Primary Care Research
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Keywords
- physical activity promotion, primary care, sedentary adults, exercise referral schemes, physical activity counseling, cardiorespiratory fitness, health behavior change, number needed to treat, long-term intervention effects, telephone counseling, self-reported physical activity, health disparities, health inequalities reduction
- MeSH terms
- Counseling, Exercise Therapy, Health Promotion, Humans, Motor Activity, Primary Health Care, Randomized Controlled Trials as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-06, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-06 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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