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Maund E, Craig D, Suekarran S, et al. Management of Frozen Shoulder: A Systematic Review and Cost-Effectiveness Analysis. Southampton (UK): NIHR Journals Library; 2012 Mar. (Health Technology Assessment, No. 16.11.)

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Management of Frozen Shoulder: A Systematic Review and Cost-Effectiveness Analysis.

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Appendix 10Mixed-treatment comparison

Network 1: studies of any intervention (i.e. conservative and invasive) and any quality

Prior: Uniform (0, 0.8)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Physical therapy without mobilisation4−1.71−2.75 to −0.67a
Steroid + physiotherapy6−1.53−2.41 to −0.75a
Electroacupuncture71.36−2.84 to 0.11
Physiotherapy + placebo2−1.22−1.98 to −0.42a
Steroid5−1.15−2.03 to −0.26a
Physiotherapy3−0.94−2.20 to 0.38
MUA + physiotherapy8−0.87−2.44 to 0.78
Sodium hyaluronate10−0.21−1.13 to 0.69
Arthrographic distension + steroid9−0.15−1.19 to 0.90
a

Did not cross line of no effect.

Data points: 13; residual deviance: 12.72; τ2 (between-study variance): 0.17 (95% CrI 0.0004 to 0.58).

Prior: Uniform (0, 2)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Physical therapy without mobilisation4−1.71−3.27 to −0.15a
Steroid + physiotherapy6−1.57−2.80 to −0.53a
Electroacupuncture7−1.36−3.55 to 0.84
Physiotherapy + placebo2−1.21−2.27 to −0.06a
Steroid5−1.14−2.31 to 0.05
Physiotherapy3−0.93−2.78 to 1.02
MUA + physiotherapy8−0.85−3.24 to 1.63
Sodium hyaluronate10−0.21−1.71 to 1.27
Arthrographic distension + steroid9−0.15−1.70 to 1.41
a

Did not cross line of no effect.

Data points: 13; residual deviance: 12.59; τ2 (between-study variance): 0.46 (95% CrI 0.0004 to 2.62).

Prior: Uniform (0, 10)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Physical therapy without mobilisation4−1.70−3.46 to 0.06
Steroid + physiotherapy6−1.57−2.93 to −0.42a
Electroacupuncture7−1.35−3.84 to 1.11
Physiotherapy + placebo2−1.21−2.40 to 0.08
Steroid5−1.14−2.44 to 0.19
Physiotherapy3−0.94−3.03 to 1.26
MUA + physiotherapy8−0.86−3.57 to 1.95
Sodium hyaluronate10−0.21−1.90 to 1.46
Arthrographic distension + steroid9−0.14−1.89 to 1.62
a

Did not cross line of no effect.

Data points: 13; residual deviance: 12.69; τ2 (between-study variance): 0.75 (95% CrI 0.0006 to 4.83).

Prior: Uniform (0, 15)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Physical therapy without mobilisation4−1.71−3.42 to 0.003
Steroid + physiotherapy6−1.57−2.93 to −0.44a
Electroacupuncture7−1.36−3.77 to 1.04
Physiotherapy + placebo2−1.22−2.38 to 0.056
Steroid5−1.143−2.45 to 0.17
Physiotherapy3−0.94−2.98 to 1.24
MUA + physiotherapy8−0.86−3.49 to 1.88
Sodium hyaluronate10−0.21−1.87 to 1.45
Arthrographic distension + steroid9−0.15−1.89 to 1.58
a

Did not cross line of no effect.

Data points: 13; residual deviance: 12.69; τ2 (between-study variance): 0.73 (95% CrI 0.0005 to 4.43).

Network 2: studies of any intervention that were of good or satisfactory quality (i.e. method of randomisation was adequate and outcome assessment was blinded)

There were five trials with data that could be used in the analysis of pain at or close to 3 months. Five interventions formed part of a connected network with placebo and the evidence was informed by four trials. The network is presented in Figure 27.

FIGURE 27. Network 2.

FIGURE 27

Network 2. PT, physical therapy.

Each line represents one comparison, for example there were two studies available for the comparison of steroid with placebo, and one study for the comparison of other physical therapy with placebo.

Prior: Uniform (0, 0.8)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Steroid + physiotherapy2−1.90−2.79 to −1.02a
Physical therapy without mobilisation5−1.70−2.66 to −0.75a
Steroid3−1.14−1.98 to −0.31a
Physiotherapy + placebo4−0.93−1.75 to −0.12a
Arthrographic distension + steroid6−0.15−1.09 to 0.80
a

Did not cross line of no effect.

Data points: 8; residual deviance: 6.30; τ2 (between-study variance): 0.13 (95% CrI 0.0002 to 0.5585).

Prior: Uniform (0, 2)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Steroid + physiotherapy2−1.90−3.06 to −0.78a
Physical therapy without mobilisation5−1.71−3.15 to −0.29a
Steroid3−1.14−2.24 to −0.03a
Physiotherapy + placebo4−0.92−2.03 to 0.16
Arthrographic distension + steroid6−0.14−1.59 to 1.29
a

Did not cross line of no effect.

Data points: 8; residual deviance: 6.50; τ2 (between-study variance): 0.38 (95% CrI 0.0002. to 2.55).

Prior: Uniform (0, 5)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Steroid + physiotherapy2−1.90−3.24 to −0.61a
Physical therapy without mobilisation5−1.71−3.43 to 0.002
Steroid3−1.14−2.42 to 0.14
Physiotherapy + placebo4−0.93−2.20 to 0.34
Arthrographic distension + steroid6−0.15−1.87 to 1.55
a

Did not cross line of no effect.

Data points: 8; residual deviance: 6.47; τ2 (between-study variance): 0.70 (95% CrI 0.0002 to 5.8).

Prior: Uniform (0, 10)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Steroid + physiotherapy2−1.909−3.31 to −0.54a
Physical therapy without mobilisation5−1.705−3.54 to 0.12
Steroid3−1.15−2.51 to 0.22
Physiotherapy + placebo4−0.9271−2.9 to 0.43
Arthrographic distension + steroid6−0.1412−1.97 to 1.70
a

Did not cross line of no effect.

Data points: 8; residual deviance: 6.59; τ2 (between-study variance): 1.02 (95% CrI 0.0002 to 7.47).

Network 3: studies of conservative treatments of any quality

There were six trials with data that could be used in the analysis of pain at or close to 3 months. Six interventions formed part of a connected network with placebo and the evidence was informed by six trials. The network is presented in Figure 28.

FIGURE 28. Network 3.

FIGURE 28

Network 3. PT, physical therapy.

Each line represents one comparison, for example there were two studies available for the comparison of steroid with placebo, and one study for the comparison of other physical therapy with placebo.

Prior: Uniform (0, 0.8)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Physical therapy without mobilisation6−1.71−2.73 to −0.68a
Steroid + physiotherapy5−1.53−2.40 to −0.75a
Electroacupuncture7−1.36−2.81 to 0.092
Physiotherapy + placebo2−1.22−1.98 to −0.42a
Steroid4−1.15−2.02 to −0.27a
Physiotherapy3−0.94−2.20 to 0.38
a

Did not cross line of no effect.

Data points: 10; residual deviance: 9.70; τ2 (between-study variance): 0.17 (95% CrI 0.0003 to 0.58).

Prior: Uniform (0, 2)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Physical therapy without mobilisation6−1.71−3.24 to −0.19a
Steroid + physiotherapy5−1.56−2.77 to −0.54a
Electroacupuncture7−1.36−3.52 to 0.79
Physiotherapy + placebo2−1.21−2.25 to −0.067a
Steroid4−1.14−2.31 to 0.034
Physiotherapy3−0.92−2.73 to 1.00
a

Did not cross line of no effect.

Data points: 10; residual deviance: 9.64; τ2 (between-study variance): 0.0.44 (95% CrI 0.0005 to 2.53).

Prior: Uniform (0, 5)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Physical therapy without mobilisation6−1.70−3.43 to −0.002a
Steroid + physiotherapy5−1.58−2.92 to −0.46a
Electroacupuncture7−1.35−3.80 to 1.05
Physiotherapy + placebo2−1.21−2.38 to 0.037
Steroid4−1.15−2.43 to 0.14
Physiotherapy3−0.93−2.98 to 1.21
a

Did not cross line of no effect.

Data points: 10; residual deviance: 9.65; τ2 (between-study variance): 0.65 (95% CrI 0.0004 to 4.29).

Prior: Uniform (0, 10)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Physical therapy without mobilisation6−1.70−3.43 to 0.059
Steroid + physiotherapy5−1.57−2.92 to −0.43a
Electroacupuncture7−1.35−3.81 to 1.13
Physiotherapy + placebo2−1.21−2.39 to 0.060
Steroid4−1.15−2.45 to 0.15
Physiotherapy3−0.92−2.99 to 1.25
a

Did not cross line of no effect.

Data points: 10; residual deviance: 9.61; τ2 (between-study variance): 0.72 (95% CrI 0.0004 to 4.54).

Network 4. Network 4: studies of conservative treatments that were of good or satisfactory quality (i.e. method of randomisation was adequate and outcome assessment was blinded)

There were three trials with data that could be used in the analysis of pain at or close to 3 months. Four interventions formed part of a connected network with placebo and the evidence was informed by four trials. The network is presented in Figure 29.

FIGURE 29. Network 4.

FIGURE 29

Network 4. PT, physical therapy.

Each line represents one comparison, for example there were two studies available for the comparison of steroid with placebo, and one study for the comparison of other physical therapy with placebo.

Prior: Uniform (0, 0.8)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Steroid + physiotherapy2−1.9−2.79 to −1.02a
Physical therapy without mobilisation5−1.7−2.66 to −0.76a
Steroid3−1.14−1.97 to −0.31a
Physiotherapy + placebo4−0.94−2.66 to −0.76a

PT, physical therapy.

a

Did not cross line of no effect.

Data points: 7; residual deviance: 5.31; τ2 (between-study variance): (95% CrI 0.0002 to 0.56).

Prior: Uniform (0, 2)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Steroid + physiotherapy2−1.911−3.06 to −0.81a
Physical therapy without mobilisation5−1.706−3.12 to −0.30a
Steroid3−1.146−2.23 to −0.06a
Physiotherapy + placebo4−0.9251−2.01 to 0.14
a

Did not cross line of no effect.

Data points: 7; residual deviance: 5.44; τ2 (between-study variance): 0.36 (95% CrI 0.0002 to 2.54).

Prior: Uniform (0, 5)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Steroid + physiotherapy2−1.912−3.24 to −0.62a
Physical therapy without mobilisation5−1.71−3.43 to 0.008
Steroid3−1.14−2.43 to 0.16
Physiotherapy + placebo4−0.93−2.22 to 0.34
a

Did not cross line of no effect.

Data points: 7; residual deviance: 5.51; τ2 (between-study variance): 0.70 (95% CrI 0.0002 to 5.87).

Prior: Uniform (0, 10)
Comparator: placebo
TreatmentNode no.SMD
Mean95% CrI
Steroid + physiotherapy2−1.91−3.35 to −0.54a
Physical therapy without mobilisation5−1.71−3.55 to 0.14
Steroid3−1.15−2.51 to 0.25
Physiotherapy + placebo4−0.93−2.32 to 0.43
a

Did not cross line of no effect.

Data points:7; residual deviance: 5.5; τ2 (between-study variance): 1.03(95% CrI 0.0002 to 7.64).

Did not cross line of no effect.

Did not cross line of no effect.

Did not cross line of no effect.

Did not cross line of no effect.

Did not cross line of no effect.

Did not cross line of no effect.

Did not cross line of no effect.

Did not cross line of no effect.

Did not cross line of no effect.

Did not cross line of no effect.

Did not cross line of no effect.

Did not cross line of no effect.

Did not cross line of no effect.

Did not cross line of no effect.

Did not cross line of no effect.

Did not cross line of no effect.

© 2012, Crown Copyright.

Included under terms of UK Non-commercial Government License.

Bookshelf ID: NBK97996
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