#0048 Author Reply to “A randomized clinical trial for neck pain among adults”
Better Research Needed for Possible Benefits of Tasuki for Neck Pain
A tasuki is a sash used to hold up the sleeves of a kimono, an important garment in traditional Japanese culture. The wearer loops the tasuki around both shoulders such that it crosses over the back. In a 2019 issue of the Journal of Occupational Health, we published the results of a small randomized clinical trial indicating that wearing a tasuki-like postural support can alleviate chronic neck pain after a week of use. Given the low-cost, low-risk, and easy-to-use nature of a tasuki, it could be an excellent option for patients seeking relief from neck pain.
Following the publication, two independent scholars, Dr. Maryam Bashir and Dr. Elpidoforos Soteriades, wrote a Letter to the Editor in which they noted several problems with the trial’s design.
One such problem was that the original study might have used a suboptimal procedure for randomizing trial participants to a control group and a tasuki-wearing group. They suggest that we should have used a technique called covariable adaptive randomization that ensures that the resulting groups are similar in terms of variables such as average ages or neck pain severities, rather than the simple randomization technique we used that is analogous to just flipping a coin or rolling a die.
Another problem was the lack of allocation concealment, which reduces bias by hiding information about the randomization.
The Letter’s authors also noted biases that could have arisen due to the trial participants knowing that I was investigating the tasuki as a potential treatment for neck pain. The reports of neck pain alleviation in the tasuki-wearing group could have been due to a placebo effect or a phenomenon called socially desirable responding, which is a bias towards responding to questions with statements that will please the questioner.
In our reply to their Letter to the Editor, we concede that Dr. Maryam Bashir and Dr. Elpidoforos Soteriades raise valid criticisms. We believe that researchers should acknowledge the limitations of their work, that open discussion of such limitations will lead to more rigorous and informative research. We appreciate the points raised in the Letter to the Editor, and hope that larger trials with rigorous methods will clarify whether the tasuki can in fact alleviate chronic neck pain.
Link to the original journal article:
https://onlinelibrary.wiley.com/doi/10.1002/1348-9585.12127
Title of the paper:
Author Reply to “A randomized clinical trial for neck pain among adults”
Authors:
Yuki Furukawa
