Author Response

Reply to the letter to the Editor “Complete transparency of a systematic review for readers”. First of all, we thank for the contribution aimed to improve a complete transparency of our systematic review for readers. It allows us to clarify some aspects that we did not specify in the published manuscript. We agree with you on the importance of the PRISMA statement that guided our systematic review, because the first author of its original paper, Prof. Liberati Alessandro, who disappeared prematurely, was our mentor. This can be an opportunity to remember him and his great commitment to the scientific community. Therefore, we confirm that we followed the PRISMA statement suggestions concerning the methods used for the systematic review. More specifically, despite we did not register the study protocol, we did not amend in any case our research design after the initiation of our study. A protocol exists but it was not made public and it is a “data not shown”. In the protocol we established a priori the objectives and methods of our review, the outcomes, the methods of data extraction and those for qualitative and quantitative synthesis. The protocol was not modified during the editing of the systematic review. Moreover, we extracted data in an agreed beforehand report, an excel cartel with color codes. We verified the report on some randomly selected studies and then it was improved accordingly. Subsequently two authors extracted all the data independently. The disagreements were solved by discussion among all the authors and if consent was not reached the decision was made by the most expert author. It was not necessary contacting other authors for more information. We searched data about the characteristics of participants (e.g. age, diagnosis, symptoms, red flags, inclusion and exclusion criteria), the characteristics of interventions (e.g. type, dosage, position, and time of traction, and type of physical therapy interventions), the characteristics of outcome measures for pain and disability. The data we extracted from included studies were about authors (names of Authors, countries, and publication years), characteristics of participants (number of participants for each group, mean age, and gender), outcome measures employed for pain and disability (e.g. VAS, NRS, Neck Pain and Disability Scale, etc.), follow-up timing (e.g. immediately post-treatment and/or at different post-treatment intervals), results (means and standard deviations at pre- and post-treatment for each outcome measure and for each follow-up time), and adverse events. We hope that these clarifications will improve the readability of the systematic review on the effectiveness of traction added to physical therapy interventions in cervical radiculopathy.