To the Editor: We applaud the efforts of Wasiak et al to apply the principles of evidence-based medicine to answer clinical questions.1 However, it is important to understand the historical context of clinical trials reported in the literature, and, when necessary (eg, when conducting a meta-analysis or when the results of trials appear to conflict), to seek additional information from the authors.
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- 1. Wasiak J, Hoare BJ, Hender KM. Does intramuscular botulinum toxin A injection improve upper-limb function in children with hemiplegic cerebral palsy? Med J Aust 2002; 177: 158. <eMJA full text>
- 2. Corry IS, Cosgrove AP, Walsh EG, et al. Botulinum toxin A in the hemiplegic upper limb: a double-blind trial. Dev Med Child Neurol 1997; 39: 185-193.
- 3. Fehlings D, Rang M, Glazier J, Steele C. An evaluation of botulinum toxin A injection to improve upper extremity function in children with hemiplegic cerebral palsy. J Pediatr 2000; 137: 331-337.
- 4. Verhagen AP, de Vet HC, De Bie RA, et al. The Delphi list: a criteria list for quality assessment of randomised clinical trials for conducting systematic reviews. J Clin Epidemiol 1998; 51: 1234-1241.
- 5. Boyd RN, Morris ME, Graham HK. Management of upper limb dysfunction in children with cerebral palsy: a systematic review. Eur J Neurol 2001; 8 (Suppl 5): 150-166.
- 6. Boyd RN, Bach T, Morris ME, et al. A randomised trial of botulinum toxin A (BTXA) and upper limb training — a functional magnetic resonance Imaging and resonant frequency study. Dev Med Child Neurol 2002; 44 (Suppl 91): B9.
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