PEDro is a free, preeminent, global resource to support evidence-based practice. It provides rapid access to articles reporting the results of randomised controlled trials, systematic reviews, and clinical practice guidelines evaluating physiotherapy interventions. This paper describes the PEDro scale (methodological quality checklist), PEDro contents, who uses PEDro, searching, browsing the latest content, and developing skills in evidence-based physiotherapy. Strategies specifically developed to break down barriers for Portuguese-speaking physiotherapists were emphasised in the paper.
All trials indexed in PEDro are assessed for methodological quality and completeness of data reporting using the 10-point PEDro scale. These ratings are used to rank search results, with the highest quality trials appearing first. Users can click through to the “Detailed Search Results” to see the ratings for each of the individual items for the trial. The PEDro scale has been translated and cross-culturally adapted into Brazilian Portuguese following best practice guidelines, so that clinicians who are not proficient in English can also use the scale.
In August 2019 PEDro indexed 44,309 articles: 34,619 trials, 9,004 reviews, and 686 guidelines. The number of trials is predicted to double, and the number of reviews and guidelines to increase four-fold, by 2025. This rapid growth highlights the importance of physiotherapists having well-developed skills in evidence-based practice so they can use the best research to inform practice, policy and teaching.
Between July 2018 and June 2019, PEDro users came from 214 countries. Physiotherapists from Brazil were the largest users (23% of all searches). PEDro was used across all states in Brazil. Five states accounted for 62% of PEDro usage in Brazil: São Paulo (29%), Minas Gerais (15%), and Bahia, Ceará, and Rio de Janeiro (all 6%).
Physiotherapists are encouraged to use the PEDro advanced search to find answers for their clinical questions. Search terms can be entered into any of 13 optional fields on this page. Six fields (Therapy, Problem, Body Part, Subdiscipline, Topic, Method) have pull-down menus with options that correspond to the coding of articles in the database. The remaining fields allow free text to be entered (Title & Abstract, Title Only, Author/Association, Source, Published Since, New Records Added Since, Score of at least). The search page is intuitive, but an analysis of the terms entered by users has identified some common errors. First, Boolean operators and parentheses do not function in any of the search fields, so should not be used in PEDro searching. Second, bibliographic details of articles are entered into PEDro using American Standard Code for Information Interchange (ASCII) characters. Therefore, users who are searching with the name “Gonçalves” in the Author/Association field or the term “esclerose múltipla” in the Title Only field would have to enter “Goncalves” or “esclerose multipla” to conduct a valid search. Automated alert messages have been added to the search page to notify users when they enter erroneous text.
When a PEDro search is conducted, the results of the search are presented in a particular order to encourage users to click on more synthesised and higher-quality research within the search results. Guidelines are shown first (sorted by year), followed by reviews (with reviews published in the Cochrane Database of Systematic Reviews appearing before reviews published in other journals, both sorted by year), and then trials (from highest quality to lowest quality). Searching PEDro is free for anyone who has access to the internet. Almost all articles in PEDro show the abstract and about half of the articles in PEDro also have links to free full text online, so even users who do not have access to a library of journals will still find it fruitful.
PEDro’s Evidence in your inbox allows physiotherapists to browse the latest content. Users can sign up to receive free monthly updates via email that detail the most recent additions to PEDro in up to 15 areas of practice. This has been a very popular service, with over 13,600 subscribers in August 2019. Brazil has a high rate of uptake, accounting for 35% of subscribers.
PEDro web-site and YouTube channel is available in 13 languages, including English and Portuguese. We also provide newsletters, blogs, Facebook and Twitter in both English and Portuguese. To assist physiotherapists to develop skills in evidence-based practice, PEDro includes a series of ‘how to’ videos and tutorials. The videos can be accessed via the PEDro search help pages and YouTube channel and include: how to ask a clinical question, and how to perform a PEDro simple or advanced search. The PEDro scale training program is currently available in English and Portuguese. The training is online through a 3-month subscription for a small fee.
PEDro facilitates the use of high-quality clinical research by physiotherapy clinicians, educators, students, and researchers. In 2019 PEDro celebrated its twentieth anniversary. Enhancements to mark this milestone included launching a new database called DiTA (Diagnostic Test Accuracy) that focuses on the accuracy of diagnostic tests used by physiotherapists.