Failure of a numerical quality assessment scale to identify potential risk of bias in a systematic review: a comparison study

BACKGROUND: Assessing methodological quality of primary studies is an essential component of systematic reviews. Following a systematic review which used a domain based system [United States Preventative Services Task Force (USPSTF)] to assess methodological quality, a commonly used numerical rating scale (Downs and Black) was also used to evaluate the included studies and comparisons were made between quality ratings assigned using the two different methods. Both tools were used to assess the 20 randomized and quasi-randomized controlled trials examining an exercise intervention for chronic musculoskeletal pain which were included in the review. Inter-rater reliability and levels of agreement were determined using intraclass correlation coefficients (ICC). Influence of quality on pooled effect size was examined by calculating the between group standardized mean difference (SMD).

RESULTS: Inter-rater reliability indicated at least substantial levels of agreement for the USPSTF system (ICC 0.85; 95% CI 0.66, 0.94) and Downs and Black scale (ICC 0.94; 95% CI 0.84, 0.97). Overall level of agreement between tools (ICC 0.80; 95% CI 0.57, 0.92) was also good. However, the USPSTF system identified a number of studies (n = 3/20) as "poor" due to potential risks of bias. Analysis revealed substantially greater pooled effect sizes in these studies (SMD -2.51; 95% CI -4.21, -0.82) compared to those rated as "fair" (SMD -0.45; 95% CI -0.65, -0.25) or "good" (SMD -0.38; 95% CI -0.69, -0.08).

CONCLUSIONS: In this example, use of a numerical rating scale failed to identify studies at increased risk of bias, and could have potentially led to imprecise estimates of treatment effect. Although based on a small number of included studies within an existing systematic review, we found the domain based system provided a more structured framework by which qualitative decisions concerning overall quality could be made, and was useful for detecting potential sources of bias in the available evidence.

Strength model for end cover separation failure in RC beams strengthened with near-surface mounted (NSM) FRP strips

As an alternative to externally bonded FRP reinforcement, near-surface mounted (NSM) FRP reinforcement can be used to effectively improve the flexural performance of RC beams. In such FRP strengthened RC beams, end cover separation failure is one of the common failure modes. This failuremode involves the detachment of the NSM FRP reinforcement together with the concrete cover along the level of the tension steel reinforcement. This paper presents a new strength model for end cover separation failure in RC beams strengthened in flexure with NSM FRP strips (i.e. rectangular FRP bars with asectional height-to-thickness ratio not less than 5), which was formulated on the basis of extensive numerical results from a parametric study undertaken using an efficient finite element approach. The proposed strength model consists of an approximate equation for the debonding strain of the FRP reinforcement at the critical cracked section and a conventional section analysis to relate this debondingstrain to the moment acting on the same section (i.e. the debonding strain). Once the debonding strain is known, the load level at end cover separation of an FRP-strengthened RC beam can be easily determined for a given load distribution. Predictions from the proposed strength model are compared with those of two existing strength models of the same type and available test results, which shows that the proposed strength model is in close agreement with test results and is far more accurate than the existing strength models.

Analytical model for bar-end cover separation failure in RC beams strengthened with near-surface mounted FRP

The flexural performance of RC beams can be improved using the near-surface mounted (NSM) FRP strengthening technique. A likely failure mode of such FRP-strengthened RC beams is bar-end cover separation which involves the detachment of the NSM FRP reinforcement together with the concrete cover along the level of the steel tension reinforcement. This paper presents a new analytical strength model for this failure mode. The proposed strength model and two existing strength models for this failure mode are compared with test results to demonstrate the superior performance of the new analytical model.

Improving composite damage modelling through automatic placement of cohesive elements

Numerous experimental studies of damage in composite laminates have shown that intralaminar (in-plane) matrix cracks lead to interlaminar delamination (out-of-plane) at ply interfaces. The smearing of in-plane cracks over a volume, as a consequence of the use of continuum damage mechanics, does not always effectively capture the full extent of the interaction between the two failure mechanisms. A more accurate representation is obtained by adopting a discrete crack approach via the use of cohesive elements, for both in-plane and out-of-plane damage. The difficulty with cohesive elements is that their location must be determined a priori in order to generate the model; while ideally the position of the crack migration, and more generally the propagation path, should be obtained as part of the problem’s solution. With the aim of enhancing current modelling capabilities with truly predictive capabilities, a concept of automatic insertion of interface elements is utilized. The consideration of a simple traction criterion in relation to material strength, evaluated at each node of the model (or of the regions of the model where it is estimated cracks might form), allows for the determination of initial crack location and subsequent propagation by the insertion of cohesive elements during the course of the analysis. Several experimental results are modelled using the commercial package ABAQUS/Standard with an automatic insertion subroutine developed in this work, and the results are presented to demonstrate the capabilities of this technique.

Experimental and numerical study of debonding in composite adhesive joints

The mode I and mode II fracture properties of the FM300-2 adhesive bond between 5HS/RTM6 laminates are determined experimentally by DCB and ELS test. The crack propagation is studied numerically by means of interface elements based on the decohesive zone model. The latter is characterized by material degradation, which is usually assumed to be linear. In the present study it is shown that if a non-linear material degradation is used with an increased magnitude of the interface relative displacement at failure it is possible to model more correctly the experimentally observed significant non-linear behaviour before the start of crack propagation. An adhesive stepped flush joint is studied experimentally and numerically. A mixed mode interaction criterion is used together with the nonlinear material degradation of the interface. Sensitivity studies are performed to study the influence of the parameters defining it.

Numerical analysis of complex failure mechanisms in composite panels

A three-dimensional continuum damage mechanics-based material model has been implemented in an implicit Finite Element code to simulate the progressive degradation of advanced composite materials. The damage model uses seven damage variables assigned to tensile, compressive and non-linear shear damage at a laminae level. The objectivity of the numerical discretization is assured using a smeared formulation. The material model was benchmarked against experimental uniaxial coupon tests and it is shown to reproduce key aspects observable during failure, such as the inclined fracture plane in matrix compression and the shear band in a ±45° tension specimen.