{"id":7544,"date":"2018-01-12T08:09:23","date_gmt":"2018-01-12T07:09:23","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=7544"},"modified":"2018-01-12T08:10:12","modified_gmt":"2018-01-12T07:10:12","slug":"letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/","title":{"rendered":"Letter in response to \u201cThe effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction\u201d"},"content":{"rendered":"<p><strong><em>By Matheus Oliveira de Almeida <\/em><\/strong><strong><em>@Matheusoa,<\/em><\/strong> <strong><em>and Bruno T Saragiotto\u00a0@bsaragiotto<\/em><\/strong><\/p>\n<p>Korakakis and colleagues\u2019 recent systematic review of extracorporeal shockwave therapy (ESWT) concluded that the intervention may be effective in the treatment of some lower limb conditions<a href=\"#_ENREF_1\"><sup>1<\/sup><\/a>. However, some aspects of the review raise doubts about the positive conclusion.<\/p>\n<p>Although the authors reported that they conducted the review following recommendations in the Cochrane Handbook<a href=\"#_ENREF_2\"><sup>2<\/sup><\/a>, there are some important departures, which have likely introduced biases. Firstly, the authors have included a non-randomised study (case-control study) in the meta-analysis. Effect estimates from non-randomised studies tend to be larger when compared to randomised controlled trials (RCT)<sup><a href=\"#_ENREF_3\">3<\/a> <a href=\"#_ENREF_4\">4<\/a><\/sup>. This is demonstrated in Figure 4 (Appendix 3; Comparison 1.2.3), with the effect size of the non-randomised study (Furia 2009; odds ratio 3.08, CI 1.59 to 5.95) being three times greater than one of the RCTs (Rompe 2009; odds ratio 9.90, CI 3.19 to 30.75) in the comparison between ESWT and control for self-perceived recovery at intermediate-term in greater trochanteric pain syndrome.<\/p>\n<p>Another methodological concern is that the authors excluded a trial at low risk of bias due to the trial\u2019s small sample size; introducing reporting bias. In a meta-analysis, studies are assigned weights based on mathematical criteria, such as study\u2019s precision, which is primarily driven by sample size. Hence, studies with relatively poor precision are assigned less weight, while studies that yield more precise estimates are assigned more weight<a href=\"#_ENREF_5\"><sup>5<\/sup><\/a>. Further, the chance of detecting a real effect increases when several studies are combined. So, there is no reason to exclude a RCT from the analysis based on a small sample size.<\/p>\n<p>Another concern is the authors\u2019 application of the GRADE approach for the quality of evidence. The authors have chosen to increase the GRADE score by one level if the treatment effect was large (e.g. ESWT versus conservative treatment in proximal hamstring tendinopathy, Table 10). We believe that this decision came from the authors\u2019 misunderstanding of the Cochrane Handbook chapter 12.2.1<a href=\"#_ENREF_2\"><sup>2<\/sup><\/a>, which advocates that the quality of evidence for observational studies can be increased if they yield large effects and there is no obvious bias explaining those effects. This is a specific recommendation for observational studies and cannot be generalised.<\/p>\n<p>These highlighted problems mean that these recommendations on the effectiveness of ESWT should be interpreted with some caution. ESWT is an expensive and sometimes painful treatment and decisions on its use need to be based upon unbiased summaries of the available evidence.<\/p>\n<p><strong><em>\u00a0<\/em><\/strong><strong><em>Matheus Oliveira de Almeida<\/em><\/strong> <strong><em>(<\/em><\/strong><strong><em>@Matheusoa<\/em><\/strong><strong><em>)<\/em><\/strong> has PhD\u00a0in Evidence Based in Medicine at Brazilian Cochrane Collaboration Centre.\u00a0Currently I am a Post-Doctoral fellow, working on methodological projects in low back pain field&#8221;<\/p>\n<div><em><strong>Bruno Saragiotto<\/strong><strong>\u00a0(@bsaragiotto)<\/strong><\/em> competed his PhD at the School of Public Health, University of Sydney and postdoc at the University of Newcastle. He is currently a research fellow at the Centre for Pain, Health and Lifestyle (<a href=\"http:\/\/centrephl.org\/\" target=\"_blank\" rel=\"noopener\">centrephl.org<\/a>). He has over 50 publications and is an associate editor of the Cochrane Back and Neck group and BMC Musculoskeletal Disorders. He also co-leads the International Collaboration for Early Career Researchers (<a href=\"http:\/\/theicecream.org\/\" target=\"_blank\" rel=\"noopener\">theICECReam.org<\/a>).<\/div>\n<div><\/div>\n<p><em><strong>References<\/strong><\/em><\/p>\n<ol>\n<li>Korakakis V, Whiteley R, Tzavara A, et al. The effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction. <em>Br J Sports Med<\/em> 2017 10.1136\/bjsports-2016-097347.<\/li>\n<li>Higgins JPT, Green S. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). 2011.<\/li>\n<li>Savovic J, Jones HE, Altman DG, et al. Influence of reported study design characteristics on intervention effect estimates from randomized, controlled trials. <em>Ann Intern Med<\/em> 2012;157(6):429-38.<\/li>\n<li>Reeves BC. Principles of research: limitations of non-randomized studies. <em>Surgery<\/em> 2008;26(3):120-24.<\/li>\n<li>Borenstein M, Hedges LV, Higgins JPT, et al. How a Meta-Analysis Works, in Introduction to Meta-Analysis. In: Sons JW, ed. Chichester, UK. 2009.<\/li>\n<\/ol>\n<p><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Matheus Oliveira de Almeida @Matheusoa, and Bruno T Saragiotto\u00a0@bsaragiotto Korakakis and colleagues\u2019 recent systematic review of extracorporeal shockwave therapy (ESWT) concluded that the intervention may be effective in the treatment of some lower limb conditions1. However, some aspects of the review raise doubts about the positive conclusion. Although the authors reported that they conducted [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[16068,8265],"class_list":["post-7544","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-featured","tag-letter-to-the-editor"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Letter in response to \u201cThe effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction\u201d - BJSM blog - social media&#039;s leading SEM voice<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Letter in response to \u201cThe effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction\u201d - BJSM blog - social media&#039;s leading SEM voice\" \/>\n<meta property=\"og:description\" content=\"By Matheus Oliveira de Almeida @Matheusoa, and Bruno T Saragiotto\u00a0@bsaragiotto Korakakis and colleagues\u2019 recent systematic review of extracorporeal shockwave therapy (ESWT) concluded that the intervention may be effective in the treatment of some lower limb conditions1. However, some aspects of the review raise doubts about the positive conclusion. Although the authors reported that they conducted [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/\" \/>\n<meta property=\"og:site_name\" content=\"BJSM blog - social media&#039;s leading SEM voice\" \/>\n<meta property=\"article:published_time\" content=\"2018-01-12T07:09:23+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2018-01-12T07:10:12+00:00\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2018\\\/01\\\/12\\\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2018\\\/01\\\/12\\\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"Letter in response to \u201cThe effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction\u201d\",\"datePublished\":\"2018-01-12T07:09:23+00:00\",\"dateModified\":\"2018-01-12T07:10:12+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2018\\\/01\\\/12\\\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\\\/\"},\"wordCount\":630,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#organization\"},\"keywords\":[\"featured\",\"Letter to the editor\"],\"articleSection\":[\"General\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2018\\\/01\\\/12\\\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2018\\\/01\\\/12\\\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2018\\\/01\\\/12\\\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\\\/\",\"name\":\"Letter in response to \u201cThe effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction\u201d - BJSM blog - social media&#039;s leading SEM voice\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#website\"},\"datePublished\":\"2018-01-12T07:09:23+00:00\",\"dateModified\":\"2018-01-12T07:10:12+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2018\\\/01\\\/12\\\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2018\\\/01\\\/12\\\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/2018\\\/01\\\/12\\\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Letter in response to \u201cThe effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction\u201d\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#website\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/\",\"name\":\"BJSM blog - social media&#039;s leading SEM voice\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#organization\",\"name\":\"BJSM blog - social media&#039;s leading SEM voice\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/files\\\/2017\\\/11\\\/blog-logo-bjsm.png\",\"contentUrl\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/files\\\/2017\\\/11\\\/blog-logo-bjsm.png\",\"width\":222,\"height\":34,\"caption\":\"BJSM blog -  social media&#039;s leading SEM voice\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#\\\/schema\\\/logo\\\/image\\\/\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\",\"name\":\"BMJ\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g\",\"caption\":\"BMJ\"},\"sameAs\":[\"https:\\\/\\\/blogs.bmj.com\\\/\"],\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bjsm\\\/author\\\/admin\\\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Letter in response to \u201cThe effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction\u201d - BJSM blog - social media&#039;s leading SEM voice","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/","og_locale":"en_US","og_type":"article","og_title":"Letter in response to \u201cThe effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction\u201d - BJSM blog - social media&#039;s leading SEM voice","og_description":"By Matheus Oliveira de Almeida @Matheusoa, and Bruno T Saragiotto\u00a0@bsaragiotto Korakakis and colleagues\u2019 recent systematic review of extracorporeal shockwave therapy (ESWT) concluded that the intervention may be effective in the treatment of some lower limb conditions1. However, some aspects of the review raise doubts about the positive conclusion. Although the authors reported that they conducted [...]Read More...","og_url":"https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/","og_site_name":"BJSM blog - social media&#039;s leading SEM voice","article_published_time":"2018-01-12T07:09:23+00:00","article_modified_time":"2018-01-12T07:10:12+00:00","author":"BMJ","twitter_card":"summary_large_image","twitter_misc":{"Written by":"BMJ","Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/#article","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/"},"author":{"name":"BMJ","@id":"https:\/\/blogs.bmj.com\/bjsm\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe"},"headline":"Letter in response to \u201cThe effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction\u201d","datePublished":"2018-01-12T07:09:23+00:00","dateModified":"2018-01-12T07:10:12+00:00","mainEntityOfPage":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/"},"wordCount":630,"commentCount":0,"publisher":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/#organization"},"keywords":["featured","Letter to the editor"],"articleSection":["General"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/","url":"https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/","name":"Letter in response to \u201cThe effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction\u201d - BJSM blog - social media&#039;s leading SEM voice","isPartOf":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/#website"},"datePublished":"2018-01-12T07:09:23+00:00","dateModified":"2018-01-12T07:10:12+00:00","breadcrumb":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/blogs.bmj.com\/bjsm\/2018\/01\/12\/letter-response-effectiveness-extracorporeal-shockwave-therapy-common-lower-limb-conditions-systematic-review-including-quantification-patient-rated-pain-reduction\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/blogs.bmj.com\/bjsm\/"},{"@type":"ListItem","position":2,"name":"Letter in response to \u201cThe effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction\u201d"}]},{"@type":"WebSite","@id":"https:\/\/blogs.bmj.com\/bjsm\/#website","url":"https:\/\/blogs.bmj.com\/bjsm\/","name":"BJSM blog - social media&#039;s leading SEM voice","description":"","publisher":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blogs.bmj.com\/bjsm\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/blogs.bmj.com\/bjsm\/#organization","name":"BJSM blog - social media&#039;s leading SEM voice","url":"https:\/\/blogs.bmj.com\/bjsm\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blogs.bmj.com\/bjsm\/#\/schema\/logo\/image\/","url":"https:\/\/blogs.bmj.com\/bjsm\/files\/2017\/11\/blog-logo-bjsm.png","contentUrl":"https:\/\/blogs.bmj.com\/bjsm\/files\/2017\/11\/blog-logo-bjsm.png","width":222,"height":34,"caption":"BJSM blog -  social media&#039;s leading SEM voice"},"image":{"@id":"https:\/\/blogs.bmj.com\/bjsm\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/blogs.bmj.com\/bjsm\/#\/schema\/person\/ba3da426ed20e8f1d933ca367d8216fe","name":"BMJ","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/b4d8f39281bcae118348a1c027347b8e53b82d42520e774a8b50dd9a6ac6c01d?s=96&d=mm&r=g","caption":"BMJ"},"sameAs":["https:\/\/blogs.bmj.com\/"],"url":"https:\/\/blogs.bmj.com\/bjsm\/author\/admin\/"}]}},"_links":{"self":[{"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/posts\/7544","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/comments?post=7544"}],"version-history":[{"count":0,"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/posts\/7544\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/media?parent=7544"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/categories?post=7544"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.bmj.com\/bjsm\/wp-json\/wp\/v2\/tags?post=7544"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}