Review of publication barriers in upper limb absence rehabilitation: A protocol for innovative literature macro-analyses.

A preliminary review of the literature suggested that rehabilitation programs for upper limb absence (ULA) may be constrained by several publication barriers. Typically, clusters of publications concentrating on a particular topic may be analyzed utilizing bibliometric or scientometric approaches. Practically, these conventional methods might be inadequate to examine these barriers as the literature about ULA rehabilitation includes hundreds of publications. The purpose of this review protocol was to introduce new literature macro-analyses utilizing ratio-based metrics to characterize the alleged publication barriers in ULA rehabilitation. The objectives were to outline the steps for literature search strategies, reference selection and analyses of the barriers focusing on growth, expertise, location, apportion, strength, population and pertinence of the literature. The protocol will follow a 16-step process including 76 tasks. The searches, organization and extraction of references will be performed following the PRISMA guidelines. A 37-point Reference Acquisition Form recording data for macro-analyses will be completed for each reference. The macro-analyses will investigated if the literature: has increased noticeably in recent years (growth); is essentially generated by a limited number of authors (expertise); is mainly USA-centric (location); does unevenly represent populations from countries with different income levels (apportion); is mainly populated by studies with limited evidence (strength); is mainly populated by studies involving a limited population (population); does unevenly focus on care interventions and clinical outcomes (pertinence). The characterization of the barriers will be limited by the mining of the source data such as estimates of the global population and inconsistent metadata across sources. It will also be limited by the interpretation of ratio-based metrics that will be inevitably subjective due to the lack of comparative data. Hopefully, subsequent reviews will assist decision-makers in selecting strategies that enhance bespoke rehabilitation programs, facilitate prosthesis use, and improve quality of life for individuals with upper limb absence.