P Vavken1, G Culen, R Dorotka. 1. Universitätsklinik für Orthopädie, Medizinische Universität Wien, Osterreich. patrick.vavken@meduniwien.ac.at
Abstract
INTRODUCTION: The demand to routinely apply evidence-based methods in orthopedic surgery increases steadily. In order to do so, however, the validity and reliability of the "evidence" has to be scrutinized. AIM: The object of this study was to assess the quality of the most recent orthopedic evidence and to determine variables that have an influence on quality. METHOD: All 2006 controlled trials from orthopedic journals with high impact factors were analysed in a cross-sectional study. A score based on the CONSORT statement was used to assess study quality. Selected variables were tested for their influence on the quality of the study. RESULTS: Two independent blinded observers reviewed 126 studies. The overall quality was moderate to high. The most neglected parameters were power analysis, intention-to-treat, and concealment. The participation of a methodologically trained investigator increases study quality significantly. There was no difference in study quality irrespective of whether or not there was statistically significant result. CONCLUSION: Using our quality score we were able show fairly good results for recent orthopedic studies. The most frequently neglected issues in orthopedic research are blinding, power analysis, and intention-to-treat. This may distort the results of clinical investigations considerably and, especially, lack of concealment causes false-positive findings. Our data show furthermore that participation of a methodologist significantly increases quality of the study and consequently strengthens the reliability of results.
INTRODUCTION: The demand to routinely apply evidence-based methods in orthopedic surgery increases steadily. In order to do so, however, the validity and reliability of the "evidence" has to be scrutinized. AIM: The object of this study was to assess the quality of the most recent orthopedic evidence and to determine variables that have an influence on quality. METHOD: All 2006 controlled trials from orthopedic journals with high impact factors were analysed in a cross-sectional study. A score based on the CONSORT statement was used to assess study quality. Selected variables were tested for their influence on the quality of the study. RESULTS: Two independent blinded observers reviewed 126 studies. The overall quality was moderate to high. The most neglected parameters were power analysis, intention-to-treat, and concealment. The participation of a methodologically trained investigator increases study quality significantly. There was no difference in study quality irrespective of whether or not there was statistically significant result. CONCLUSION: Using our quality score we were able show fairly good results for recent orthopedic studies. The most frequently neglected issues in orthopedic research are blinding, power analysis, and intention-to-treat. This may distort the results of clinical investigations considerably and, especially, lack of concealment causes false-positive findings. Our data show furthermore that participation of a methodologist significantly increases quality of the study and consequently strengthens the reliability of results.
Authors: Thomas Bartels; Kay Brehme; Martin Pyschik; Stephan Schulze; Karl-Stefan Delank; Georg Fieseler; Kevin G Laudner; Souhail Hermassi; René Schwesig Journal: J Exerc Rehabil Date: 2018-02-26
Authors: Patrick Vavken; Anne Kathleen B Ganal-Antonio; Julia Quidde; Francis H Shen; Jens R Chapman; Dino Samartzis Journal: Global Spine J Date: 2015-03-13