• GroenwoldRolf H HRHH0000-0001-9238-6999Department of Clinical Epidemiology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, the Netherlands. R.H.H.Groenwold@lumc.nl.Department of Biomedical Data Sciences, Leiden University Medical Cente, L X van Rossenberg, SmeeingD P JDPJDepartment of Trauma Surgery, Rijnstate Hospital, Arnhem, the Netherlands., R M Houwert, J W Schoones, MuijsS P JSPJDepartment of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, the Netherlands., F C Oner, Y de Jong, B J M van de Wall, and NEXT study group.
• Department of Clinical Epidemiology, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333 ZA, the Netherlands. R.H.H.Groenwold@lumc.nl.
• Eur J Trauma Emerg Surg. 2025 Jan 24; 51 (1): 3636.

PurposeConfounding in observational studies can be mitigated by selecting only those patients, in whom equipoise of both treatments is secured by experts' disagreement over optimal therapy.MethodsWe conducted a systematic review to identify observational studies in the field of orthopedic trauma surgery that utilized expert panels for patient inclusion in order to limit the potential for confounding.ResultsFour studies were identified that used expert panels to select participants based on expert disagreement. Derived from these studies and our own experience, recommendations were made regarding reporting of the size and composition of the expert panel, the information the expert panel receives, criteria for disagreement, selection of patients, and statistical analysis.ConclusionWith this review we aim to provide insight into this study design and to stimulate discussions about the potential of expert panels to control for confounding in studies of medical treatments.© 2025. The Author(s).

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