Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Oct 2003
Validity of index of suspicion for pulmonary embolism after hip arthroplasty.
Pulmonary embolism after total hip arthroplasty is problematic, and intravenous heparin treatment in the absence of pulmonary embolism carries risk. Algorithms for treating pulmonary embolism often cite clinical index of suspicion as a basis for initiating intravenous heparin, but most information regarding variables to predict pulmonary embolism originate from studies of patients rather than only from patients who had arthroplasty. We studied the hypothesis that a more homogenous subpopulation, patients who had total hip arthroplasty, may have findings more accurately predictive of pulmonary embolism. ⋯ No significant differences were found between patients with or without pulmonary embolism regarding subjective complaints, physical examination, blood gas results, electrocardiogram findings, radiographs of the chest, and imaging of the veins of the legs. All attempts to model these variables into an index of suspicion that accurately predicted pulmonary embolism were unsuccessful. We advise adherence to established treatment algorithms rather than clinical suspicion when deciding whether to initiate heparin therapy.
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Clin. Orthop. Relat. Res. · Oct 2003
Publication rates of abstracts presented at annual musculoskeletal tumor society meetings.
Beware of the unpublished abstract. What is the publication rate of abstracts presented at Musculoskeletal Tumor Society meetings, and how does this compare with other orthopaedic and medical meetings? Three hundred thirty-six podium presentations from six annual meetings were identified and their publication was searched at a minimum of 3 years after the event. An effort was made to determine what percent of these abstracts eventually were published in a peer-reviewed journal. ⋯ The rate of publication and time until publication was similar to other orthopaedic meetings and to other medical disciplines. Changes to the cohort, title, or authors occurred in approximately (1/3) of the published articles compared with the abstracts. These results suggest that for various reasons the majority of presented material at Musculoskeletal Tumor Society meetings may not survive peer review and may not be scientifically valid.