Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Oct 2019
ReviewWhat Are the Implications of Alternative Alpha Thresholds for Hypothesis Testing in Orthopaedics?
Clinical research in orthopaedics typically reports the presence of an association after rejecting a null hypothesis of no association using an alpha threshold of 0.05 at which to evaluate a calculated p value. This arbitrary value is a factor that results in the current difficulties reproducing research findings. A proposal is gaining attention to lower the alpha threshold to 0.005. However, it is currently unknown how alpha thresholds are used in orthopaedics and the distribution of p values reported. ⋯ Surgeons and scientists in orthopaedics should understand that the default alpha threshold of 0.05 represents an arbitrary value that could be lowered to help reduce type-I errors; however, it must also be appreciated that such a change could increase type-II errors, increase resource utilization, and preferentially select findings from lower-quality studies.
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Clin. Orthop. Relat. Res. · May 2019
Meta AnalysisIs the Risk of Infection Lower with Sutures than with Staples for Skin Closure After Orthopaedic Surgery? A Meta-analysis of Randomized Trials.
Two previous meta-analyses comparing staples versus sutures have led to conflicting relative risks for surgical site infection between skin closure methods after orthopaedic surgery. Consequently, the choice of sutures or staples for skin closure continues to be a subject of conversation. Recently, additional randomized trials have been published, and an updated meta-analysis is needed to inform this debate. ⋯ Level I, therapeutic study.
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Clin. Orthop. Relat. Res. · Mar 2019
Meta AnalysisDoes Tourniquet Use in TKA Increase Postoperative Pain? A Systematic Review and Meta-analysis.
Although tourniquets are commonly used during TKA, that practice has long been surrounded by controversy. Quantifying the case for or against tourniquet use in TKA, in terms of patient-reported outcomes such as postoperative pain, is a priority. ⋯ Level I, therapeutic study.
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Clin. Orthop. Relat. Res. · Mar 2019
Outcome Selection and Methodological Quality of Major and Minor Shoulder Surgery Studies: A Scoping Review.
Core outcome sets aim to select and standardize the choice of important outcomes reported in clinical trials to encourage more effective data synthesis, increase the reliability of comparing results, and minimize reporting bias. A core outcome set for elective shoulder surgery has yet to be defined, and therefore a systematic assessment of outcomes and methodology is necessary to inform the development of a core outcome set. ⋯ Level I, therapeutic study.
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Clin. Orthop. Relat. Res. · Apr 2018
Are Psychosocial Factors Associated With Patient-reported Outcome Measures in Patients With Rotator Cuff Tears? A Systematic Review.
Psychosocial factors are key determinants of health and can influence patient-reported outcomes after rotator cuff tears. However, to our knowledge, a systematic review of published studies has not been conducted to determine the degree of consistency and strength of the relationship between psychosocial factors and patient-reported outcomes in this patient population. ⋯ Level III, therapeutic study.