The use of systematic reviews to justify orthopaedic trauma randomized controlled trials: A cross-sectional analysis

Research output: Contribution to journalArticle

Abstract

Objective: Orthopaedic trauma is one of the largest surgical fields in medicine, and as such, requires the latest evidence to ensure the best standard of care. Systematic reviews are an invaluable resource that compiles an exhaustive summary of the most current evidence on a given clinical question. The primary aim of this study is to evaluate the use of systematic reviews as justification in conducting randomized controlled trials published in high impact orthopaedic trauma journals. Methods: We analyzed randomized controlled trials published in the top three high impact orthopaedic trauma journals between 2015 and 2018. We performed data extraction blind, independent, and in duplicative manner to ensure the validity of the findings. For each trial, data was extracted by the number of systematic reviews cited in each clinical trial and whether or not the study used a systematic review as justification for conducting the trial. A subgroup of general orthopaedic clinical trials were included for comparison. Results: Of 144 articles retrieved, 128 were included. Overall, 71.1% (91/128; [95% CI, 63.2–78.9]) of included orthopaedic trauma randomized controlled trials referenced a systematic review and 28.9% (37/128) of studies did not cite a systematic review. Of the 91 trials that referenced a systematic review, 33.0% (30/91; [95% CI, 23.3–42.6]) of RCTs cited a systematic review as trial justification, whether that be “verbatim” or “inferred”. “Verbatim” justifications occurred in 20.0% (6/30; [95% CI, 5.7–34.3]) of included trauma RCTs that cited a systematic review as justification for conducting the trial and “inferred” justifications occurred in 80.0% (24/30; [95% CI, 65.7–94.3]). Conclusion: Systematic reviews are frequently cited in orthopaedic trauma RCTs but are not commonly cited as justification for conducting a clinical trial. Ideally, evidentiary uncertainty regarding a research question should be established by existing literature through a systematic review to reduce research waste.

Original languageEnglish
JournalInjury
DOIs
StateAccepted/In press - 1 Jan 2019

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Orthopedics
Randomized Controlled Trials
Cross-Sectional Studies
Wounds and Injuries
Clinical Trials
Standard of Care
Research
Uncertainty
Medicine

Keywords

  • Clinical trial
  • Cross-sectional analysis
  • Epidemiology
  • Meta-analysis
  • Meta-research
  • Methods
  • Orthopaedics
  • Randomized controlled trials
  • Research waste
  • Systematic review

Cite this

@article{2921f6e3eae640f2aa5cd097232e136d,
title = "The use of systematic reviews to justify orthopaedic trauma randomized controlled trials: A cross-sectional analysis",
abstract = "Objective: Orthopaedic trauma is one of the largest surgical fields in medicine, and as such, requires the latest evidence to ensure the best standard of care. Systematic reviews are an invaluable resource that compiles an exhaustive summary of the most current evidence on a given clinical question. The primary aim of this study is to evaluate the use of systematic reviews as justification in conducting randomized controlled trials published in high impact orthopaedic trauma journals. Methods: We analyzed randomized controlled trials published in the top three high impact orthopaedic trauma journals between 2015 and 2018. We performed data extraction blind, independent, and in duplicative manner to ensure the validity of the findings. For each trial, data was extracted by the number of systematic reviews cited in each clinical trial and whether or not the study used a systematic review as justification for conducting the trial. A subgroup of general orthopaedic clinical trials were included for comparison. Results: Of 144 articles retrieved, 128 were included. Overall, 71.1{\%} (91/128; [95{\%} CI, 63.2–78.9]) of included orthopaedic trauma randomized controlled trials referenced a systematic review and 28.9{\%} (37/128) of studies did not cite a systematic review. Of the 91 trials that referenced a systematic review, 33.0{\%} (30/91; [95{\%} CI, 23.3–42.6]) of RCTs cited a systematic review as trial justification, whether that be “verbatim” or “inferred”. “Verbatim” justifications occurred in 20.0{\%} (6/30; [95{\%} CI, 5.7–34.3]) of included trauma RCTs that cited a systematic review as justification for conducting the trial and “inferred” justifications occurred in 80.0{\%} (24/30; [95{\%} CI, 65.7–94.3]). Conclusion: Systematic reviews are frequently cited in orthopaedic trauma RCTs but are not commonly cited as justification for conducting a clinical trial. Ideally, evidentiary uncertainty regarding a research question should be established by existing literature through a systematic review to reduce research waste.",
keywords = "Clinical trial, Cross-sectional analysis, Epidemiology, Meta-analysis, Meta-research, Methods, Orthopaedics, Randomized controlled trials, Research waste, Systematic review",
author = "Johnson, {Austin L.} and Corbin Walters and Harrison Gray and Trevor Torgerson and Checketts, {Jake X.} and Marshall Boose and Brent Norris and Matt Vassar",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.injury.2019.11.004",
language = "English",
journal = "Injury",
issn = "0020-1383",
publisher = "Elsevier Ltd",

}

TY - JOUR

T1 - The use of systematic reviews to justify orthopaedic trauma randomized controlled trials

T2 - A cross-sectional analysis

AU - Johnson, Austin L.

AU - Walters, Corbin

AU - Gray, Harrison

AU - Torgerson, Trevor

AU - Checketts, Jake X.

AU - Boose, Marshall

AU - Norris, Brent

AU - Vassar, Matt

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: Orthopaedic trauma is one of the largest surgical fields in medicine, and as such, requires the latest evidence to ensure the best standard of care. Systematic reviews are an invaluable resource that compiles an exhaustive summary of the most current evidence on a given clinical question. The primary aim of this study is to evaluate the use of systematic reviews as justification in conducting randomized controlled trials published in high impact orthopaedic trauma journals. Methods: We analyzed randomized controlled trials published in the top three high impact orthopaedic trauma journals between 2015 and 2018. We performed data extraction blind, independent, and in duplicative manner to ensure the validity of the findings. For each trial, data was extracted by the number of systematic reviews cited in each clinical trial and whether or not the study used a systematic review as justification for conducting the trial. A subgroup of general orthopaedic clinical trials were included for comparison. Results: Of 144 articles retrieved, 128 were included. Overall, 71.1% (91/128; [95% CI, 63.2–78.9]) of included orthopaedic trauma randomized controlled trials referenced a systematic review and 28.9% (37/128) of studies did not cite a systematic review. Of the 91 trials that referenced a systematic review, 33.0% (30/91; [95% CI, 23.3–42.6]) of RCTs cited a systematic review as trial justification, whether that be “verbatim” or “inferred”. “Verbatim” justifications occurred in 20.0% (6/30; [95% CI, 5.7–34.3]) of included trauma RCTs that cited a systematic review as justification for conducting the trial and “inferred” justifications occurred in 80.0% (24/30; [95% CI, 65.7–94.3]). Conclusion: Systematic reviews are frequently cited in orthopaedic trauma RCTs but are not commonly cited as justification for conducting a clinical trial. Ideally, evidentiary uncertainty regarding a research question should be established by existing literature through a systematic review to reduce research waste.

AB - Objective: Orthopaedic trauma is one of the largest surgical fields in medicine, and as such, requires the latest evidence to ensure the best standard of care. Systematic reviews are an invaluable resource that compiles an exhaustive summary of the most current evidence on a given clinical question. The primary aim of this study is to evaluate the use of systematic reviews as justification in conducting randomized controlled trials published in high impact orthopaedic trauma journals. Methods: We analyzed randomized controlled trials published in the top three high impact orthopaedic trauma journals between 2015 and 2018. We performed data extraction blind, independent, and in duplicative manner to ensure the validity of the findings. For each trial, data was extracted by the number of systematic reviews cited in each clinical trial and whether or not the study used a systematic review as justification for conducting the trial. A subgroup of general orthopaedic clinical trials were included for comparison. Results: Of 144 articles retrieved, 128 were included. Overall, 71.1% (91/128; [95% CI, 63.2–78.9]) of included orthopaedic trauma randomized controlled trials referenced a systematic review and 28.9% (37/128) of studies did not cite a systematic review. Of the 91 trials that referenced a systematic review, 33.0% (30/91; [95% CI, 23.3–42.6]) of RCTs cited a systematic review as trial justification, whether that be “verbatim” or “inferred”. “Verbatim” justifications occurred in 20.0% (6/30; [95% CI, 5.7–34.3]) of included trauma RCTs that cited a systematic review as justification for conducting the trial and “inferred” justifications occurred in 80.0% (24/30; [95% CI, 65.7–94.3]). Conclusion: Systematic reviews are frequently cited in orthopaedic trauma RCTs but are not commonly cited as justification for conducting a clinical trial. Ideally, evidentiary uncertainty regarding a research question should be established by existing literature through a systematic review to reduce research waste.

KW - Clinical trial

KW - Cross-sectional analysis

KW - Epidemiology

KW - Meta-analysis

KW - Meta-research

KW - Methods

KW - Orthopaedics

KW - Randomized controlled trials

KW - Research waste

KW - Systematic review

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U2 - 10.1016/j.injury.2019.11.004

DO - 10.1016/j.injury.2019.11.004

M3 - Article

C2 - 31711650

AN - SCOPUS:85075334645

JO - Injury

JF - Injury

SN - 0020-1383

ER -