McMaster University

McMaster University

The Influence of Large Clinical Trials in Orthopaedic Trauma

We would like to share with you the most recent publication from the MacOrtho team. This paper, titled "The Influence of Large Clinical Trials in Orthopaedic Trauma: Do They Change Practice?" has been published in the Journal of Orthopaedic Trauma .

Find the abstract below and click here to access the full-version of the article.

Khan H, Hussain N, Bhandari M.The Influence of Large Clinical Trials in Orthopaedic Trauma: Do They Change Practice? J Orthop Trauma. 2013 Apr 19. [Epub ahead of print]


OBJECTIVES: To evaluate the influence of top fracture trials on the practice of orthopaedic surgeons.Design: This is a cross-sectional study.

PARTICIPANTS: We electronically administered the survey to all members of the Canadian Orthopaedic Association. We received responses for 222 surveys, of which, 178 surveys were completed.

INTERVENTION:: We distributed a survey which evaluated the influence of 7 important fracture studies (6 Randomized Controlled Trials [RCT's] and 1 Prospective Cohort study) on practice, patient care and overall advancement of knowledge in the field of orthopaedics. This study was approved by our local ethics review board.

MAIN OUTCOME MEASURE: The primary outcome measure was the perceived general influence and impact of important fracture studies on the perceptions and practice of orthopaedic surgeons.

RESULTS: The Clavicular Fixation Trial (2007) and Tibial Fracture Trial (SPRINT, 2008) were perceived by surgeons to have the greatest influence on advancing overall knowledge in the field, improving personal practice, and the most influence on improving patient care. On the other hand, the Bone Stimulation in Fractures Trial (2011) and the rhBMP-2-BESST Trial (2002) had the lowest mean influence ranks. The probability of changing practice was significantly higher (Odds Ratio 2.89, 95%CI: 2.16-3.88, p<0.00001) when studies had positive outcomes in comparison to negative.

CONCLUSIONS: Despite the complexity and costs associated with clinical trials in orthopaedic trauma, the results from this survey suggest that these studies result in a demonstrable perceived influence and impact on the practice of orthopaedic surgeons.

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