High-quality randomised controlled trials (RCTs)
evaluating surgical therapies are fundamental to the delivery of
evidence-based orthopaedics. Orthopaedic clinical trials have unique
challenges; however, when these challenges are overcome, evidence
from trials can be definitive in its impact on surgical practice.
In this review, we highlight several issues that pose potential
challenges to orthopaedic investigators aiming to perform surgical randomised
controlled trials. We begin with a discussion on trial design issues,
including the ethics of sham surgery, the importance of sample size,
the need for patient-important outcomes, and overcoming expertise
bias. We then explore features surrounding the execution of surgical
randomised trials, including ethics review boards, the importance
of organisational frameworks, and obtaining adequate funding. Cite this article:
Using inaccurate quotations can propagate misleading
information, which might affect the management of patients. The
aim of this study was to determine the predictors of quotation inaccuracy
in the peer-reviewed orthopaedic literature related to the scaphoid.
We randomly selected 100 papers from ten orthopaedic journals. All references
were retrieved in full text when available or otherwise excluded.
Two observers independently rated all quotations from the selected
papers by comparing the claims made by the authors with the data
and expressed opinions of the reference source. A statistical analysis
determined which article-related factors were predictors of quotation
inaccuracy. The mean total inaccuracy rate of the 3840 verified
quotes was 7.6%. There was no correlation between the rate of inaccuracy
and the impact factor of the journal. Multivariable analysis identified
the journal and the type of study (clinical, biomechanical, methodological,
case report or review) as important predictors of the total quotation
inaccuracy rate. We concluded that inaccurate quotations in the peer-reviewed
orthopaedic literature related to the scaphoid were common and slightly
more so for certain journals and certain study types. Authors, reviewers
and editorial staff play an important role in reducing this inaccuracy.
