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How useful are meta-analyses in orthopedic trauma?
Charles M Court-Brown1, Margaret M McQueen
1Department of Orthopaedic Trauma, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom. courtbrown@aol.com
The Journal of Trauma
|March 15, 2011
Summary
Most orthopedic trauma meta-analyses offer little new clinical insight. Researchers question the clinical usefulness of this research, finding many conclusions are not novel or are absent entirely.
Area of Science:
- Orthopedic Trauma Research
- Evidence-Based Medicine
Background:
- Meta-analysis is a widely accepted research method in orthopedic trauma.
- Its conclusions are presumed to enhance surgeon knowledge and clinical practice.
- Previous studies have critiqued meta-analysis methodology but not clinical utility.
Purpose of the Study:
- To evaluate the clinical usefulness of conclusions from orthopedic trauma meta-analyses.
- To assess the novelty and impact of findings on surgical care.
Main Methods:
- Reviewed 60 orthopedic trauma meta-analyses published from 2000 onwards.
- Classified meta-analysis conclusions based on innovation and clinical care improvement potential.
- Differentiated analyses by origin: Cochrane Collaboration versus independent surgeons.
Main Results:
- Only 6.7% of meta-analyses provided novel, clinically useful information.
- 36.7% of studies lacked conclusions entirely.
- 41.7% presented conclusions already present in existing literature.
- Approximately 70% of Cochrane Collaboration meta-analyses had no conclusions.
Conclusions:
- Significant variability exists in the clinical usefulness of orthopedic trauma meta-analyses.
- The overall clinical utility of this research methodology is questionable.
- Further evaluation is needed to ensure meta-analyses contribute meaningfully to orthopedic trauma care.