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Related Concept Videos

Randomized Experiments01:13

Randomized Experiments

The randomization process involves assigning study participants randomly to experimental or control groups based on their probability of being equally assigned. Randomization is meant to eliminate selection bias and balance known and unknown confounding factors so that the control group is similar to the treatment group as much as possible. A computer program and a random number generator can be used to assign participants to groups in a way that minimizes bias.
Simple randomization
Simple...
Psychosurgery01:30

Psychosurgery

Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...

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Single-Port Robotic-assisted Transaxillary Breast-conserving Surgery: A Prospective, Single-arm, Non-randomized Phase IIa Clinical Trial
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Randomized trials in surgery: how far have we come?

S Samuel Bederman1, James G Wright

  • 1Department of Orthopaedic Surgery, University of California at Irvine, 101 The City Drive South, Pavilion III, Orange, CA 92868, USA. sbederma@uci.edu

The Journal of Bone and Joint Surgery. American Volume
|July 20, 2012
PubMed
Summary

Randomized controlled trials (RCTs) are crucial for evidence-based medicine in orthopaedics. While their quantity and quality have significantly improved, unique challenges still hinder widespread adoption in surgical practice.

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Area of Science:

  • Orthopaedic Surgery
  • Evidence-Based Medicine
  • Clinical Research Methodology

Background:

  • Randomized controlled trials (RCTs) represent the highest level of evidence in medical research.
  • Historically, clinical research relied on less rigorous methods like case series and expert opinions.
  • The integration of RCTs is vital for informing medical practice, guidelines, policy, and reimbursement.

Purpose of the Study:

  • To assess the evolution and impact of randomized controlled trials in orthopaedic surgery.
  • To highlight the shift towards evidence-based medicine within the field.
  • To examine the growth in high-quality studies over a defined period.

Main Methods:

  • Analysis of study types published in The Journal of Bone and Joint Surgery (American Volume) from 1975 to 2005.
  • Tracking the increase in Level-I studies (RCTs) over three decades.
  • Review of trends in orthopaedic research methodology.

Main Results:

  • A significant increase in the number of Level-I studies in orthopaedic surgery was observed.
  • Level-I studies constituted over 20% of publications in JBJS by 2005.
  • Substantial improvements in both the quantity and quality of RCTs in the field were noted.

Conclusions:

  • Orthopaedic surgery has made considerable progress in adopting rigorous research methodologies like RCTs.
  • The rise of comparative effectiveness research may further shape the definition of best evidence.
  • Despite improvements, specific challenges remain that limit the universal application of RCTs in orthopaedics.