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Related Experiment Video

Updated: May 20, 2026

Clinical Efficacy of an Innovative Multidimensional Traction Therapy in Moderate Adolescent Idiopathic Scoliosis
07:12

Clinical Efficacy of an Innovative Multidimensional Traction Therapy in Moderate Adolescent Idiopathic Scoliosis

Published on: February 10, 2026

Emerging designs in orthopaedics: expertise-based randomized controlled trials.

Vanessa A Scholtes1, Thomas H Nijman, Loes van Beers

  • 1Department of Orthopaedic Surgery, Joint Research, Onze Lieve Vrouwe Gasthuis, PO Box 95500, 1090 HM, Amsterdam, The Netherlands. v.a.b.scholtes@olvg.nl

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

Conventional randomized controlled trials (RCTs) in surgery face limitations due to surgeon bias. Expertise-based trials, where patients are randomized to expert surgeons, offer a solution to improve surgical intervention studies.

Related Concept Videos

Blinding01:11

Blinding

Blinding is a commonly used method of not telling participants which treatment a subject is receiving. Blinding is a critical part of a randomized control trial or RCT. It reduces the bias that affects the results. In an RCT, blinding is used in the form of a placebo. A placebo effect occurs when untreated subjects falsely believe they have received the treatment and report improved symptoms. A placebo or a dummy treatment is administered to subjects to negate the bias caused by such an effect.

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Area of Science:

  • Surgical research methodology
  • Clinical trial design

Background:

  • Conventional randomized controlled trials (RCTs) are standard in surgical research.
  • Surgeons may exhibit reluctance towards new surgical techniques, impacting trial objectivity.
  • Differential expertise bias can arise in conventional RCTs when surgeons perform unfamiliar interventions.

Purpose of the Study:

  • To discuss the limitations of conventional RCTs in the surgical field.
  • To introduce expertise-based trials as an alternative methodology.
  • To highlight the potential of expertise-based trials in overcoming conventional RCT limitations.

Main Methods:

  • Discussion of limitations inherent in conventional surgical RCTs.
  • Explanation of the principles of expertise-based trials.

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Clinical Efficacy of an Innovative Multidimensional Traction Therapy in Moderate Adolescent Idiopathic Scoliosis

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  • Analysis of how patient randomization to expert surgeons addresses bias.

    • Main Results:

    • Conventional randomization may lead to interventions performed by less experienced or motivated surgeons.
    • This can introduce differential expertise bias, compromising trial validity.
    • Expertise-based trials offer a method to mitigate this bias.

    Conclusions:

    • Expertise-based trials present a valuable approach to enhance the rigor of surgical research.
    • Careful consideration of potential pitfalls is crucial for the successful implementation of expertise-based trials.
    • This methodology can lead to more reliable evidence for surgical interventions.