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Participating in multicenter randomized controlled trials: what's the relative value?

Paul Tornetta1, Mandy Pascual, Katelyn Godin

  • 1Department of Orthopaedic Surgery, Boston Medical Center, Dowling 2 North, 850 Harrison Avenue, Boston, MA 02118, USA. ptornetta@gmail.com

The Journal of Bone and Joint Surgery. American Volume
|July 20, 2012
PubMed
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Investigator contributions to large randomized controlled trials (RCTs) in orthopaedic surgery are undervalued by academic promotion committees. Evolving promotion cultures is crucial to recognize the value of multicenter RCT participation.

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Area of Science:

  • Orthopaedic Surgery
  • Clinical Trials
  • Academic Medicine

Background:

  • High-quality, large-scale, multicenter randomized controlled trials (RCTs) are increasingly recognized for their value in orthopaedic surgery.
  • Investigator efforts in RCTs, particularly multicenter ones, are often underappreciated for academic merit.
  • Participation in RCTs offers benefits including clinical practice improvements and personal incentives.

Purpose of the Study:

  • To discuss the benefits of investigator involvement in large-scale RCTs.
  • To examine the perception and recognition of investigator contributions to multicenter RCTs by academic promotion committees.
  • To advocate for a cultural evolution in academic promotion to appropriately value RCT participation.

Main Methods:

  • Qualitative discussion of the value and benefits of investigator participation in large-scale RCTs.
  • Analysis of how academic promotion committees perceive and recognize contributions to multicenter RCTs.
  • Review of existing academic promotion criteria and their alignment with RCT participation.

Main Results:

  • Academic promotion committees tend to undervalue contributions to multicenter RCTs compared to studies with lower levels of evidence.
  • Investigator involvement in large RCTs yields significant benefits for clinical practice and decision-making.
  • Current academic promotion systems do not adequately recognize the rigorous efforts involved in multicenter RCTs.

Conclusions:

  • A cultural shift in academic promotion is necessary to ensure appropriate valuation of investigator contributions to large multicenter RCTs.
  • Recognizing the value of RCT participation will encourage more high-quality research in orthopaedic surgery.
  • Aligning academic incentives with research contributions is essential for advancing evidence-based practice.