Analysis of Reference Practices among Practicing Orthopaedicians in India

Area of Science:

• Orthopaedic Surgery
• Medical Information Science

Background:

• On-The-Go (OTG) references are critical for timely clinical decisions in patient care.
• Assessing orthopaedicians' knowledge and attitudes towards these references is vital for practice improvement.

Purpose of the Study:

• To evaluate orthopaedicians' knowledge of clinical usefulness and quality appraisal of various reference methods.
• To understand their attitudes towards the utility of OTG references in practice.

Main Methods:

• A web-based survey was distributed to Tamil Nadu Orthopaedic Association members via snowball sampling.
• The survey, designed by the Quality Appraisal Committee (QAC) of the Orthopaedic Research Group (ORG), comprised 17 items.
• Association and correlation analyses were performed to identify areas for improving reference practices.

Main Results:

• 177 orthopaedicians completed the survey; 45.8% knew of Oxford Levels of Evidence but not its application for critical appraisal.
• 86.5% expressed concern about the quality of reference content.
• Online research articles were the most common reference source (54.2%), followed by digital applications (21.4%).
• Familiarity with evidence appraisal concepts (bias, heterogeneity, fragility) correlated with using Level I studies.
• Active journal subscription correlated with understanding 'spin' and study heterogeneity.
• Younger participants (<40 years) showed better knowledge of bias, heterogeneity, and fragility.

Conclusions:

• This study is the first to examine the information-seeking behavior of orthopaedicians.
• OTG references are integral to orthopaedic practice, with online articles being the primary source.
• Integrating quality appraisal knowledge into the orthopaedic curriculum is recommended to enhance decision-making in patient care.