Reporting Clinical Outcomes in Hand Surgery Randomized Controlled Trials: A Systematic Review Using Wide-Awake Local...

Area of Science:

• Orthopedic Surgery
• Clinical Trials Methodology

Background:

• Clinical outcome reporting in hand surgery randomized controlled trials (RCTs) lacks standardization.
• Wide-awake local anesthesia no tourniquet (WALANT) is increasingly used in hand and upper limb surgery, necessitating clear outcome evaluation.

Purpose of the Study:

• To comprehensively evaluate clinical outcome reporting in hand surgery RCTs.
• To use WALANT studies as a model for assessing outcome reporting practices.

Main Methods:

• Systematic review adhering to PRISMA guidelines.
• Searched five databases for WALANT RCTs in upper limb surgery up to April 1, 2023.
• Assessed study quality using the revised Cochrane risk-of-bias tool.

Main Results:

• 11 RCTs involving 889 patients were included.
• Technical outcomes were most frequently reported (73%), while functional outcomes were least reported (36%).
• Identified challenges in standardizing functional and patient-reported outcomes.

Conclusions:

• Significant diversity exists in outcome reporting and assessment tools across hand surgery RCTs.
• The prevalence of technical outcomes over functional and patient-reported outcomes limits comprehensive evaluation.
• Standardization of outcome reporting is essential for improving patient care and evidence-based decision-making.