Bridging the methodological gap in multitrauma literature: a competency-based educational framework and clinical...

The statistical complexity of contemporary multitrauma literature has increased considerably in recent years, which may pose challenges for clinicians seeking to interpret high-impact research and apply evidence-based practices. Characterizing this methodological landscape and exploring education-oriented approaches may help to improve the interpretability of the literature and support informed clinical decision-making.

A cross-sectional analysis was conducted on the 100 most-cited multitrauma studies published in Science Citation Index Expanded journals indexed in the Web of Science database between January 2018 and November 2025. The statistical methods used in each article were categorized into the three competency levels of introductory, intermediate, and advanced based on a literature-derived classification framework. Associations between methodological characteristics and the journal's impact factor (IF) were examined.

Across the 100 studies, a total of 1210 statistical procedures were identified, with a mean of 12.1 ± 3.8 methods per article. Only 8% (n = 8) of the studies could be fully interpreted using introductory-level statistical knowledge, whereas 92% required intermediate (n = 61) or advanced (n = 31) analytical competency. Articles employing advanced statistical methods (mean IF: 9.03), techniques for handling missing data (mean IF: 8.22), and randomized controlled trial designs (mean IF: 18.87) were published in significantly higher-impact journals (p < 0.05).

The findings of this study suggest the presence of a methodological gap between high-impact multitrauma literature and the level of statistical training commonly received by clinicians. This gap may complicate the critical appraisal of contemporary research and the translation of evidence into practice. As a potential response, we propose a complementary dual strategy: a practical "methodological appraisal filter" to support current clinicians and a structured, competency-based biostatistics curriculum emphasizing regression modeling, survival analysis, and advanced epidemiological methods.