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

Area of Science:

• Trauma Surgery
• Biostatistics
• Medical Education

Background:

• Contemporary multitrauma literature exhibits increasing statistical complexity.
• This complexity challenges clinicians' ability to interpret high-impact research and apply evidence-based practices.
• Characterizing the methodological landscape is crucial for informed clinical decision-making.

Purpose of the Study:

• To analyze the statistical methods used in highly cited multitrauma studies.
• To assess the level of statistical competency required to interpret this literature.
• To identify associations between statistical methods, study design, and journal impact factor.

Main Methods:

• Cross-sectional analysis of 100 top-cited multitrauma studies (2018-2025).
• Categorization of statistical methods into introductory, intermediate, and advanced levels.
• Examination of correlations between methodological characteristics and journal impact factor.

Main Results:

• A total of 1210 statistical procedures were identified across 100 studies.
• Only 8% of studies were interpretable with introductory statistical knowledge; 92% required intermediate or advanced competency.
• Advanced statistical methods, missing data techniques, and randomized controlled trials were associated with higher journal impact factors.

Conclusions:

• A significant gap exists between the statistical complexity of high-impact multitrauma literature and clinicians' training.
• This gap hinders critical appraisal and evidence translation.
• Proposed solutions include a "methodological appraisal filter" and a competency-based biostatistics curriculum.