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Ayele M, Yilak G, Alamrew A, Lake ES, Tilahun BD. Magnitude and associated factors of unmet need for family planning among reproductive-aged women in Ethiopia: An umbrella review. PLoS One 2024; 19:e0308085. [PMID: 39088583 PMCID: PMC11293703 DOI: 10.1371/journal.pone.0308085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 07/16/2024] [Indexed: 08/03/2024] Open
Abstract
INTRODUCTION The World Health Organization defines women with an unmet need for family planning as individuals who are fecund, sexually active, and wanting to either to limit childbirth or postpone their next birth but are not utilizing any form of contraception. Previous meta-analyses and systematic reviews have focused on this topic, but no comprehensive summary of the evidence was available. Therefore, the aim of this study was to provide a summary of the findings on the unmet need for family planning among reproductive-aged women in Ethiopia. METHOD A search was conducted in PubMed, Google Scholar, CINAHL, Scopus, Cochrane Library, and RESEARCH 4 LIFE including Hinari, to identify relevant systematic reviews and meta-analyses of studies on the prevalence and determinants of the unmet need for family planning in Ethiopia. The methodological quality of the included studies was assessed using the Assessment of Multiple Systematic Reviews tool, and the estimates were pooled using a random-effects meta-analysis model. RESULTS The umbrella review included five studies with a total of 56,169 reproductive-aged women. The pooled prevalence of unmet need for family planning was found to be 27.44% (95% CI: 22.32-32.55), with the heterogeneity index (I square = 99.45%, P = 0.000). Failure to discuss with her partner about family planning methods (OR: 2.90, 95% CI: 1.81, 4.00), being illiterate (OR: 2.17, 95% CI: 1.42, 2.92), age at first marriage (OR: 1.37, 95% CI: 1.30, 1.44), and educational status of woman's partner (OR: 2.61, 95% CI: 0.83, 4.40) were the factors significantly and positively associated with unmet needs for family planning. CONCLUSION The study concludes that the unmet need for family planning in Ethiopia is a significant issue that can be addressed through increasing the educational levels of women and their partners, promoting open discussions about family planning, and preventing early marriages. Collaboration between families, school administrators, and healthcare providers is essential to mitigating this problem.
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Affiliation(s)
- Mulat Ayele
- Department of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Gizachew Yilak
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Abebaw Alamrew
- Department of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Eyob Shitie Lake
- Department of Midwifery, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Befkad Derese Tilahun
- Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
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Ajrawat P, Dwyer T, Whelan D, Theodoropoulos J, Murnaghan L, Bhargava M, Ogilvie-Harris D, Chahal J. A Comparison of Quadriceps Tendon Autograft With Bone-Patellar Tendon-Bone Autograft and Hamstring Tendon Autograft for Primary Anterior Cruciate Ligament Reconstruction: A Systematic Review and Quantitative Synthesis. Clin J Sport Med 2021; 31:392-399. [PMID: 31233432 DOI: 10.1097/jsm.0000000000000765] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 12/21/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE There is growing enthusiasm for the increased use of quadriceps tendon (QT) autograft for primary anterior cruciate ligament reconstruction (ACLR). The purpose of this analysis was to synthesize and quantitatively assess the available evidence comparing QT autograft with hamstring tendon (HT) and bone-patellar tendon-bone (BPTB) autografts, regarding functional outcomes, knee stability, anterior knee pain, and revision rates. DATA SOURCES A search in MEDLINE, EMBASE, PubMed, and the Cochrane Central Register of Controlled Trials for eligible studies up to May 2018 was conducted. Two reviewers selected studies based on inclusion criteria and assessed methodological quality. Outcomes analyzed were anterior knee pain, graft failure rates, knee stability, functional outcomes, and adverse events. Pooled analyses were performed for continuous and dichotomous variables where appropriate. MAIN RESULTS Ten studies (1 randomized trial and 9 nonrandomized cohorts) met our inclusion criteria, which included 1398 patients. The analysis showed no statistical difference in anterior knee pain when comparing QT and HT autografts, but a significant difference between QT and BPTB autografts [odds ratio, 0.15 (95% confidence interval, 0.08-0.27); P < 0.001]. There were no differences between all 3 autografts in revision rates, knee stability, and patient-reported functional outcomes. CONCLUSIONS Quadriceps tendon autograft is a suitable graft alternative for primary ACLR, as it achieves good clinical outcomes with a low incidence of anterior knee pain. Given the limited quality of the included studies, there is a need for a well-designed multicenter randomized control trial comparing QT autograft with other primary ACL autografts to confirm our findings. LEVEL OF EVIDENCE Level IV systematic review.
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Affiliation(s)
- Prabjit Ajrawat
- Orthopaedic Sports Medicine (UTOSM), University of Toronto, Women's College Hospital, Toronto, ON, Canada ; and
| | - Tim Dwyer
- Orthopaedic Sports Medicine (UTOSM), University of Toronto, Women's College Hospital, Toronto, ON, Canada ; and
| | - Daniel Whelan
- Orthopaedic Sports Medicine (UTOSM), University of Toronto, Women's College Hospital, Toronto, ON, Canada ; and
| | - John Theodoropoulos
- Orthopaedic Sports Medicine (UTOSM), University of Toronto, Women's College Hospital, Toronto, ON, Canada ; and
| | - Lucas Murnaghan
- Orthopaedic Sports Medicine (UTOSM), University of Toronto, Women's College Hospital, Toronto, ON, Canada ; and
| | - Manoj Bhargava
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Darrell Ogilvie-Harris
- Orthopaedic Sports Medicine (UTOSM), University of Toronto, Women's College Hospital, Toronto, ON, Canada ; and
| | - Jaskarndip Chahal
- Orthopaedic Sports Medicine (UTOSM), University of Toronto, Women's College Hospital, Toronto, ON, Canada ; and
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Desai B, Desai V, Shah S, Srinath A, Saleh A, Simunovic N, Duong A, Sprague S, Bhandari M. Pilot randomized controlled trials in the orthopaedic surgery literature: a systematic review. BMC Musculoskelet Disord 2018; 19:412. [PMID: 30474552 PMCID: PMC6260657 DOI: 10.1186/s12891-018-2337-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 11/07/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The primary objective of this systematic review is to examine the characteristics of pilot randomized controlled trials (RCTs) in the orthopaedic surgery literature, including the proportion framed as feasibility trials and those that lead to definitive RCTs. This review aim to answer the question of whether pilot RCTs lead to definitive RCTs, whilst investigating the quality, feasibility and overall publication trends of orthopaedic pilot trials. METHODS Pilot RCTs in the orthopaedic literature were identified from three electronic databases (EMBASE, MEDLINE, and Pubmed) searched from database inception to January 2018. Search criteria included the evaluation of at least one orthopaedic surgical intervention, research on humans, and publication in English. Two reviewers independently screened the pool of pilot trials, and conducted a search for corresponding definitive trials. Screened pilot RCTs were assessed for feasibility outcomes related to efficiency, cost, and/or timeliness of a large-scale clinical trial involving a surgical intervention. The quality of the pilot and definitive trials were assessed using the Checklist to Evaluate a Report of a Non-Pharmacological Trial (CLEAR NPT). RESULTS The initial search for pilot RCTs yielded 3857 titles, of which 49 articles were relevant for this review. 73.5% (36/49) of the orthopaedic pilot RCTs were framed as feasibility trials. Of these, 5 corresponding definitive trials (10.2%) were found, of which four were published and one ongoing. Based on author responses, the lack of a definitive RCT following the pilot trial was attributed to a lack of funding, inadequacies in recruitment, and belief that the pilot RCT sufficiently answered the research question. CONCLUSIONS Based on this systematic review, most pilot RCTs were characterized as feasibility trials. However, the majority of published pilot RCTs did not lead to definitive trials. This discrepancy was mainly attributed to poor feasibility (e.g. poor recruitment) and lack of funding for an orthopaedic surgical definitive trial. In recent years this discrepancy may be due to researchers saving on time and cost by rolling their pilot patients into the definitive RCT rather than publish a separate pilot trial.
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Affiliation(s)
- Bijal Desai
- Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
| | - Veeral Desai
- Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
| | - Shivani Shah
- Schulich School of Medicine and Dentistry, Western University, London, ON Canada
| | - Archita Srinath
- Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Amr Saleh
- Faculty of Health Sciences, McMaster University, Hamilton, ON Canada
| | - Nicole Simunovic
- Department of Health Research Methods, Evidence, and Impact (HEI), Division of Orthopaedic Surgery, McMaster University, Hamilton, ON Canada
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, ON Canada
| | - Andrew Duong
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, ON Canada
| | - Sheila Sprague
- Department of Health Research Methods, Evidence, and Impact (HEI), Division of Orthopaedic Surgery, McMaster University, Hamilton, ON Canada
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, ON Canada
| | - Mohit Bhandari
- Department of Health Research Methods, Evidence, and Impact (HEI), Division of Orthopaedic Surgery, McMaster University, Hamilton, ON Canada
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, ON Canada
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Chacón-Moscoso S, Sanduvete-Chaves S, Anguera MT, Losada JL, Portell M, Lozano-Lozano JA. Preliminary Checklist for Reporting Observational Studies in Sports Areas: Content Validity. Front Psychol 2018; 9:291. [PMID: 29568280 PMCID: PMC5853306 DOI: 10.3389/fpsyg.2018.00291] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 02/21/2018] [Indexed: 11/24/2022] Open
Abstract
Observational studies are based on systematic observation, understood as an organized recording and quantification of behavior in its natural context. Applied to the specific area of sports, observational studies present advantages when comparing studies based on other designs, such as the flexibility for adapting to different contexts and the possibility of using non-standardized instruments as well as a high degree of development in specific software and data analysis. Although the importance and usefulness of sports-related observational studies have been widely shown, there is no checklist to report these studies. Consequently, authors do not have a guide to follow in order to include all of the important elements in an observational study in sports areas, and reviewers do not have a reference tool for assessing this type of work. To resolve these issues, this article aims to develop a checklist to measure the quality of sports-related observational studies based on a content validity study. The participants were 22 judges with at least 3 years of experience in observational studies, sports areas, and methodology. They evaluated a list of 60 items systematically selected and classified into 12 dimensions. They were asked to score four aspects of each item on 5-point Likert scales to measure the following dimensions: representativeness, relevance, utility, and feasibility. The judges also had an open-format section for comments. The Osterlind index was calculated for each item and for each of the four aspects. Items were considered appropriate when obtaining a score of at least 0.5 in the four assessed aspects. After considering these inclusion criteria and all of the open-format comments, the resultant checklist consisted of 54 items grouped into the same initial 12 dimensions. Finally, we highlight the strengths of this work. We also present its main limitation: the need to apply the resultant checklist to obtain data and, thus, increase quality indicators of its psychometric properties. For this reason, as relevant actions for further development, we encourage expert readers to use it and provide feedback; we plan to apply it to different sport areas.
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Affiliation(s)
- Salvador Chacón-Moscoso
- HUM-649 Innovaciones Metodológicas en Evaluación de Programas, Departamento de Psicología Experimental, Facultad de Psicología, Universidad de Sevilla, Sevilla, Spain
- Departamento de Psicología, Universidad Autónoma de Chile, Santiago de Chile, Chile
| | - Susana Sanduvete-Chaves
- HUM-649 Innovaciones Metodológicas en Evaluación de Programas, Departamento de Psicología Experimental, Facultad de Psicología, Universidad de Sevilla, Sevilla, Spain
| | - M. Teresa Anguera
- Faculty of Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - José L. Losada
- Faculty of Psychology, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Mariona Portell
- Department of Psychobiology and Methodology of Health Sciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - José A. Lozano-Lozano
- HUM-649 Innovaciones Metodológicas en Evaluación de Programas, Departamento de Psicología Experimental, Facultad de Psicología, Universidad de Sevilla, Sevilla, Spain
- Departamento de Psicología, Universidad Autónoma de Chile, Santiago de Chile, Chile
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Zhang ZW, Cheng J, Liu Z, Ma JC, Li JL, Wang J, Yang KH. Epidemiology, quality and reporting characteristics of meta-analyses of observational studies published in Chinese journals. BMJ Open 2015; 5:e008066. [PMID: 26644119 PMCID: PMC4680011 DOI: 10.1136/bmjopen-2015-008066] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE The aim of this study was to examine the epidemiological and reporting characteristics as well as the methodological quality of meta-analyses (MAs) of observational studies published in Chinese journals. METHODS 5 Chinese databases were searched for MAs of observational studies published from January 1978 to May 2014. Data were extracted into Excel spreadsheets, and Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Assessment of Multiple Systematic Reviews (AMSTAR) checklists were used to assess reporting characteristics and methodological quality, respectively. RESULTS A total of 607 MAs were included. Only 52.2% of the MAs assessed the quality of the included primary studies, and the retrieval information was not comprehensive in more than half (85.8%) of the MAs. In addition, 50 (8.2%) MAs did not search any Chinese databases, while 126 (20.8%) studies did not search any English databases. Approximately 41.2% of the MAs did not describe the statistical methods in sufficient details, and most (95.5%) MAs did not report on conflicts of interest. However, compared with the before publication of the MOOSE Checklist, the quality of reporting improved significantly for 20 subitems after publication of the MOOSE Checklist, and 7 items of the included MAs demonstrated significant improvement after publication of the AMSTAR Checklist (p<0.05). CONCLUSIONS Although many MAs of observational studies have been published in Chinese journals, the reporting quality is questionable. Thus, there is an urgent need to increase the use of reporting guidelines and methodological tools in China; we recommend that Chinese journals adopt the MOOSE and AMSTAR criteria.
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Affiliation(s)
- Zhe-wen Zhang
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Juan Cheng
- The First Hospital of Lanzhou University, Lanzhou, China
| | - Zhuan Liu
- School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Ji-chun Ma
- The First School of Clinical Medicine of Lanzhou University, Lanzhou, China
| | - Jin-long Li
- The First School of Clinical Medicine of Lanzhou University, Lanzhou, China
| | - Jing Wang
- The First School of Clinical Medicine of Lanzhou University, Lanzhou, China
| | - Ke-hu Yang
- Evidence-Based Medicine Center, Institute of Traditional Chinese and Western Medicine, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
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Cowan JB, Mlynarek RA, Nelissen RGHH, Pijls BGCW, Gagnier JJ. Evaluation of Quality of Lower Limb Arthroplasty Observational Studies Using the Assessment of Quality in Lower Limb Arthroplasty (AQUILA) Checklist. J Arthroplasty 2015; 30:1513-7. [PMID: 25922315 DOI: 10.1016/j.arth.2015.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 03/12/2015] [Accepted: 03/24/2015] [Indexed: 02/01/2023] Open
Abstract
UNLABELLED This study used the assessment of quality in lower limb arthroplasty (AQUILA) checklist to assess the quality of lower limb arthroplasty observational studies. Among 132 studies the mean reporting quality score was 5.4 (SD=1.2) out of 8 possible points. Most studies adequately reported reasons for revisions (98%) and prosthesis brand and fixation (95%) in sufficient detail. Only 3% of studies adequately reported the number of patients unwilling to participate, 15% stated a clear primary research question or hypothesis, 11% reported a worst-case analysis or competing risk analysis for endpoints, and 42% reported more than 5% of patients were lost to follow-up. There is significant room for improvement in the reporting and methodology of lower limb arthroplasty observational studies. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- James B Cowan
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Ryan A Mlynarek
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan
| | - Rob G H H Nelissen
- Department of Orthopaedics, Leiden University Medical Center, RC Leiden, The Netherlands
| | - Bart G C W Pijls
- Department of Orthopaedics, Leiden University Medical Center, RC Leiden, The Netherlands
| | - Joel J Gagnier
- Departments of Orthopaedic Surgery and Epidemiology, University of Michigan, Ann Arbor, Michigan
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Evaniew N, Nuttall J, Farrokhyar F, Bhandari M, Ghert M. What are the levels of evidence on which we base decisions for surgical management of lower extremity bone tumors? Clin Orthop Relat Res 2014; 472:8-15. [PMID: 24081669 PMCID: PMC3889455 DOI: 10.1007/s11999-013-3311-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Accepted: 09/19/2013] [Indexed: 01/31/2023]
Abstract
BACKGROUND Benign and malignant lower extremity primary bone tumors are among the least common conditions treated by orthopaedic surgeons. The literature supporting their surgical management has historically been in the form of observational studies rather than prospective controlled studies. Observational studies are prone to confounding bias, sampling bias, and recall bias. QUESTIONS/PURPOSES (1) What are the overall levels of evidence of articles published on the surgical management of lower extremity bone tumors? (2) What is the overall quality of reporting of studies in this field based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist? (3) What are the most common pitfalls in reporting that authors might improve on? METHODS All studies describing the surgical management of lower extremity primary bone tumors from 2002 to 2012 were systematically reviewed. Two authors independently appraised levels of evidence. Quality of reporting was assessed with the STROBE checklist. Pitfalls in reporting were quantified by determining the 10 most underreported elements of research study design in the group of studies analyzed, again using the STROBE checklist as the reference standard. Of 1387 studies identified, 607 met eligibility criteria. RESULTS There were no Level I studies, two Level II studies, 47 Level III studies, 308 Level IV studies, and 250 Level V studies. The mean percentage of STROBE points reported satisfactorily in each article as graded by the two reviewers was 53% (95% confidence interval, 42%-63%). The most common pitfalls in reporting were failures to justify sample size (2.2% reported), examine sensitivity (2.2%), account for missing data (9.8%), and discuss sources of bias (14%). Followup (66%), precision of outcomes (64%), eligibility criteria (55%), and methodological limitations (53%) were variably reported. CONCLUSIONS Observational studies are the dominant evidence for the surgical management of primary lower extremity bone tumors. Numerous deficiencies in reporting limit their clinical use. Authors may use these results to inform future work and improve reporting in observational studies, and treating surgeons should be aware of these limitations when choosing among the various options with their patients.
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Affiliation(s)
- Nathan Evaniew
- />Division of Orthopaedics, Department of Surgery, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON L8L 8E7 Canada
| | - James Nuttall
- />Division of Orthopaedics, Department of Surgery, McMaster University, 711 Concession Street, Hamilton, ON L8V 1C3 Canada
| | - Forough Farrokhyar
- />Department of Clinical Epidemiology and Biostatistics, McMaster University, 39 Charlton Ave.East, Hamilton, ON L8N 1Y3 Canada
| | - Mohit Bhandari
- />Division of Orthopaedics, Department of Surgery, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON L8L 8E7 Canada
- />Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON L8L 8E7 Canada
| | - Michelle Ghert
- />Division of Orthopaedics, Department of Surgery, McMaster University, 711 Concession Street, Hamilton, ON L8V 1C3 Canada
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Pignataro GS, Lins TÁ, Oliveira JRALMD, Moraes VYD, Okamura A, Belloti JC, Faloppa F. Prospective Non-randomized Studies in Orthopaedics and Traumatology: Systematic Assessment of its Methodological Quality. Rev Bras Ortop 2013; 48:126-130. [PMID: 31211117 PMCID: PMC6565849 DOI: 10.1016/j.rboe.2012.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 05/28/2012] [Indexed: 10/26/2022] Open
Abstract
In surgical interventions, randomization and blinding may be difficult to implement. In this situation, non-randomized prospective studies (EPNR) can generate the best evidence. The objective of this study is to evaluate, by means of the scale proposed by Downs & Black, the quality of EPNR published in our country and to assess the interobserver reproducibility of this scale. EPNR published in Acta Ortopedica Brasileira and Revista Brasileira de Ortopedia until 2011 and prior to 2006 were included. Two of us independently applied the Downs & Black scale. The studies were stratified by period of publication, journal and type of intervention. The scores obtained were considered to assess the reliability of the scale and groups comparison. 59 studies were considered, seven excluded during the assessments. There were no differences between the scores, except for the type of intervention, which showed better methodological quality for studies involving clinical interventions (p < 0.001). The correlation coefficient for the Downs & Black score was 0.79 (95% CI 0.65 to 0.88), demonstrating good reliability. EPNR present methodological quality similar when stratified by the periodic publication and publication period. Studies with clinical interventions have better methodological quality. The Downs & Black scale shows good interobserver reproducibility.
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Affiliation(s)
- Gustavo Soriano Pignataro
- Third-year Resident Physician, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil
| | - Theophilo Ásfora Lins
- Third-year Resident Physician, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil
| | | | - Vinícius Ynoe de Moraes
- Third-year Resident Physician, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil
| | - Aldo Okamura
- Third-year Resident Physician, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, SP, Brazil
| | - João Carlos Belloti
- Adjunct Professor, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, UNIFESP, Sao Paulo, SP, Brazil
| | - Flávio Faloppa
- Titular Professor, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, UNIFESP, Sao Paulo, SP, Brazil
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9
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Pignataro GS, Lins TÁ, Oliveira JRALMD, Moraes VYD, Okamura A, Belloti JC, Faloppa F. Estudos prospectivos e não randomizados na ortopedia e traumatologia: avaliação sistemática da qualidade metodológica. Rev Bras Ortop 2013. [DOI: 10.1016/j.rbo.2012.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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10
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Sheffler LC, Yoo B, Bhandari M, Ferguson T. Observational studies in orthopaedic surgery: the STROBE statement as a tool for transparent reporting. J Bone Joint Surg Am 2013; 95:e14(1-12). [PMID: 23389794 DOI: 10.2106/jbjs.l.00484] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Lindsey C Sheffler
- Department of Orthopaedic Surgery, University of California, San Francisco, 500 Parnassus Avenue, MU 320W, San Francisco, CA 94143-0728, USA.
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Stegeman SA, de Jong M, Sier CFM, Krijnen P, Duijff JW, van Thiel TPH, de Rijcke PAR, Soesman NMR, Hagenaars T, Boekhoudt FD, de Vries MR, Roukema GR, Tanka AFK, van den Bremer J, van der Meulen HGWM, Bronkhorst MWGA, van Dijkman BA, van Zutphen SWAM, Vos DI, Schep NWL, Eversdijk MG, van Olden GDJ, van den Brand JGH, Hillen RJ, Frölke JPM, Schipper IB. Displaced midshaft fractures of the clavicle: non-operative treatment versus plate fixation (Sleutel-TRIAL). A multicentre randomised controlled trial. BMC Musculoskelet Disord 2011; 12:196. [PMID: 21864352 PMCID: PMC3175212 DOI: 10.1186/1471-2474-12-196] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 08/24/2011] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The traditional view that the vast majority of midshaft clavicular fractures heal with good functional outcomes following non-operative treatment may be no longer valid for all midshaft clavicular fractures. Recent studies have presented a relatively high incidence of non-union and identified speciic limitations of the shoulder function in subgroups of patients with these injuries. AIM A prospective, multicentre randomised controlled trial (RCT) will be conducted in 21 hospitals in the Netherlands, comparing fracture consolidation and shoulder function after either non-operative treatment with a sling or a plate fixation. METHODS/DESIGN A total of 350 patients will be included, between 18 and 60 years of age, with a dislocated midshaft clavicular fracture. The primary outcome is the incidence of non-union, which will be determined with standardised X-rays (Antero-Posterior and 30 degrees caudocephalad view). Secondary outcome will be the functional outcome, measured using the Constant Score. Strength of the shoulder muscles will be measured with a handheld dynamometer (MicroFET2). Furthermore, the health-related Quality of Life score (ShortForm-36) and the Disabilities of Arm, Shoulder and Hand (DASH) Outcome Measure will be monitored as subjective parameters. Data on complications, bone union, cosmetic aspects and use of painkillers will be collected with follow-up questionnaires. The follow-up time will be two years. All patients will be monitored at regular intervals over the subsequent twelve months (two and six weeks, three months and one year). After two years an interview by telephone and a written survey will be performed to evaluate the two-year functional and mechanical outcomes. All data will be analysed on an intention-to-treat basis, using univariate and multivariate analyses. DISCUSSION This trial will provide level-1 evidence for the comparison of consolidation and functional outcome between two standardised treatment options for dislocated midshaft clavicular fractures. The gathered data may support the development of a clinical guideline for treatment of clavicular fractures. TRIAL REGISTRATION Netherlands National Trial Register NTR2399.
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Affiliation(s)
- Sylvia A Stegeman
- Department of Surgery-Traumatology, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands
| | - Mireille de Jong
- Department of Surgery-Traumatology, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands
| | - Cornelis FM Sier
- Department of Surgery-Traumatology, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands
| | - Pieta Krijnen
- Department of Surgery-Traumatology, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands
| | - Jan W Duijff
- Department of Surgery-Traumatology, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands
| | - Tom PH van Thiel
- Department of Surgery, Streekziekenhuis Koningin Beatrix, P.O. box 9005, 7100 GG Winterswijk, the Netherlands
| | - Piet AR de Rijcke
- Department of Surgery, IJsselland Hospital, P.O. box 690, 2900 AR Capelle a/d IJssel, the Netherlands
| | - Nicolaj MR Soesman
- Department of Surgery, Vlietland Hospital, P.O. box 215, 3100 AE Schiedam, the Netherlands
| | - Tjebbe Hagenaars
- Department of Surgery-Traumatology, Erasmus Medical Centre, P.O. box 2040, 3000 CA Rotterdam, the Netherlands
| | - Freek D Boekhoudt
- Department of Surgery, Hospital Gelderse Vallei, P.O. box 9025, 6710 HN Ede, the Netherlands
| | - Mark R de Vries
- Department of Surgery, Reinier de Graaf Group, P.O. box 5011, 2600 GA Delft, the Netherlands
| | - Gert R Roukema
- Department of Surgery, Maasstad Hospital, P.O. box 9100, 3007 AC Rotterdam, the Netherlands
| | - Andras FK Tanka
- Department of Surgery, Spaarne Hospital, P.O. box 770, 2130 AT Hoofddorp, the Netherlands
| | - Jephta van den Bremer
- Department of Surgery, Rijnland Hospital, P.O. box 4220, 2350 CC Leiderdorp, the Netherlands
| | - Hub GWM van der Meulen
- Department of Surgery, Haga Hospital, P.O. box 40551, 2504 LN The Hague, the Netherlands
| | - Maarten WGA Bronkhorst
- Department of Surgery, Bronovo Hospital, P.O. box 96900, 2509 JH The Hague, the Netherlands
| | - Bart A van Dijkman
- Department of Surgery, Flevo Hospital, P.O. box 3005, 1300 EG, Almere, the Netherlands
| | - Stephan WAM van Zutphen
- Department of Surgery, Tweesteden Hospital, P.O. box 90107, 5000 LA Tilburg, the Netherlands
| | - Dagmar I Vos
- Department of Surgery, Amphia Hospital, P.O. box 90158, 4800 RK Breda, the Netherlands
| | - Niels WL Schep
- Department of Surgery, Academic Medical Centre, P.O. box 22660, 1100 DD Amsterdam, the Netherlands
| | - Martin G Eversdijk
- Department of Surgery, St Jansdal Hospital, P.O. box 138, 3840 AC Harderwijk, the Netherlands
| | - Ger DJ van Olden
- Department of Surgery, Meander Medical Centre, P.O. box 1502, 3800 BM Amersfoort, the Netherlands
| | - Johan GH van den Brand
- Department of Surgery, Medical Centre Alkmaar, P.O. box 501, 1800 AM Alkmaar, the Netherlands
| | - Robert Jan Hillen
- Department of Orthopaedics, Waterland Hospital, P.O. box 250, 1440 AG Purmerend, the Netherlands
| | - Jan Paul M Frölke
- Department of Surgery, Radboud University Nijmegen Medical Centre, P.O. box 9101, 6500 HB Nijmegen, the Netherlands
| | - Inger B Schipper
- Department of Surgery-Traumatology, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands
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Affiliation(s)
| | | | - Mohit Bhandari
- McMaster University, Hamilton, Canada,Address for correspondence: Dr. Mohit Bhandari, 2309 Hoover Court, Hamilton, L7P 4V2, ON, Canada. E-mail:
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Affiliation(s)
| | | | - Mohit Bhandari
- McMaster University, Canada,Address for correspondence: Dr. Mohit Bhandari, 2309 Hoover Court, Hamilton, L7P 4V2, Ontario, Canada. E-mail:
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