More well developed orthopaedic prediction models

It seems that appropriate methodology in the development of prediction models is becoming more common in our field. These two recent studies caught my attention: Development of a model to predict the probability of incurring a complication during spine surgery and Prediction of 90-day mortality after total hip arthroplasty. Both studies report calibration performance and […]

Mesmerized by clinical prediction models

I am not a surgical oncologist but I came across with this study:  A deep survival interpretable radiomics model of hepatocellular carcinoma patients. Authors conclude: In summary, novel deep radiomic analysis provides improved performance for risk assessment of HCC prognosis compared with Cox survival models and may facilitate stratification of HCC patients and personalization of […]

Implications of binomial distribution in the daily orthopaedic practice

Deep infection is a devastating complication in the orthopaedic surgery. It usually requires a revision surgery and a risk for further complications increases greatly. Functional outcome is usually much worse after deep infection compared to uneventful primary surgery especially if removal of implants is required to eridicate the infection. Deep infection are often systematically recorded […]

How to investigate “novel techniques”?

I liked the study by Lapner et al. very much. Their study was titled “Preoperative bone marrow stimulation does not improve functional outcomes in arthroscopic cuff repair: a prospective randomized controlled trial”. They proposed a new concept to improve healing of rotator cuff repair. Authors hypothesized that preoperative ultrasound-guided bone channeling in the footprint 5-7 […]

What sort of improvement we need in our research?

This is not a new study but I came across to this study by Brophy et al. titled “Update on the Methodological Quality of Research Published in The American Journal of Sports Medicine“. They concluded: Despite a dramatic increase in the number of published articles, the research published in AJSM shifted toward more prospective, randomized, […]

Why do we need randomized trials?

Discussion about randomized controlled trials (RCT) has been extensive in social media during this spring due to corona virus epidemic. This discussion was especially heated when “not so good” clinical trial was published stating that hydroxychloroquine is efficient in the treatment of corona virus disease (CoViD-19). I drew this picture and posted it on Twitter. […]

Exploratory or confirming study?

Methodology is hard. And making valid inferences is very hard. With regard to these topics, orthopaedic research is not very different to other field in medicine. It means that misconceptions, misunderstandings and flawed approaches are prevalent also in our field. American Journal of Sports Medicine published recently two papers which both made a quite common, […]

Propensity scores, orthopaedics and shared decision making

This is something I posted on Twitter last October. Extended discussion can be found below the tweets Propensity score matching is often used when two cohorts of patient are compared. Aim is to have somewhat comparable groups so effect of treatment or intervention could be estimated reliably. In short, two groups of patient tread by […]