Statistical Fragility of Single-Row Versus Double-Row Anchoring for Rotator Cuff Repair: A Systematic Review of Comparative Studies.
P value
double row
fragility index
fragility quotient
rotator cuff
single row
statistical significance
Journal
Orthopaedic journal of sports medicine
ISSN: 2325-9671
Titre abrégé: Orthop J Sports Med
Pays: United States
ID NLM: 101620522
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
received:
06
01
2022
accepted:
17
02
2022
entrez:
16
5
2022
pubmed:
17
5
2022
medline:
17
5
2022
Statut:
epublish
Résumé
Comparative studies and randomized controlled trials (RCTs) often use the The purpose of this study was to examine the statistical stability of studies comparing single-row to double-row rotator cuff repair. It was hypothesized that the findings of these studies would be vulnerable to a small number of outcome event reversals, often fewer than the number of patients lost to follow-up. Systematic review; Level of evidence, 3. We analyzed comparative studies and RCTs on primary single-row versus double-row rotator cuff repair that were published between 2000 and 2021 in 10 leading orthopaedic journals. Statistical significance was defined as a Of 4896 studies screened, 22 comparative studies, 10 of which were RCTs, were ultimately included for analysis. A total of 74 outcomes were examined. Overall, the median FI was 2 (interquartile range [IQR], 1-3), and the median FQ was 0.035 (IQR, 0.020-0.057). The mean FI was 2.55 ± 1.29, and the mean FQ was 0.043 ± 0.027. In 64% of outcomes, the FI was less than the number of patients lost to follow-up.) Additionally, 81% of significant outcomes needed just a single outcome reversal to lose their significance. Over half of the studies currently used to guide clinical practice have a number of patients lost to follow-up greater than their FI. The results of these studies should be interpreted within the context of these limitations. Future analyses may benefit from the inclusion of the FI and the FQ in their statistical analyses.
Sections du résumé
Background
UNASSIGNED
Comparative studies and randomized controlled trials (RCTs) often use the
Purpose/Hypothesis
UNASSIGNED
The purpose of this study was to examine the statistical stability of studies comparing single-row to double-row rotator cuff repair. It was hypothesized that the findings of these studies would be vulnerable to a small number of outcome event reversals, often fewer than the number of patients lost to follow-up.
Study Design
UNASSIGNED
Systematic review; Level of evidence, 3.
Methods
UNASSIGNED
We analyzed comparative studies and RCTs on primary single-row versus double-row rotator cuff repair that were published between 2000 and 2021 in 10 leading orthopaedic journals. Statistical significance was defined as a
Results
UNASSIGNED
Of 4896 studies screened, 22 comparative studies, 10 of which were RCTs, were ultimately included for analysis. A total of 74 outcomes were examined. Overall, the median FI was 2 (interquartile range [IQR], 1-3), and the median FQ was 0.035 (IQR, 0.020-0.057). The mean FI was 2.55 ± 1.29, and the mean FQ was 0.043 ± 0.027. In 64% of outcomes, the FI was less than the number of patients lost to follow-up.) Additionally, 81% of significant outcomes needed just a single outcome reversal to lose their significance.
Conclusion
UNASSIGNED
Over half of the studies currently used to guide clinical practice have a number of patients lost to follow-up greater than their FI. The results of these studies should be interpreted within the context of these limitations. Future analyses may benefit from the inclusion of the FI and the FQ in their statistical analyses.
Identifiants
pubmed: 35571970
doi: 10.1177/23259671221093391
pii: 10.1177_23259671221093391
pmc: PMC9096204
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
23259671221093391Informations de copyright
© The Author(s) 2022.
Déclaration de conflit d'intérêts
One or more of the authors has declared the following potential conflict of interest or source of funding: R.L.P. has received grant support and education payments from Arthrex. D.W. has received education payments from Arthrex and Smith & Nephew; consulting fees from Newclip, Ipsen Biosciences, DePuy/Medical Device Business Services, and Vericel; and hospitality payments from Linvatec and Stryker. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
Références
Am J Sports Med. 2021 Oct;49(12):3437-3442
pubmed: 33646884
J Shoulder Elbow Surg. 2015 Oct;24(10):1544-54
pubmed: 25940379
J Bone Joint Surg Am. 2012 Jul 18;94(14):1249-57
pubmed: 22810395
J Clin Epidemiol. 2014 Jun;67(6):622-8
pubmed: 24508144
Am J Sports Med. 2008 Jul;36(7):1310-6
pubmed: 18413680
Am J Sports Med. 2015 Aug;43(8):1976-82
pubmed: 26055919
Pediatr Crit Care Med. 2019 Jun;20(6):e258-e262
pubmed: 31013262
Knee Surg Sports Traumatol Arthrosc. 2020 Feb;28(2):339-352
pubmed: 31190245
Crit Care Med. 2016 Nov;44(11):e1142-e1143
pubmed: 27755081
Osteoporos Int. 2021 Sep;32(9):1713-1723
pubmed: 33595680
Arthroscopy. 2019 Oct;35(10):2803-2813
pubmed: 31604496
Arthroscopy. 2005 Nov;21(11):1307-16
pubmed: 16325080
Am J Sports Med. 2018 Jan;46(1):116-121
pubmed: 28942685
JBJS Rev. 2020 May;8(5):e0203
pubmed: 32427776
Arthroscopy. 2009 Jan;25(1):4-12
pubmed: 19111212
Am J Sports Med. 2013 Oct;41(10):2270-7
pubmed: 23942285
Am J Sports Med. 2016 Apr;44(4):948-56
pubmed: 26797698
Eur J Trauma Emerg Surg. 2021 May 31;:
pubmed: 34056677
J Pediatr Orthop. 2018 Sep;38(8):e418-e423
pubmed: 29979332
Am J Sports Med. 2021 Aug;49(10):2827-2833
pubmed: 33211555
Spine J. 2015 Oct 1;15(10):2188-97
pubmed: 26072464
J Orthop Trauma. 2019 Dec;33(12):e466-e470
pubmed: 31356443
Arthroscopy. 2014 Sep;30(9):1156-65
pubmed: 24821226
Am J Sports Med. 2007 Aug;35(8):1254-60
pubmed: 17554104
Arthroscopy. 2010 Nov;26(11):1419-26
pubmed: 20875720
J Am Acad Orthop Surg. 2019 Apr 1;27(7):e324-e329
pubmed: 30325880
J Shoulder Elbow Surg. 2020 Oct;29(10):2015-2026
pubmed: 32951642
Am J Sports Med. 2017 Jul;45(9):2164-2170
pubmed: 27895038
J Shoulder Elbow Surg. 2018 Jun;27(6):1021-1029
pubmed: 29289493
Spine (Phila Pa 1976). 2021 Feb 1;46(3):198-208
pubmed: 32756285
Eur J Orthop Surg Traumatol. 2018 Jul;28(5):859-868
pubmed: 29270867
Int Orthop. 2012 Sep;36(9):1877-83
pubmed: 22584619
Am J Sports Med. 2020 Jun;48(7):1568-1574
pubmed: 32391732
Arthroscopy. 2012 Jan;28(1):16-24
pubmed: 21982391
Am J Sports Med. 2019 May;47(6):1427-1433
pubmed: 31042439
Crit Care Med. 2019 Mar;47(3):456-462
pubmed: 30394920
SICOT J. 2018;4:57
pubmed: 30547879
Arthroscopy. 2011 Apr;27(4):453-62
pubmed: 21444007
Cartilage. 2021 Dec;13(1_suppl):147S-155S
pubmed: 33969744
Arthroscopy. 2016 May;32(5):753-61
pubmed: 26821959
Clin Orthop Relat Res. 2010 Mar;468(3):885-92
pubmed: 19921345
J Clin Epidemiol. 1990;43(2):201-9
pubmed: 2303850
Am J Sports Med. 2007 Aug;35(8):1247-53
pubmed: 17452513
JAMA Surg. 2019 Jan 01;154(1):74-79
pubmed: 30422256
JAMA. 2016 Mar 15;315(11):1141-8
pubmed: 26978209
Arthroscopy. 2021 Jun;37(6):1983-1989
pubmed: 33539980
Arthroscopy. 2012 Jul;28(7):909-15
pubmed: 22365267