Do Authors Report Surgical Expertise in Open Spine Surgery Related Randomized Controlled Trials? A Systematic Review on Quality of Reporting

Abstract

This study shows that in open spine surgery RCTs information on skill and experience is scarcely reported. Authors often fail to report essential methodological safeguards. These studies may therefore be prone to expertise bias.

Strategies to improve the credibility of meta-analyses in spine surgery: a systematic survey

“…Van Oldenrijk et al [78] showed that spine surgery RCTs frequently fail to report essential methodological safeguards such as allocation concealment, blinding, and adherence to the intention-to-treat principle, but Devereaux et al [79] showed in an observational study of 105 RCTs that safeguards against bias in RCTs were often adequate despite incomplete reporting. Chan et al [80] surveyed the authors of 43 orthopedic surgery RCTs and identified that 28% to 40% of the trials had blinding of relevant groups despite unclear reporting.…”

Bias in cervical total disc replacement trials

“…In technically demanding procedures such as spine surgery, a surgeon's skill and expertise is expected to play an important role in the outcome of the procedure [43]. In the most commonly cited CDR studies which are IDE studies, the surgeons performing TDR and ACDF are highly selected surgeons.…”

Lessons from the infuse trials: do we need a classification of bias in scientific publications and editorials?

“…Furthermore, blinding was unclear in 55 % of patients, 72 % of ward staff, 74 % of rehabilitation staff, 46 % of clinical outcome assessors, and 38 % of nonclinical outcome assessors. A recent review of the randomized control trials in spine surgery from 2005 to 2010 reported that only 10 % report surgical experience, which is usually a description of the learning curve [38]. Equally as alarming, 77 % of studies were unclear about the concealment of treatment allocation, 68 % were unclear regarding the blinding of participants, 77 % were unclear regarding the blinding of outcome assessors, and 67 % were unclear of adhering to the intention-to-treat principle [38].…”

“…A recent review of the randomized control trials in spine surgery from 2005 to 2010 reported that only 10 % report surgical experience, which is usually a description of the learning curve [38]. Equally as alarming, 77 % of studies were unclear about the concealment of treatment allocation, 68 % were unclear regarding the blinding of participants, 77 % were unclear regarding the blinding of outcome assessors, and 67 % were unclear of adhering to the intention-to-treat principle [38]. The implementation of guidelines such as CONSORT and CLEAR NPT aim to minimize methodological bias and improve the quality of reporting among the randomize control From [28], with permission trials, especially in the current time of reliance upon comparative effectiveness research.…”