Editorial: Getting the Most from What You Read in Orthopaedic Journals

Editorial: The Sacredness of Surgery

“…We believe this is time and money very well spent. The second step is to ensure that our patient doesn't choose surgery based on misconceptions: Misconceptions about a procedure's efficacy in general [4] (which often are overstated because of the kinds of bias so prevalent in retrospective surgical research [19]), or misconceptions about a musculoskeletal procedure's ability to help somatic symptoms in a patient with psychological distress (even in the presence of "objective" musculoskeletal pathology, which may be nothing more than age-related tissue changes [3,22]).…”

Editorial: When to Trust a Meta-analysis or Systematic Review About a Surgical Treatment, and Why

“…The main kinds of bias that accrue in retrospective and observational surgical research do not offset one another, they're additive. Selection bias (treatment groups with baseline differences in elements that may affect the outcomes in question), transfer bias (follow-up that is insufficiently long or complete to discern all relevant harms of treatment), and assessment bias (using nonvalidated endpoints when evaluating outcomes) befoul retrospective studies more than randomized trials, and they all tend to make the novel treatment appear better than it actually is [7]. If one pools a population of studies that tends to suffer from those limitations in a meta-analysis, the meta-analysis will tend to amplify those biases and overestimate the benefits of treatment.…”

When should we adopt new technology into our practices?

“…Again, the answer is decidedly low-tech, if not downright unsexy: Human nature [11] as well as the common kinds of biases that cause us to overestimate our effectiveness in other areas [12] typically beset research about our newest tools. These include selection bias, transfer bias, and assessment bias, as well as the conflation of statistical significance with clinical importance (Table 1).…”