The Use of Systematic Reviews in Orthopaedic Traumatology

Abstract

Purpose Systematic reviews (SRs) are an invaluable resource that can be used to justify whether or not there is a need to conduct a new randomized controlled trial (RCT). New RCTs are warranted when previous SRs cite a lack of evidence in literature. The primary aim of this study is to evaluate the use of SRs as justification in conducting RCTs published in high impact orthopaedic trauma journals. Methods We analyzed RCTs published in the top three high impact orthopaedic trauma journals. Data was extracted by the number of SRs cited in each RCT. Each citation was analyzed for justification in conducting the trial. Citations found to be “verbatim” directly cite a lack of sufficient information specified in a SR as the purpose for conducting the trial. Results Of the 144 trials retrieved, 128 were included. Overall, 70.3% (90/128) of trials referenced a SR while 29.6% (38/128) did not reference a SR. Of these 128 trials, 23% (30/128) cited at least one SR as justification for conducting the trial, with most found in the introduction (16/30). Therefore, 76.6% (98/128) made no reference of SR guiding RCT design. Conclusion Based on the findings of this study, SRs are not being sufficiently cited as justification for conducting a RCT in orthopaedic traumatology. Trialists may consider using evidence from existing SRs for designing RCTs to combat performing duplicative trials.