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Bob's ACL WWWBoard
Level Of Evidence: Skill of Surgeon/Graft Type Ranking
Posted By: TC
Date: Saturday, 9 January 2010, at 3:53 a.m.
I've now read through hundreds of medical abstracts,many directly contradicting each other, and the one firm conclusion I have is that most of these so called studies are ridiculously small and don’t control for bias. The sample sizes are tiny, e.g. 64 or 156. To their credit, most of the studies are labeled as such and marked “Level of evidence III” or “Level IV”. Level V is just expert opinion and each level moves up a little from there. Ideally they should all be level I or II.
It is even more amazing when you consider that consumer companies wouldn’t think of coming out with a new flavor of cream cheese or Jell-O without thousands tested in a sample size and with factors controlled for demographics,seasonality, price etc. Granted, these situations are easier to set up and measure with supermarket scanners than measuring surgical outcome and follow up since you need cooperation from patients but the point remains. The studies may be contradictory because they are small and don’t control for other factors.
I’m starting to think that one of the factors not controlled for in these studies is skill of the surgeon, and may be the most important.
I’d be interested in how others rank this in comparison to some of the following factors for a successful outcome: Skill of surgeon vs graft type, prehap, rehab, physical therapist, age of patient, activity level of patient and previous injury?
Messages In This Thread
- Level Of Evidence: Skill of Surgeon/Graft Type Ranking (views: 48) -- TC -- Saturday, 9 January 2010, at 3:53 a.m.
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