학술논문

Inadequate harms reporting among randomized controlled trials cited as supporting evidence in the AAOS management of hip fractures in older adults clinical practice guideline recommendations.
Document Type
Academic Journal
Author
Howard C; Oklahoma State University, Center for Health Sciences, Tulsa, OK, USA. Electronic address: connerhoward10@okstate.edu.; Sell T; Burrell College of Osteopathic Medicine, Las Cruces, NM, USA.; Abraham C; Kansas City University College of Osteopathic Medicine, Kansas City, MO, USA.; Anderson JM; Oklahoma State University Medical Center, Department of Orthopaedic Surgery, Tulsa, OK, USA.; Norris B; Oklahoma State University Medical Center, Department of Orthopaedic Surgery, Tulsa, OK, USA; Orthopaedic Trauma Services of Oklahoma, Tulsa, OK, USA.; Anderson RM; Oklahoma State University, Center for Health Sciences, Tulsa, OK, USA.; Vu TK; Kansas City University College of Osteopathic Medicine, Kansas City, MO, USA.; Vassar M; Oklahoma State University, Center for Health Sciences, Tulsa, OK, USA.; Checketts JX; Oklahoma State University Medical Center, Department of Orthopaedic Surgery, Tulsa, OK, USA.
Source
Publisher: Elsevier Country of Publication: Netherlands NLM ID: 0226040 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0267 (Electronic) Linking ISSN: 00201383 NLM ISO Abbreviation: Injury Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Recommendations within clinical practice guidelines (CPGs) are heavily influenced by results from randomized controlled trials (RCTs). Therefore, it is imperative that all RCT outcomes are reported thoroughly to ensure CPGs are created using accurate information. Here, we evaluate the quality of harms reporting using the CONSORT Extension for Harms in RCTs underpinning recommendations in the American Academy of Orthopedic Surgeons (AAOS) Management of Hip Fractures in Older Adults CPG.
Methods: Each RCT cited as evidence for recommendations in the AAOS Management of Hip Fractures in Older Adults CPG was evaluated using the CONSORT Extension for Harms to determine the quality of harms reporting. Descriptive statistics (frequencies, percentages, 95 % confidence intervals) were used to summarize adherence to CONSORT Harms items. A linear regression model was used to evaluate the CONSORT Harms influence on the quality of reporting over time.
Results: Among the 156 RCTs identified, there were a total of 31,848 participants. Most RCTs were conducted at a single center (137; 87.8 %) and in a single-blind manner (130; 83.3 %). Fifty-four (34.6 %) RCTs did not provide funding statements. Trials adequately reported an average of 6.65 out of 18 CONSORT Extension for Harms items (37.0 %). One RCT adequately reported all items, while five reported zero items. Forty-seven RCTs (30.1 %) reported ≥ 50 % of items and 73 (46.8 %) reported ≤ 33.3 % of items. The linear regression model demonstrated no significant increase in mean adherence over time (adjusted R2 = -0.006; p = 0.563).
Conclusion: Our results highlight inadequate harms reporting among RCTs in the AAOS Management of Hip Fractures in Older Patients CPG. While the CONSORT Harms Extension was intended to enhance reporting, the linear regression model did not demonstrate significant improvements over time.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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