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Stengel, Dirk; Mutschler, Wolf; Dubs, Luzi; Kirschner, Stephan and Renkawitz, Tobias (2021): Klinische Studien in Unfallchirurgie und Orthopädie: lesen, interpretieren und umsetzen. In: Unfallchirurg, Vol. 124, No. 12: pp. 1007-1017

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Abstract

Informative, participatory clinical decision-making needs to combine both skills and expertise as well as current scientific evidence. The flood of digital information makes it difficult in everyday clinical practice to keep up to date with the latest publications. This article provides assistance for coping with this problem. A basic understanding of prior and posterior probabilities as well as systematic error (bias) makes it easier to weigh up the benefits and risks, e.g. of a (surgical) intervention compared to a nonsurgical treatment. Randomized controlled trials (RCT, with all modern modifications) deliver undistorted results but in orthopedic and trauma surgery can lead to a heavily selected nonrepresentative sample and the results must be confirmed or refuted by further, independent RCTs. Large-scale observational data (e.g. from registries) can be modelled in a quasi-experimental manner and accompany RCTs in health technology assessment.

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