Abstract
Purpose
An estimated 85% of research is of limited value or wasted because the wrong research questions are addressed. We sought to identify research gaps using American Academy of Orthopaedic Surgeon (AAOS) clinical practice guidelines Treatment of Osteoarthritis of the Knee and Surgical Management of Osteoarthritis of the Knee. Using these recommendations, we conducted searches of ClinicalTrials.gov to discover the extent to which new and ongoing research addresses areas of deficiency.
Methods
For each recommendation in the AAOS guidelines, we created participants, intervention, comparator, outcomes questions, and search strings using a systematic process. Searches were then conducted of ClinicalTrials.gov to locate relevant studies.
Results
Our searches of ClinicalTrials.gov returned 945 studies for surgical and 1416 for non-surgical management of osteoarthritis. Of the 945 studies returned using our search string for surgical trials, 186 (20%) were relevant to 30 (79%) of the 38 recommendations made within the surgical management guideline. Of the 1416 studies returned using our search for non-surgical trials, 360 (25%) were relevant to 16 (89%) of the 18 recommendations made within the conservative management guideline.
Conclusions
The development of clinical practice guidelines is a unique opportunity to simultaneously redefine day-to-day decision-making and provide a critical analysis of the status of the literature. Upon our search of the literature since the guidelines introduction, we have found that some inconclusive areas have received more attention than others. Our results should guide researchers towards conducting research on the topics most in need and, by doing so, strengthen the clinical practice guideline recommendations.
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References
Chalmers I, Glasziou P (2009) Avoidable waste in the production and reporting of research evidence. Lancet 374(9683):86–89
National Institute of Health (2017) NIH research portfolio online reporting tools (RePORT): estimates of funding for various research, condition, and disease categories (RCDC). NIH, Bethesda https://report.nih.gov/categorical_spending.aspx. Accessed 21 Aug 2017
National Institute of Arthritis and Musculoskeletal and Skin Diseases (2017) Osteoarthritis initiative. NIH, Bethesda https://www.niams.nih.gov/Funding/Funded_Research/Osteoarthritis_Initiative/default.asp. Accessed 21 Aug 2017
Jevsevar DS, Brown GA, Jones DL, Matzkin DG, Manner PA, Mooar P et al (2013) The American Academy of Orthopaedic Surgeons evidence-based guideline on: treatment of osteoarthritis of the knee, 2nd edition. J Bone Joint Surg Am 95(20):1885–1886
McGrory B, Weber K, Lynott JA, Richmond JC, Davis CM, Jr YA et al (2016) The American Academy of Orthopaedic Surgeons evidence-based clinical practice guideline on surgical management of osteoarthritis of the knee. J Bone Joint Surg Am 98(8):688–692
Clarke M, Williamson P (2015) Core outcome sets and trial registries. Trials 16:216
Moja LP, Moschetti I, Nurbhai M, Compagnoni A, Liberati A, Grimshaw JM et al (2009) Compliance of clinical trial registries with the World Health Organization minimum data set: a survey. Trials 10:56
Methley AM, Campbell S, Chew-Graham C, McNally R, Cheraghi-Sohi S (2014) PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res 14:579
Cross M, Smith E, Hoy D et al (2014) The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis 73(7):1323–1330
Pedowitz RA, Yamaguchi K, Ahmad CS, Burks RT et al (2011) American Academy of Orthopaedic Surgeons: optimizing the management of rotator cuff problems. J Am Acad Orthop Surg 19(6):368–379
Martínez García L, Sanabria AJ, García Alvarez E, Trujillo-Martín MM, Etxeandia-Ikobaltzeta I, Kotzeva A et al (2014) The validity of recommendations from clinical guidelines: a survival analysis. CMAJ 186(16):1211–1219
American Association of Hip and Knee Surgeons (2017) Caring for your hips and knees without surgery. AAHKS. http://www.aahks.org/care-for-hips-and-knees/caring-for-your-hips-and-knees-without-surgery. Accessed 21 Aug 2017
Hepper CT, Halvorson JJ, Duncan ST, Gregory AJ, Dunn WR, Spindler KP (2009) The efficacy and duration of intra-articular corticosteroid injection for knee osteoarthritis: a systematic review of level I studies. J Am Acad Orthop Surg 17(10):638–646
Campbell KA, Saltzman BM, Mascarenhas R, Khair MM, Verma NN, Bach BR Jr et al (2015) Does intra-articular platelet-rich plasma injection provide clinically superior outcomes compared with other therapies in the treatment of knee osteoarthritis? A systematic review of overlapping meta-analyses. Arthroscopy 31(11):2213–2221
Hussain SM, Neilly DW, Baliga S, Patil S, Meek R (2016) Knee osteoarthritis: a review of management options. Scott Med J 61(1):7–16
Goldberg BA, Scarlat MM (2017) No free lunch in orthopedics. Int Orthop 41:1963–1964
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Scott, J., Checketts, J.X., Horn, J.G. et al. “Knee osteoarthritis and current research for evidence—are we on the right way?”. International Orthopaedics (SICOT) 42, 2105–2112 (2018). https://doi.org/10.1007/s00264-018-3932-9
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DOI: https://doi.org/10.1007/s00264-018-3932-9