Randomised controlled trials in hand surgery : a scoping review
Heikkinen, Juuso; Das De, Soumen; Jokihaara, Jarkko; Jaatinen, Kati; Buchbinder, Rachelle; Karjalainen, Teemu (2022-10-10)
Heikkinen J, Das De S, Jokihaara J, et alRandomised controlled trials in hand surgery: a scoping reviewBMJ Open 2022;12:e062773. doi: 10.1136/bmjopen-2022-062773
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https://creativecommons.org/licenses/by-nc/4.0/
https://urn.fi/URN:NBN:fi-fe2023062759336
Tiivistelmä
Abstract
Objectives: To identify the evidence gaps that exist regarding the efficacy or effectiveness of hand surgery.
Setting: A scoping review. We systematically searched MEDLINE, Embase and CENTRAL databases to identify all hand surgical randomised controlled trials from inception to 7 November 2020.
Results: Of the 220 identified randomised controlled trials, none were fundamental efficacy trials, that is, compared surgery with placebo surgery. 172 (78%) trials compared the outcomes of different surgical techniques, and 143 (65%) trials were trauma related. We identified only 47 (21%) trials comparing surgery with non-operative care or injection.
Conclusions: The evidence supporting use of surgery especially for chronic hand conditions is scarce. To determine optimal care for people with hand conditions, more resources should be aimed at placebo-controlled trials and pragmatic effectiveness trials comparing hand surgery with non-operative care.
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