TY - JOUR
T1 - Randomised controlled trials in hand surgery
T2 - a scoping review
AU - Heikkinen, Juuso
AU - Das De, Soumen
AU - Jokihaara, Jarkko
AU - Jaatinen, Kati
AU - Buchbinder, Rachelle
AU - Karjalainen, Teemu
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/10/10
Y1 - 2022/10/10
N2 - 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. CONCLUSION: 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. PROSPERO REGISTRATION NUMBER: CRD42019122710.
AB - 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. CONCLUSION: 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. PROSPERO REGISTRATION NUMBER: CRD42019122710.
KW - hand & wrist
KW - plastic & reconstructive surgery
KW - surgery
UR - http://www.scopus.com/inward/record.url?scp=85139472225&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2022-062773
DO - 10.1136/bmjopen-2022-062773
M3 - Article
C2 - 36216426
AN - SCOPUS:85139472225
SN - 2044-6055
VL - 12
JO - BMJ Open
JF - BMJ Open
IS - 10
M1 - e062773
ER -