Can We Trust Knee Meniscus Studies? One-Way Crossover Confounds Intent-to-Treat Statistical Methods.

Lubowitz, James H; D'Agostino, Ralph B; Provencher, Matthew T; Rossi, Michael J; Brand, Jefferson C · Arthroscopy · 2016

review · Level V

Where this comes from

Abstract

Randomized controlled studies have a high level of evidence. However, some patients are not treated in the manner to which they were randomized and actually switch to the alternative treatment (crossover). In such cases, "intent-to-treat" statistical methods require that such a switch be ignored, resulting in bias. Thus, the study conclusions could be wrong. This bias is a common problem in the knee meniscus literature.

Medical subject headings

Anatomy