The Effect of Level I Evidence on Surgical Decision Making in the United States Versus Canada.
cross_sectional · Level IV
Where this comes from
- Record sourced from PubMed, PMID 30680367.
- Also identified by DOI 10.5435/JAAOSGlobal-D-18-00056 and PMC identifier 6336576.
- Licence recorded as CC BY-NC-ND.
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Abstract
In this study, we examined the difference that randomized trials favoring either surgery or nonsurgical treatment had on the surgical indications of American versus Canadian surgeons. One randomized trial favoring surgical management of clavicle fractures and another one favoring nonsurgical management of Achilles tendon ruptures were used. American and Canadian orthopaedic surgeons were surveyed regarding their surgical indications for these injuries. More than 2000 US and 200 Canadian responses were received. For clavicles, 57% of US respondents indicated that the trial changed their practice, with 64% operating on more fractures, compared with Canadians at 78% and 68%, respectively. For Achilles, 37% of US respondents indicated that the trial changed their practice, with 29% operating on fewer ruptures, compared with Canadians at 72% and 67%, respectively. American surgeons seem more willing to alter their practice to "evidence-based" indications for a trial that favors surgery rather than one that does not.