title: Putting the baby back in the bathwater: the interpretation of randomised trials in surgery.
abstract: Recently, several high impact randomised controlled trials have been published suggesting no greater benefit from orthopaedic surgery over conservative treatment, or limited surgical intervention. These studies can have profound effects on clinical practice, leading to the abandonment of previously widely-used operations. How do surgeons who believe these operations are beneficial over conservative treatment rationalise these findings, and justify their use with hospital administrators and health care funders who require evidence for the value and efficacy of surgical treatment?
authors.affiliation: Toronto Western Hospital, 399 Bathurst St, EW 1-439, Toronto, Ontario, M5T 2S8, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Gandhi
authors.affiliation: University of Toronto, 399 Bathurst Street, EW 1-449, Toronto, Ontario M5T 2S8, Canada.
authors.forename: A V
authors.initials: AV
authors.lastname: Perruccio
authors.affiliation: Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
authors.forename: S
authors.initials: S
authors.lastname: Kakar
authors.affiliation: University College London Hospitals, 235 Euston Road, London NW1 2BU, UK.
authors.forename: F S
authors.initials: FS
authors.lastname: Haddad
mesh_terms: D005592:Fracture Fixation / Q000592:standards; D006801:Humans; D019637:Orthopedic Procedures / Q000592:standards*; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D018570:Risk Assessment / Q000379:methods; D016896:Treatment Outcome
keywords: randomised trials; outcomes