title: Do large pragmatic randomised trials change clinical practice?: assessing the impact of the Distal Radius Acute Fracture Fixation Trial (DRAFFT).
abstract: OBJECTIVE
  Our aim, using English Hospital Episode Statistics data before during and after the Distal Radius Acute Fracture Fixation Trial (DRAFFT), was to assess whether the results of the trial affected clinical practice.
  
  
  METHODS
  Data were grouped into six month intervals from July 2005 to December 2014. All patient episodes in the National Health Service involving emergency surgery for an isolated distal radial fracture were included.
  
  
  RESULTS
  Clinical practice in England had not changed in the five years before DRAFFT: 75% of patients were treated with plate fixation versus 12% with Kirschner (K)-wires. After the publication of the trial, the proportion of patients having K-wire fixation rose to 42% with a concurrent fall in the proportion having fixation with a plate to 48%. The proportion of 'other' procedures stayed the same.
  
  
  CONCLUSIONS
  It appears that surgeons in the United Kingdom do change their practice in response to large, pragmatic, multicentre clinical trials in musculoskeletal trauma.
authors.affiliation: The Kadoorie Centre, John Radcliffe Hospital, Oxford, OX3 9DU, UK.
authors.forename: M L
authors.initials: ML
authors.lastname: Costa
authors.affiliation: South Tees Hospitals NHS Foundation Trust, Marton Road, Middlesbrough, TS4 3BW, UK.
authors.forename: S S
authors.initials: SS
authors.lastname: Jameson
authors.affiliation: Newcastle University and Northumbria Healthcare, Northumbria, NE63 9JJ, UK.
authors.forename: M R
authors.initials: MR
authors.lastname: Reed
mesh_terms: D001860:Bone Plates; D001864:Bone Wires; D004059:Diffusion of Innovation; D004739:England; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data / Q000639:trends*; D006302:Health Services Research / Q000379:methods; D006801:Humans; D064792:Pragmatic Clinical Trials as Topic; D011364:Professional Practice / Q000706:statistics & numerical data / Q000639:trends*; D011885:Radius Fractures / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D014954:Wrist Injuries / Q000601:surgery
keywords: Clinical trial; change in practice; distal radius fracture