An evaluation of the quality of statistical design and analysis of published medical research : results from a systematic survey of general orthopaedic journals

Background: The application of statistics in reported research in trauma and orthopaedic surgery has become ever more important and complex. Despite the extensive use of statistical analysis, it is still a subject which is often not conceptually well understood, resulting in clear methodological flaws and inadequate reporting in many papers. Methods: A detailed statistical survey sampled 100 representative orthopaedic papers using a validated questionnaire that assessed the quality of the trial design and statistical analysis methods. Results: The survey found evidence of failings in study design, statistical methodology and presentation of the results. Overall, in 17% (95% confidence interval; 10–26%) of the studies investigated the conclusions were not clearly justified by the results, in 39% (30–49%) of studies a different analysis should have been undertaken and in 17% (10–26%) a different analysis could have made a difference to the overall conclusions. Conclusion: It is only by an improved dialogue between statistician, clinician, reviewer and journal editor that the failings in design methodology and analysis highlighted by this survey can be addressed

The interaction of activator of G protein signalling 1 (AGS1) with signalling components

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A systems approach to cancer

Doctors have a duty to teach and share information. This applies at all levels of the medical hierarchy: from consultants supervising trainees to house officers supporting students on the wards. But the duty to share does not stop at teaching; medicine thrives on collaboration. Doctors collaborate with medical colleagues, allied health professionals, and with patients in every consultation. A Systems Approach to Cancer represents collaboration between academics, clinicians, and student doctors. It addresses cancer – a disease which can only ever be beaten by collaborative partnerships, initiative, and commitment from the next generation of health professionals. This book stands to achieve three goals. First, it will encourage students to take control of their own learning. Studying medicine requires a high degree of independence and students should not be afraid to think laterally when they perceive a deficit in existing study resources. Second, it demonstrates that genuinely useful outcomes can arise from students and teachers talking to, and working with, one another. Finally, it adds an additional resource – uniquely informed by the undergraduate perspective – to student textbooks on cancer. I wish the editors every success in realising these ambitions

A systematic survey of the quality of research reporting in general orthopaedic journals

The poor reporting and use of statistical methods in orthopaedic papers has been widely discussed by both clinicians and statisticians. A detailed review of research published in general orthopaedic journals was undertaken to assess the quality of experimental design, statistical analysis and reporting. A representative sample of 100 papers was assessed for compliance to CONSORT and STROBE guidelines and the quality of the statistical reporting was assessed using a validated questionnaire. Overall compliance with CONSORT and STROBE guidelines in our study was 59% and 58% respectively, with very few papers fulfilling all criteria. In 37% of papers patient numbers were inadequately reported; 20% of papers introduced new statistical methods in the 'results' section not previously reported in the 'methods' section, and 23% of papers reported no measurement of error with the main outcome measure. Taken together, these issues indicate a general lack of statistical rigour and are consistent with similar reviews undertaken in a number of other scientific and clinical research disciplines. It is imperative that the orthopaedic research community strives to improve the quality of reporting; a failure to do so could seriously limit the development of future research

Load Modeling Transmission Research

This report articulates and justifies the preliminary selection of diagnostic applications for data from micro-synchrophasors (µPMUs) in electric power distribution systems that will be further studied and developed within the scope of the three-year ARPA-e award titled Micro-synchrophasors for Distribution Systems

The safety of peri-articular local anaesthetic injection for patients undergoing total knee replacement with autologous blood transfusion

Intra-operative, peri-articular injection of local anaesthesia is an increasingly popular way of controlling pain following total knee replacement. At the same time, the problems associated with allogenic blood transfusion have led to interest in alternative methods for managing blood loss after total knee replacement, including the use of auto-transfusion of fluid from the patient's surgical drain. It is safe to combine peri-articular infiltration with auto-transfusion from the drain. We performed a randomised clinical trial to compare the concentration of local anaesthetic in the blood and in the fluid collected in the knee drain in patients having either a peri-articular injection or a femoral nerve block. Clinically relevant concentrations of local anaesthetic were found in the fluid from the drains of patients having peri-articular injections (4.92 μg/ml (sd 3.151)). However, none of the patients having femoral nerve blockade had detectable levels. None of the patients in either group had clinically relevant concentrations of local anaesthetic in their blood after re-transfusion. The evidence from this study suggests that it is safe to use peri-articular injection in combination with auto-transfusion of blood from peri-articular drains during knee replacement surgery