The use of artificial intelligence (AI) is rapidly growing across many domains, of which the medical field is no exception. AI is an umbrella term defining the practical application of algorithms to generate useful output, without the need of human cognition. Owing to the expanding volume of patient information collected, known as ‘big data’, AI is showing promise as a useful tool in healthcare research and across all aspects of patient care pathways. Practical applications in orthopaedic surgery include: diagnostics, such as fracture recognition and tumour detection; predictive models of clinical and patient-reported outcome measures, such as calculating mortality rates and length of hospital stay; and real-time rehabilitation monitoring and surgical training. However, clinicians should remain cognizant of AI’s limitations, as the development of robust reporting and validation frameworks is of paramount importance to prevent avoidable errors and biases. The aim of this review article is to provide a comprehensive understanding of AI and its subfields, as well as to delineate its existing clinical applications in trauma and orthopaedic surgery. Furthermore, this narrative review expands upon the limitations of AI and future direction. Cite this article:
Preprint servers allow authors to publish full-text manuscripts or interim findings prior to undergoing peer review. Several preprint servers have extended their services to biological sciences, clinical research, and medicine. The purpose of this study was to systematically identify and analyze all articles related to Trauma & Orthopaedic (T&O) surgery published in five medical preprint servers, and to investigate the factors that influence the subsequent rate of publication in a peer-reviewed journal. All preprints covering T&O surgery were systematically searched in five medical preprint servers (medRxiv, OSF Preprints, Preprints.org, PeerJ, and Research Square) and subsequently identified after a minimum of 12 months by searching for the title, keywords, and corresponding author in Google Scholar, PubMed, Scopus, Embase, Cochrane, and the Web of Science. Subsequent publication of a work was defined as publication in a peer-reviewed indexed journal. The rate of publication and time to peer-reviewed publication were assessed. Differences in definitive publication rates of preprints according to geographical origin and level of evidence were analyzed.Aims
Methods
It has been suggested that the direct anterior approach (DAA) should be used for total hip arthroplasty (THA) instead of the posterior approach (PA) for better early functional outcomes. We conducted a value-based analysis of the functional outcome and associated perioperative costs, to determine which surgical approach gives the better short-term outcomes and lower costs. This meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol and the Cochrane Handbook. Several online databases were searched. Non-stratified and stratified meta-analyses were conducted to test the confounding biases in the studies which were included. The mean cost and probability were used to determine the added costs of perioperative services.Aims
Methods
Studies have addressed the issue of increasing prevalence of work-related musculoskeletal (MSK) pain among different occupations. However, contributing factors to MSK pain have not been fully investigated among orthopaedic surgeons. Thus, this study aimed to approximate the prevalence and predictors of MSK pain among Saudi orthopaedic surgeons working in Riyadh, Saudi Arabia. A cross-sectional study using an electronic survey was conducted in Riyadh. The questionnaire was distributed through email among orthopaedic surgeons in Riyadh hospitals. Standardized Nordic questionnaires for the analysis of musculoskeletal symptoms were used. Descriptive measures for categorical and numerical variables were presented. Student’s t-test and Pearson’s χ2 test were used. The level of statistical significance was set at p ≤ 0.05.Introduction
Methods
Objectives. Despite the fact that research
The maintenance of quality and integrity in clinical
and basic science research depends upon peer review. This process
has stood the test of time and has evolved to meet increasing work
loads, and ways of detecting
By and large, physicians and surgeons trust what they read, even if they take authors’ conclusions with a pinch of salt. There is a world of difference between being cautious about the implications of what you read and being defrauded by dishonest researchers.
In 2006, approximately 1.3 million peer-reviewed scientific articles were published, aided by a large rise in the number of available scientific journals from 16 000 in 2001 to 23 750 by 2006. Is this evidence of an explosion in scientific knowledge or just the accumulation of wasteful publications and junk science? Data show that only 45% of the articles published in the 4500 top scientific journals are cited within the first five years of publication, a figure that is dropping steadily. Only 42% receive more than one citation. For better or for worse, “Publish or Perish” appears here to stay as the number of published papers becomes the basis for selection to academic positions, for tenure and promotions, a criterion for the awarding of grants and also the source of funding for salaries. The high pressure to publish has, however, ushered in an era where scientists are increasingly conducting and publishing data from research performed with ‘questionable research practices’ or even committing outright
Research is the quest for information. It is not an excuse for attending meetings in exotic places, nor is it an escape from clinical work that has become uninteresting. The early orthopaedic joumals contained reports of patients who have been treated by individual surgeons in specific, often novel, ways. There was little scientific structure, but nevertheless these papers were valuable as they disseminated knowledge to other Surgeons and also stimulated enquiry. Orthopaedic research has developed dramatically over the last two or three decades. Patient related research has been advanced as a result of the availability of new techniques for example electron microscopy, DNA sequencing and the Genome, together with the discovery of the fine details of the cytokine control of cellular processes. This has gone hand in hand with the development of surgical sophistication allowing more adventurous interventions. Joint replacement and internal fixation have led to close associations between orthopaedic surgeons and scientists from other disciplines, notably engineers and material scientists. This multi-disciplinary involvement is typical of orthopaedic surgeons and results in each discipline benefiting from the specialist knowledge of the others. The natural tendeney for orthopaedic surgeons to be interested in mechanical items is clear from a study of the distribution of interesting cars in the hospital car park!. The efficacy of different treatment methods should be challenged and this has resulted in the need for careful audit and epidemiological review. In some instances this has resulted in the conclusion that often used treatments are not effective. The assiduous application of the Cochrane principles is often very revealing, not least in that it indicates the lack of properly conducted orthopaedic trials. Academic orthopaedics is in danger. In many countries the speciality is under pressure, normally as a result of economic measures that restrict the avallability of salarles and grants. In spite of these restrictions, it is surprising that there is a steady supply of excellent papers. How much better it could be with more funding. The purpose of publícation is to share information. It should be the aim of every research worker to make a contribution to the understanding of the subject and to share his findings with his colleagues. Curiously many researchers feeI that their commitment to their project is complete as soon as they finish the trial and have the results. The preparafion of their work for dissemination through publication is often a very weak link and in some instances is absent. This is a dangerous tendency as their information may not be broadcast, wasting the scientific endeavour and endangering the status of the fundíng organisation, whose charitable status often depends on sharing the fruitg of research. The incentive to publish is very variable. In some institutions the very existenee of a research department depends on a ‘paper score’ which is normally calculated from the product of the number of papers and the impact factor of the j ournal in which they are published. The calculation used to determine the impact factor of ajournal does not favour orthopaedic journals, as most orthopaedic papers are not quoted prolifically within the first year of publication. In contrast orthopaedic papers tend to have a much longer and more valuable lifetime and to some this is the more important and relevant feature. Unfortunately, the long-term value of the papers is not part of the calculation of impact factor. In order to achieve a high impact factor the publication must be in a rapidly changing field and contain at least a tiny element of special originality, which leads to it being quoted by most of the workers in that field. In the publishing world there is an ongoing discussion conceming an index that is more relevant than the impact factor. For some, the competition for publication is so intense that there is ‘salami slicing’. Salami slicing is a process of publishing very small morsels of information in short papers instead of producing the complete study. It is done intentionally to increase the number of papers published and is frowned upon by scientific editors. Even worse there are cases of plagiarism and
