We explore the limitations of complete reliance
on evidence-based medicine which can be diminished by confounding
issues and sampling bias. Other strategies which may be reasonably
invoked are discussed. Cite this article:
Cite this article:
Continuing professional development (CPD) refers
to the ongoing participation in activities that keep a doctor up
to date and fit to practise once they have completed formal training.
It is something that most will do naturally to serve their patients
and to enable them to run a safe and profitable practice. Increasingly,
regulators are formalising the requirements for evidence of CPD,
often as part of a process of revalidation or relicensing. This paper reviews how orthopaedic journals can be used as part
of the process of continuing professional development. Cite this article:
The importance for observing the intention-to-treat
approach in clinical studies is explained. Cite this article:
The variation in surgical performance, both between
centres and individual surgeons, has recently been of significant
political, media and public interest. Within the United Kingdom, a
government agenda to increase accountability amongst surgeons has
led to the online publication of ‘surgeon-level’ data. Surgeons,
journalists and the public need to understand these data if they
are to be useful in driving up standards of surgical care. This
Editorial describes the use of Funnel Plots, which are the common
means by which such data are presented, and discusses how the plots
are generated. Cite this article:
Due to economic constraints, it has been suggested that joint replacement patients can be followed up in primary care. There are clinical, ethical and academic reasons why we must ensure that our joint replacements are appropriately clinically and radiologically followed up to minimise complications. This Editorial discusses this.
In cerebral palsy, the site and severity of the brain lesion are directly linked to gross motor function and the development of musculoskeletal deformities. The relationship between walking ability and orthopaedic surgery in children with cerebral palsy is not fully understood. The development of new tools such as the Functional Assessment Questionnaire and the Functional Mobility Scale can be used to give new insights on the functional impact of multilevel surgery. These scales are most useful as part of systematic, long-term follow-up.
This editorial examines the influence of the National Institute for Clinical Excellence (NICE) on the conduct of orthopaedic surgery. It proffers criticism and suggests ways of improvement.