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Reporting Clinical Outcomes in Hand Surgery Randomized Controlled Trials: A Systematic Review Using Wide-Awake Local Anesthesia No Tourniquet Studies as a Model. | LitMetric

AI Article Synopsis

  • The study aimed to assess how clinical outcomes are reported in randomized controlled trials (RCTs) focused on hand surgery, particularly those using wide-awake local anesthesia without a tourniquet (WALANT).
  • A systematic review was conducted, analyzing 11 RCTs involving 889 patients, which revealed that technical outcomes were reported most frequently (73%), while functional outcomes were reported least often (36%).
  • The findings highlighted significant variability in outcome reporting, underscoring the need for more standardized methods in future research to improve patient care.

Article Abstract

Purpose: The purpose of this study was to comprehensively evaluate clinical outcome reporting in hand surgery randomized controlled trials (RCTs), using wide-awake local anesthesia no tourniquet (WALANT) studies as a model.

Methods: This International Prospective Register of Systematic Reviews-registered systematic review (CRD42023461653) adheres to preferred reporting items for systematic reviews and meta-analysis guidelines, focusing on RCTs evaluating WALANT in hand and upper limb surgery. A systematic search across five databases was conducted to include all eligible articles from inception until search date (April 1, 2023). Inclusion criteria encompassed WALANT RCTs in upper limb surgery, with exclusion criteria addressing non-RCTs and non-English studies. Data extraction covered study characteristics, patient demographics, procedures performed, and outcomes reported. The revised Cochrane risk-of-bias tool for randomized trials was employed for quality assessment.

Results: The search identified 304 articles-after screening, 11 were included for analysis, encompassing 889 patients in WALANT RCTs. Technical outcomes were most reported (73%), whereas functional was least commonly reported (36%). The analysis encompassed a heterogeneous patient cohort, with an average follow-up period of 41.3 days. Challenges in standardizing functional outcomes and patient-reported outcomes were identified. The Cochrane risk-of-bias tool for randomized trials indicated an overall low risk, affirming the methodological rigor of the included studies.

Conclusions: A significant diversity in outcome reporting and assessment tools was identified, emphasizing the challenges in standardization and outcome reporting across RCTs. Although technical outcomes were prevalent, patient-reported and functional outcomes were often lacking. The study underscores the need for further research standardization to optimize patient care and advance evidence-based decision making, as variability in outcomes reporting hinders the ability to draw consistent conclusions and comparisons across studies.

Type Of Study/level Of Evidence: Therapy/Prevention, Etiology/Harm IA.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652286PMC
http://dx.doi.org/10.1016/j.jhsg.2024.08.007DOI Listing

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