COMPARATIVE STUDY
JOURNAL ARTICLE

Misuse of baseline comparison tests and subgroup analyses in surgical trials

Mohit Bhandari, P J Devereaux, Patricia Li, Doug Mah, Ki Lim, Holger J Schünemann, Paul Tornetta
Clinical Orthopaedics and related Research 2006, 447: 247-51
16672904
It is unclear whether the misuse of statistical tests that compare patients' baseline characteristics and subgroup analyses in randomized controlled trials can be extrapolated to the surgical literature. We did an observational study evaluating the current use of baseline comparability tests and subgroup analyses in surgical randomized controlled trials. Published surgical randomized controlled trials in four medical journals were identified. We also identified randomized controlled trials in the Journal of Bone and Joint Surgery (American and British volumes). We identified 72 randomized controlled trials, with a mean of 10 +/- 8 baseline variables. Of 166 significance tests, 17 (10%) were significant. Twenty-seven (38%) trials included 54 subgroup analyses with a minimum of one and maximum of 23 subgroup analyses per study. Inappropriate emphasis on subgroup analyses occurred frequently. Forty-nine (91%) analyses were performed post hoc without prior hypotheses. Investigators reported differences between subgroups in 31 (57%) of the analyses, all of which were featured in the summary or conclusion. These inferences may be misleading, making their application to clinical practice unwarranted.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
16672904
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"