The limited impact of randomized controlled trials on the management of greater trochanteric pain syndrome as demonstrated by fragility Indices: A citation analysis
Notice bibliographique
Résumé
IMPORTANCE: Greater trochanteric pain syndrome (GTPS) is a chronic condition commonly defined as pain in the lateral hip joint that can be severely limiting to activities of daily living, sleep, and overall quality of life. It encompasses numerous disease states causing pain in the region of the greater trochanter of the femur. Noninvasive management approaches for GTPS include corticosteroid injections and physiotherapy, preferred as first-line interventions prior to surgical interventions. Understanding the impact of randomized control trials (RCTs) can enhance the understanding of treatment paradigms. OBJECTIVE: To identify factors and study characteristics associated with the impact, as measured by the citation density of RCTs in the management of GTPS. EVIDENCE REVIEW: MEDLINE, EMBASE, CENTRAL, SCOPUS, and Web of Science were searched from database inception to September 5, 2023 for RCTs evaluating conservative and surgical interventions for GTPS. The inclusion criteria for this systematic review were level I evidence, assessment of at least two different approaches to the management of GTPS, published in English, and featuring human subjects. Pertinent study characteristics were extracted from the included trials after title/abstract and full-text screening. Citation metrics were obtained from the Clarivate Web of Knowledge database on September 28, 2023. The fragility index (FI) and continuous fragility index (CFI) were calculated for primary outcomes across all included RCTs. Univariate regression models were used to assess correlations between citation density and a variety of study characteristics. A sub-analysis by category of intervention (injectable modalities, non-invasive modalities, and surgical modalities) was also performed, with an ANOVA of study and bibliometric characteristics. FINDINGS: Twenty-one studies published from 2009 to 2023 comprising 1683 patients (1690 hips) met inclusion criteria and were eligible for analysis. Treatments ranged from non-invasive (n = 8), injectable (n = 12), to surgical modalities (n = 1). Eleven different countries were represented amongst the included RCTs; 71.4 % were from the United States or Europe, with the remaining 28.6 % originating from Australia. The median journal impact factor of published studies was 3.4 (IQR 2.4-4.8). The mean citation density across all three intervention categories were injectable modalities (4.37 ± 3.39), noninvasive modalities (3.27 ± 1.77), and surgical modalities (1, not applicable). The median CFI was 2 (IQR 0-12). Correlation analysis demonstrated a statistically significant correlation to year published (R = -0.473, p = 0.03) and study sample size (R = 0.735, p < 0.01). CONCLUSIONS AND RELEVANCE: RCTs assessing the management of GTPS demonstrate a varied range of clinical uptake, as evidenced by citation density. An array of different healthcare disciplines is involved in GTPS management, signified by the diversity of journals publishing RCTs on the topic. The median CFI is low compared to other citation analyses in orthopedics, demonstrating that the collective conclusions drawn by these studies are limited by fragility. Additionally, RCTs on surgical treatments for cases refractory to nonsurgical management are notably underrepresented, highlighting the necessity for further evaluation. LEVEL OF EVIDENCE: I.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,186 | 0,638 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,024 | 0,032 |
| Bibliométrie | 0,035 | 0,036 |
| Études des sciences et des technologies | 0,001 | 0,003 |
| Communication savante | 0,010 | 0,010 |
| Science ouverte | 0,004 | 0,005 |
| Intégrité de la recherche | 0,005 | 0,004 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,010 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».