A systematic review of systematic reviews comparing simple trapeziectomy versus trapeziectomy with ligament reconstruction and tendon interposition for trapeziometacarpal osteoarthritis
Bibliographic record
Abstract
Background: The outcomes of simple trapeziectomy (T) versus trapeziectomy with ligament reconstruction and tendon interposition (LRTI) for trapeziometacarpal (TMC) osteoarthritis have been compared in several systematic reviews (SRs) with conflicting results across the various outcomes studied. Despite a lack of conclusions regarding the superiority of one treatment versus the other, LRTI remains the most popular surgical option. This raises the questions of whether published SRs are of high methodological quality, and whether discordant conclusions can be attributed to differences in methodologic quality. To answer these, a SR of SRs comparing T vs LRTI was conducted. Methods: A search of MEDLINE, EMBASE, and the Cochrane Database of SRs was performed from 1946 to September 18, 2023. SRs directly comparing T vs LRTI for TMC osteoarthritis were selected for inclusion. Methodological characteristics, results and conclusions of the selected SRs were extracted. Outcomes and conclusions were assessed for disagreement in the context of methodological differences. Quality of the included reviews was assessed using the AMSTAR 2 tool. Results: protocol (5 of 7 SRs), failure to provide a list of excluded studies and justification for each (5 of 7 SRs), failure to account for risk of bias from primary studies when discussing results (4 of 7 SRs), and failure to justify methods used for meta-analysis (4 of 5 meta-analyses). Conclusions: SRs comparing T vs LRTI have had methodological or reporting flaws which limit confidence in results. Future SRs should ensure a rigorous methodology is followed and clearly reported in the publication.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.034 | 0.136 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.017 | 0.017 |
| Bibliometrics | 0.016 | 0.015 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.005 | 0.005 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".