Abstract | November 18, 2023

Comparison of the Original and Updated American Academy of Orthopaedic Surgeons Clinical Practice Guidelines on Distal Radius Fractures

Charlotte Pecot, BA, Tulane University School of Medicine, New Orleans, LA

Sophia Mavrommatis, BSBA, University of Minnesota Medical School, Minneapolis, MN; Ramesses Akamefula, BS, Tulane University School of Medicine, New Orleans, LA; Tessa R. Lavorgna, BS, Tulane University School of Medicine, New Orleans, LA; Dainn Woo, MD, Orthopaedic Surgery, PGY4, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Andrew D. Sobel, MD, Assistant Professor of Clinical Orthopaedic Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA

Learning Objectives

  1. Compare the characteristics of the 2009 Clinical Practice Guideline on Distal Radius Fractures to those of the updated 2020 version.
  2. Describe the impact of these characteristics on the quality of recommendations.

Introduction:
The American Academy of Orthopaedic Surgeons publishes Clinical Practice Guidelines (CPGs) intended to provide up-to-date and evidence-based recommendations regarding the treatment of musculoskeletal pathologies. The aim of this study is to analyze the included studies within the original (2009) and updated (2020) CPGs on Distal Radius Fractures (DRF) and compare their characteristics.

Methods:
Manuscripts of studies included in the 2009 and 2020 versions of the DRF CPG were reviewed. The level of evidence (LOE), date of publication, journal of publication, country of origin, and funding status were determined for all eligible references. T-tests and chi-square tests were utilized in comparing continuous and categorical variables between CPGs.

Results:
There was no difference between the mean LOE (2.0 vs. 2.0, p=0.96) or the proportion of high-quality studies (LOE 1 and 2) included in the two CPGs (86.5% vs. 90.9%, p=0.37) (Figure 1). The mean time from study publication to inclusion in the CPG in the 2009 and 2020 versions of the DRF CPG was 9.97 and 11.06 years, respectively (p=0.395). There was no difference in the percentage of studies that had been published within 5 years of the CPGs’ publications (33.78% vs. 32.95%, p=0.91). There was no difference in the percentage of studies conducted at institutions outside of the United States (72.9% vs. 87.50%, p=0.05). Approximately 7% of studies in the 2009 CPG were funded by foundations within the United States and this value was not different from the 3.4% in the 2020 CPG (p=0.33) (Figure 2). Finally, studies published in hand- and wrist-specific journals comprised 10.8% and 22.7% of the 2009 and 2020 DRF CPGs, respectively (p=0.046).

Conclusion:
The characteristics of the original and updated CPGs are similar with regard to quality of LOE and the proportions of studies with international origins and funding from sources within the United States. A minority of included studies were from United States institutions and even fewer were funded. Studies included in the 2020 CPG were, on average, more likely to be published in a hand- and wrist-specific journal.

References and Resources

N/A

Posted in: Surgery & Surgical Specialties67
Back to Abstracts