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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Comparisons of Patient Demographics in Prospective Sports, Shoulder, and National Database Initiatives
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Comparisons of Patient Demographics in Prospective Sports, Shoulder, and National Database Initiatives

机译：比较预期运动，肩膀和国家数据库计划中患者的人口统计数据

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Background: There has been increased emphasis in orthopaedics on high-quality prospective research to provide evidence-based treatment guidelines, particularly in sports medicine/shoulder surgery. The external validity of these studies has not been established, and the generalizability of the results to clinical practice in the United States is unknown. Hypothesis: Comparison of patient demographics in major prospective studies of arthroscopic sports and shoulder surgeries to patients undergoing the same procedures in the National Surgical Quality Improvement Program (NSQIP) database will show substantial differences to question the generalizability and external validity of those studies. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study utilized patients undergoing arthroscopic anterior cruciate ligament reconstruction (ACLR), meniscectomy (MX), rotator cuff repair (RCR), and shoulder stabilization (SS) from the NSQIP database (2005-2013). Two prospective studies (either randomized controlled trials or, in 1 case, a major cohort study) were identified for each of the 4 procedures for comparison. Demographic variables available for comparison in both the identified prospective studies and the NSQIP included age, sex, and body mass index (BMI). Results: From the NSQIP database, 5576 ACLR patients, 18,882 MX patients, 7282 RCR patients, and 993 SS patients were identified. The comparison clinical studies included cohort sizes as follows: ACLR, n = 121 and 2683; MX, n = 146 and 330; RCR, n = 90 and 103; SS, n = 88 and 196. Age differed significantly between the NSQIP and the patients in 6 of the 8 prospective clinical studies. Sex differed significantly between the NSQIP and the patients in 7 of the 8 prospective clinical studies. BMI differed significantly between the NSQIP and the patients of all 4 of the prospective clinical studies that reported this demographic variable. Conclusion: Significant differences exist for patient age, sex, and BMI between patients included in major sports medicine/shoulder prospective studies and corresponding patients undergoing the same procedures in a nationwide database of academic and community centers in the United States. Future work is needed to understand whether major prospective clinical studies—frequently performed in high-volume, specialized practices—are truly indicative of the types of patients treated and expected results in the general orthopaedic practice. This study additionally argues for the importance of initiating a national registry dedicated to patients undergoing orthopaedic procedures in the United States.
机译：背景：整形外科越来越重视高质量的前瞻性研究，以提供循证治疗指南，尤其是运动医学/肩部手术。这些研究的外部有效性尚未确定，结果在美国的临床实践普遍性尚不明确。假设：在关节镜运动和肩部手术的主要前瞻性研究中，与在美国国家外科手术质量改善计划（NSQIP）数据库中接受相同程序的患者进行的人口统计学比较将显示出很大的差异，以质疑这些研究的可推广性和外部有效性。研究设计：横断面研究;证据等级，3。方法：本研究采用的患者来自NSQIP数据库（2005-2013年），接受关节镜前交叉韧带重建（ACLR），半月板切除术（MX），肩袖修复（RCR）和肩关节稳定（SS）。对于这4种比较方法中的每一种，均确定了两项前瞻性研究（随机对照试验或一项主要队列研究）。在已确定的前瞻性研究和NSQIP中可用于比较的人口统计学变量包括年龄，性别和体重指数（BMI）。结果：从NSQIP数据库中，鉴定出5576例ACLR患者，18,882 MX患者，7282 RCR患者和993 SS患者。比较临床研究包括以下队列规模：ACLR，n = 121和2683; MX，n = 146和330; RCR，n = 90和103; SS，n = 88和196。在8项前瞻性临床研究中，有6例的NSQIP与患者之间的年龄差异显着。在8项前瞻性临床研究中，有7项在NSQIP和患者之间性别存在显着差异。 NSQIP与报告此人口统计学变量的所有四项前瞻性临床研究的患者之间，BMI均存在显着差异。结论：在美国全国性学术和社区中心数据库中，主要运动医学/肩膀前瞻性研究中包括的患者与接受相同程序的相应患者之间，患者年龄，性别和BMI存在显着差异。需要做进一步的工作来了解主要的前瞻性临床研究（通常以大批量，专业化的实践进行）是否真正表明了一般骨科实践中所治疗的患者类型和预期结果。这项研究还提出了在美国建立专门针对接受骨科手术患者的国家注册系统的重要性。

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