It is interesting to wonder which papers we publish will become significant in hand surgery. As with all research it is not always obvious. The paper on a systematic review of outcome measures in thumb carpo-metacarpal (CMC) joint arthritis is significant in highlighting the lack of any consistent outcome measures in the hand surgery literature for assessing our treatment of thumb CMC joint arthritis. It helps establish the baseline for advancing research but it may not have much effect in changing clinical practice. We are publishing papers on the outcome of three very different treatments for thumb CMC joint arthritis. Comparison is difficult not least because of the lack of consistent outcome measures and so most surgeons will not change their practice having read these papers. It could be argued that none of these papers is strong enough to change practice. We continue to need higher quality research to move on our patient care.
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