比较胶原酶注射与经皮穿刺筋膜切开术治疗杜普伊特伦病的已发表随机试验的偏差:系统性综述。

IF 4.3 2区 医学 Q1 ORTHOPEDICS
David Eckerdal, Hendrik Pakosta, Muhanned Ali, Isam Atroshi
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引用次数: 0

摘要

目的:在治疗杜普伊特伦挛缩症方面,胶原酶注射和经皮针式筋膜切开术的疗效比较存在争议。对这两种治疗方法进行比较的随机对照试验(RCT)报告的结果大多暗示治疗效果、持久性和并发症相似。我们旨在就方法质量和偏倚风险对这些 RCT 进行审查:我们检索了截至 2023 年 5 月的 PubMed 和 Cochrane Library 数据库。纳入了所有比较胶原酶注射与针式筋膜切开术的 RCT。符合条件的文章由两名研究人员进行审阅,其中一名研究人员对每篇文章的标题、作者、发表年份、期刊和研究来源进行盲审。为了评估研究方法的质量,我们采用了改良的贾达德评分法,从 0 分(质量最低)到 5 分(质量最高)不等。我们使用科克伦偏倚风险工具(RoB 2)评估偏倚风险:有五项研究符合条件,其中204名患者接受了胶原酶注射治疗,209名患者接受了针刺法筋膜切开术治疗。五项研究的改良 Jadad 评分从 1 分到 2 分不等,所有研究的总体偏倚风险都很高。只有两项研究的预试验方案可以检索到,这与已发表的文章存在重大差异:结论:已发表的研究性临床试验比较了胶原酶注射与针式筋膜切开术在治疗杜普伊特伦挛缩症中的应用,结果显示偏倚风险很高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bias in published randomized trials that compare collagenase injection with percutaneous needle fasciotomy in the treatment of Dupuytren disease: a systematic review.

Purpose: Controversy exists regarding the comparative efficacy of collagenase injection and percutaneous needle fasciotomy in the treatment of Dupuytren contracture. The randomized controlled trials (RCTs) that have compared the two treatment methods have reported results mostly implying similar treatment efficacy, durability, and complications. We aimed to review these RCTs regarding methodical quality and risk of bias.

Methods: We searched PubMed and Cochrane Library databases up to May 2023. All RCTs comparing collagenase injection with needle fasciotomy were included. Eligible articles were reviewed by two researchers, of whom one was blinded to each article's title, authors, year of publication, journal, and source of the studies. To assess methodical quality, we used the modified Jadad scale yielding a score of 0 (lowest quality) to 5 (highest quality). We assessed risk of bias with the Cochrane risk-of-bias tool (RoB 2).

Results: Five studies were eligible, comprising 204 patients treated with collagenase injection and 209 patients treated with needle fasciotomy. The modified Jadad score ranged from 1 to 2 points in the five studies, and the overall risk of bias was high in all studies. Pretrial protocols could be retrieved for only two studies, revealing important discrepancies with the published articles.

Conclusion: The published RCTs that have compared collagenase injection with needle fasciotomy in the treatment of Dupuytren contracture demonstrate a high risk of bias.

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来源期刊
Efort Open Reviews
Efort Open Reviews Medicine-Orthopedics and Sports Medicine
CiteScore
6.60
自引率
2.90%
发文量
101
审稿时长
13 weeks
期刊介绍: EFORT Open Reviews publishes high-quality instructional review articles across the whole field of orthopaedics and traumatology. Commissioned, peer-reviewed articles from international experts summarize current knowledge and practice in orthopaedics, with the aim of providing systematic coverage of the field. All articles undergo rigorous scientific editing to ensure the highest standards of accuracy and clarity. This continuously published online journal is fully open access and will provide integrated CME. It is an authoritative resource for educating trainees and supports practising orthopaedic surgeons in keeping informed about the latest clinical and scientific advances. One print issue containing a selection of papers from the journal will be published each year to coincide with the EFORT Annual Congress. EFORT Open Reviews is the official journal of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) and is published in partnership with The British Editorial Society of Bone & Joint Surgery.
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