Seminars in Spine Surgery
Volume 21, Issue 4 , Pages 264-267, December 2009

Pearls and Pitfalls in Evidence Based Medicine: What We've Learned About Outcomes Research in Spine Surgery

  • Adam M. Pearson, MD, MS

      Affiliations

    • Department of Orthopaedic Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH
    • Corresponding Author InformationAddress reprint requests to Adam M. Pearson, MD, MS, Department of Orthopaedics, Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756
    • ,
  • James N. Weinstein, DO, MS

      Affiliations

    • Department of Orthopaedic Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH
    • Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth Hitchcock Medical Center, Lebanon, NH

Spine care has become increasingly evidence-based. The investigators who have generated this evidence have learned important lessons that should help guide future trials: 1. Patients will agree to enroll in studies and to be randomized; 2. Patients will crossover between treatment arms if it is an option; 3. Observational studies can provide the best answers to some questions; 4. High quality clinical research is extremely expensive and work-intensive; 5. High quality spine research is needed now more than ever. This paper reviews these issues as they have arisen in recent clinical studies.

Keywords: clinical trials, spine surgery, crossover

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PII: S1040-7383(09)00074-4

doi:10.1053/j.semss.2009.08.010

Seminars in Spine Surgery
Volume 21, Issue 4 , Pages 264-267, December 2009

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