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An Evidence-Based Approach to the Adoption of New Technology

Ahn, Henry MD, FRCSC1; Bhandari, Mohit MD, MSc, FRCSC2; Schemitsch, Emil H. MD, FRCSC1

doi: 10.2106/JBJS.H.01593
Design, Conduct, and Interpretation of Nonrandomized Orthopaedic Studies--A Practical Approach

New orthopaedic technology is constantly being developed to help improve patient care. New technology may lead to a waste of resources or lead to harm for the patient if it is not properly evaluated before it is accepted as a standard of care. The purpose of this article is to assess how new technology can be implemented safely while maintaining an environment that allows for surgical innovation through an evidence-based approach. Although randomized controlled trials (Level-I evidence) are typically seen as the so-called gold standard with regard to treatment efficacy, randomized trials may not be the most effective form of evaluating a new technology. In many circumstances, a prospective cohort series or large registry that documents outcomes and adverse events may be more effective and practical for the evaluation of a new surgical technology.

1Division of Orthopaedic Surgery, St. Michael's Hospital, 55 Queen Street East, Suite 800, Toronto, ON M5C 1R6, Canada. E-mail address for H. Ahn:

2Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON L8L 2X2, Canada

Copyright © 2009 by The Journal of Bone and Joint Surgery, Incorporated
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