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Evidence-Based Hand Surgery: The Role of Cochrane ReviewsFrom the Department of Trauma and Hand Surgery, University Hospital, Düsseldorf, Germany, the University of Freiburg, Institute of Medical Biometry and Medical Informatics, Germany, the Cochrane Centre, Freiburg, Germany, the Institute for Research in Operative Medicine, University of Witten/Herdecke, Germany and the Study Centre of the German Surgical Society (SDGC), University of Heidelberg, Germany Correspondence: Michael Schädel-Höpfner, MD, Department of Trauma and Hand Surgery, University Hospital, Moorenstraße 5, D-40225 Düsseldorf, Germany. Tel.: +49 211 8104405; fax: +49 211 8104902. E-mail: schaedel{at}uni-duesseldorf.de. A detailed literature search was performed to investigate whether the increasing importance of evidence-based hand surgery is reflected in the actual status of Cochrane reviews. Fourteen Cochrane reviews were found and evaluated. Of these, five reviews were in the field of distal radial fractures and four concerned carpal tunnel syndrome. Cochrane reviews were also found for antibiotic treatment, rehabilitation after flexor tendon injuries, mallet finger injuries, little finger metacarpal neck fractures and thumb joint arthritis. All 14 reviews were compromised by methodological flaws and significant clinical heterogeneity of the included studies. Within most reviews the underlying evidence was insufficient and only a very limited number of clinical recommendations could be made. In conclusion, the existing Cochrane reviews in the field of hand surgery show both an increasing interest in establishing systematically summarised knowledge and an enormous demand for good-quality randomised controlled trials.
Key Words: hand surgery • Cochrane review • overview • evidence • outcome
Journal of Hand Surgery (European Volume), Vol. 33, No. 2,
110-117 (2008) |
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