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Forming the Research Question.

Clin Plast Surg. 2008 Apr;35(2):189-193

Authors: Thoma A, McKnight L, McKay P, Haines T

The most important precondition for performing a clinical research project in plastic surgery, or any other surgical subspecialty, is the need to inquire the "right question." Although this might seem to be an easy task, in truth it requires a lot of effort and hard work. This article addresses the key points to recollect when formulating a research question.

PMID: 18298991 [PubMed - as supplied by publisher]

(Source: Clinics in Plastic Surgery)

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Study design and hierarchy of evidence for surgical decision making.

Clin Plast Surg. 2008 Apr;35(2):195-205

Authors: Sprague S, McKay P, Thoma A

This article provides a historical overview of the hierarchy of evidence for surgical decision making and discusses key study designs in the hierarchy of evidence. This encompasses meta-analyses, randomized controlled trials, and observational studies, including cohort and case-controlled studies, case series and case reports, and basic science studies. This article also reviews the principles and importance of evidence-based plastic surgery and describes several systems to rate the strength of the scientific evidence.

PMID: 18298992 [PubMed - in process]

(Source: Clinics in Plastic Surgery)

Related Articles

The role of systematic reviews in clinical research and practice.

Clin Plast Surg. 2008 Apr;35(2):207-14

Authors: Haines T, McKnight L, Duku E, Perry L, Thoma A

Well-conducted systematic reviews and meta-analyses provide the best quality evidence for clinical decision-making. This article presents the key role of systematic reviews in clinical decision-making, discussing the steps and pitfalls to avoid in conducting systematic reviews and meta-analyses.

PMID: 18298993 [PubMed - in process]

(Source: Clinics in Plastic Surgery)

Related Articles

Clinical research in breast surgery: reduction and postmastectomy reconstruction.

Clin Plast Surg. 2008 Apr;35(2):215-26

Authors: Pusic AL, McCarthy C, Cano SJ, Klassen AF, Kerrigan CL

In the last decade, entirely new techniques in breast reduction and reconstruction have evolved. What remains unclear is whether or not these new procedures, some of which carry additional surgical risk and cost, are superior from a patient perspective. Thus, plastic surgeons are ever more reliant on clinical research to provide high-level evidence to facilitate clinical decision-making, as well as policy negotiations and advocacy. This article provides an overview of the strengths and weaknesses of different study designs, the appropriateness of various outcome measures, and the importance of establishing a powerful evidence base in breast surgery.

PMID: 18298994 [PubMed - in process]

(Source: Clinics in Plastic Surgery)

Related Articles

Clinical research in head and neck reconstruction.

Clin Plast Surg. 2008 Apr;35(2):227-37

Authors: Levis C, Archibald S

Reconstructive head and neck surgery is not unlike other surgical fields in its paucity of clinical research. Difficulties exist in the design and execution of surgical studies, and there are many challenges and limitations that must be addressed. In this article, the types of studies that make up head and neck reconstructive literature are reviewed, as well as the evolution toward the use of quality-of-life scales, which measure patients' satisfaction with their state of health and function.

PMID: 18298995 [PubMed - in process]

(Source: Clinics in Plastic Surgery)

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Measuring Outcomes in Hand Surgery.

Clin Plast Surg. 2008 Apr;35(2):239-250

Authors: Alderman AK, Chung KC

Outcomes research in hand surgery provides patients and providers with objective, reliable information to assist in making medical decisions. Endpoint measures in outcomes research and the instruments used to evaluate these endpoints are often specific to a particular disease or region. Hand surgery has many different measurable outcomes that can be used to monitor the quality of surgical practice, inform practice guidelines, and aid in the appropriate allocation of healthcare resources. In this article, we review some research techniques available to study the following surgical outcomes of the hand: national trends in surgical care, surgical complications, objective measures of hand function, patient-reported measures of hand function, and economic burden.

PMID: 18298996 [PubMed - as supplied by publisher]

(Source: Clinics in Plastic Surgery)

Related Articles

Clinical Research in Pediatric Plastic Surgery and Systematic Review of Quality-of-Life Questionnaires.

Clin Plast Surg. 2008 Apr;35(2):251-67

Authors: Klassen AF, Stotland MA, Skarsgard ED, Pusic AL

In the first part of this article, examples of different research designs used to study pediatric patients who undergo plastic surgery are described. The remainder of the article discusses the measurement of outcomes in pediatric plastic surgery research, with a particular focus on the assessment of quality of life (QOL). Issues specific to measuring QOL in children are discussed (eg, developmental considerations, use of self- versus proxy report). The results of a systematic literature review to identify and appraise pediatric plastic surgery condition-specific measures of QOL are presented.

PMID: 18298997 [PubMed - in process]

(Source: Clinics in Plastic Surgery)

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Clinical research in aesthetic surgery.

Clin Plast Surg. 2008 Apr;35(2):269-73

Authors: Ching S, Rockwell G, Thoma A, Antony MM

Clinical research in aesthetic surgery cannot use traditional objective measures of surgical success. Present research designs and methods used in aesthetic surgery limit the ability to conduct meaningful clinical research. Outcomes research may be ideally suited for assessing patients in aesthetic surgery. A critical aspect of an outcomes-based approach is to select appropriate instruments for investigations. Widely accepted, standardized methods for assessing outcomes would allow for comparison of surgical techniques and provide a common basis for clinical investigations.

PMID: 18298998 [PubMed - in process]

(Source: Clinics in Plastic Surgery)

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The Role of the Randomized Controlled Trial in Plastic Surgery.

Clin Plast Surg. 2008 Apr;35(2):275-284

Authors: Thoma A, Sprague S, Temple C, Archibald S

This article discusses the role of the randomized controlled trial (RCT) in plastic surgery. There are unique challenges in the execution of an RCT in plastic surgery, including: (1) surgical equipoise, (2) the surgical learning curve, (3) differential care, (4) randomization, (5) concealment, (6) expertise-based design, (7) blinding, (8) intention-to-treat analysis, (9) loss to follow-up, and (10) treatment effect and implications for sample size calculations. The RCTs conducted in plastic surgery to date are generally of poor quality in design and reporting, are fraught with bias, and have small sample sizes, thus this article attempts to help future investigators perform better quality RCTs.

PMID: 18298999 [PubMed - as supplied by publisher]

(Source: Clinics in Plastic Surgery)

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The Use of Cost-effectiveness Analysis in Plastic Surgery Clinical Research.

Clin Plast Surg. 2008 Apr;35(2):285-296

Authors: Thoma A, Strumas N, Rockwell G, McKnight L

The goal of this article is to introduce clinical investigators to the basic concepts of cost-effectiveness analysis. This line of research is not commonly pursued in clinical studies probably because of unfamiliarity of plastic surgeons with the field of health economics and health research methodology in general. The authors believe that the coupling of cost-effectiveness analysis with clinical studies is important and should be incorporated into surgical clinical research.

PMID: 18299000 [PubMed - as supplied by publisher]

(Source: Clinics in Plastic Surgery)