University of Alabama at Birmingham, Birmingham, Alabama.
University of Arizona, Tucson, Arizona.
J Bone Joint Surg Am. 2020 Mar 4;102(5):e19. doi: 10.2106/JBJS.19.01095.
Biomedical research is essential for optimizing patient care. Research has suggested inadequacies in nonorthopaedic trainees' understanding of study design and biostatistics. This study assesses orthopaedic residents' knowledge of common biostatistical and study design concepts, as well as their confidence in utilizing the medical literature.
A validated survey assessing knowledge and the application of study design concepts was administered to residents at 10 U.S. institutions. The survey tested knowledge as well as confidence and attitudes regarding common biostatistics principles. The association of demographic characteristics, work activities, and confidence and attitude ratings with test performance were examined using t tests and analysis of variance.
The survey response rate was 64% (178 of 279). The largest group of participants were men (83%, 137 of 165), were between the ages of 26 and 30 years (59%, 105 of 177), and had graduated medical school within the past 4 to 10 years (43%, 76 of 175). Fifty-three percent (93 of 176) had prior biostatistics training, while 44% (77 of 176) had prior epidemiology training. Less than 5% of biostatistics or epidemiology training had taken place after medical school. Forty-seven percent (83 of 176) were unable to determine a study's design. Thirty-eight percent (67 of 178) could not apply the concept of specificity and sensitivity. Eighty-three percent (147 of 178) could not assess the strength of a relationship using odds ratios. Sixty-nine percent (123 of 178) understood the implications of p values. Previous biostatistics training, but not epidemiology or evidence-based medicine training; inclusion of reading research, attending conferences, and data analysis; as well as a self-reported finding of statistics as important for the analysis of one's own research data were significantly associated with better test performance (p < 0.05).
Notable deficits exist in orthopaedic residents' biostatistical knowledge. Greater emphasis is needed to improve biostatistics and research design training. The impact of biostatistics knowledge and/or aptitude on clinical decision-making is an area of suggested research.
生物医学研究对于优化患者护理至关重要。研究表明，非矫形外科受训者对研究设计和生物统计学的理解存在不足。本研究评估了矫形外科住院医师对常见生物统计学和研究设计概念的了解程度，以及他们利用医学文献的信心。
在美国 10 家机构向住院医师发放了一份评估知识和研究设计概念应用的经过验证的调查。该调查测试了知识，以及对常见生物统计学原理的信心和态度。使用 t 检验和方差分析检查了人口统计学特征、工作活动以及信心和态度评分与测试表现之间的关联。
调查回复率为 64%（178/279）。最大的参与者群体是男性（83%，137/165），年龄在 26 至 30 岁之间（59%，105/177），并且在过去 4 至 10 年内毕业于医学院（43%，76/175）。53%（93/176）之前接受过生物统计学培训，而 44%（77/176）之前接受过流行病学培训。不到 5%的生物统计学或流行病学培训是在医学院毕业后进行的。47%（83/176）无法确定研究的设计。38%（67/178）无法应用特异性和敏感性的概念。83%（147/178）无法使用比值比评估关系的强度。69%（123/178）理解 p 值的含义。以前的生物统计学培训，但不是流行病学或循证医学培训；包括阅读研究、参加会议和数据分析；以及自我报告的统计学对分析自己的研究数据很重要，这些都与更好的测试表现显著相关（p <0.05）。
矫形外科住院医师的生物统计学知识存在明显缺陷。需要更加重视提高生物统计学和研究设计培训。生物统计学知识和/或能力对临床决策的影响是一个建议的研究领域。
