手部外科的随机对照试验：范围综述。
Randomised controlled trials in hand surgery: a scoping review.
机构信息
Orthopedic and Traumatology, Oulu University Hospital, Oulu, Finland
Department of Hand & Reconstructive Microsurgery, National University Hospital, Singapore.
出版信息
BMJ Open. 2022 Oct 10;12(10):e062773. doi: 10.1136/bmjopen-2022-062773.
OBJECTIVES
To identify the evidence gaps that exist regarding the efficacy or effectiveness of hand surgery.
SETTING
A scoping review. We systematically searched MEDLINE, Embase and CENTRAL databases to identify all hand surgical randomised controlled trials from inception to 7 November 2020.
RESULTS
Of the 220 identified randomised controlled trials, none were fundamental efficacy trials, that is, compared surgery with placebo surgery. 172 (78%) trials compared the outcomes of different surgical techniques, and 143 (65%) trials were trauma related. We identified only 47 (21%) trials comparing surgery with non-operative care or injection.
CONCLUSION
The evidence supporting use of surgery especially for chronic hand conditions is scarce. To determine optimal care for people with hand conditions, more resources should be aimed at placebo-controlled trials and pragmatic effectiveness trials comparing hand surgery with non-operative care.
PROSPERO REGISTRATION NUMBER
CRD42019122710.
目的
确定在手外科领域中，关于手术疗效或效果的证据空白。
背景
这是一项范围性综述研究。我们系统性地检索了 MEDLINE、Embase 和 CENTRAL 数据库，以确定从建库至 2020 年 11 月 7 日所有的手外科随机对照试验。
结果
在 220 项确定的随机对照试验中，没有一项是基本疗效试验，也就是说，没有将手术与安慰剂手术进行比较。172 项（78%）试验比较了不同手术技术的结果，143 项（65%）试验与创伤有关。我们仅发现了 47 项（21%）将手术与非手术治疗或注射进行比较的试验。
结论
支持手术（尤其是慢性手部疾病）应用的证据很少。为了确定手部疾病患者的最佳治疗方法，应将更多资源用于安慰剂对照试验和比较手外科与非手术治疗的实用性有效性试验。
PROSPERO 注册号：CRD42019122710。
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