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Biomedical subjects

Damian Griffin

Publications and source records attributed to Damian Griffin.

5 recordsLinked to original sources
PubMed2005

Path analysis of factors for delayed healing and nonunion in 416 operatively treated tibial shaft fractures.

UNLABELLED: A prospective observational study was done in 41 trauma centers. Four hundred sixteen patients with tibial shaft fractures were treated operatively and followed up for at least 6 months. Fifty-two (13%) cases of delayed healing or nonunion were reported. In such nonrandomized observational studies, multiple interrelationships exist between prognostic factors and patient outcomes. We used path analyses to investigate prognostic factors associated with the occurrence of delayed healing or nonunion. The most important factors were identified using multivariate regression analyses, and interrelationships between factors were illustrated using a path diagram. Fractures with open injuries less than and greater than 5 cm were 3.6 and 5.7 times as likely, respectively, to have delayed healing or nonunion as fractures with no skin injuries. The Müller-AO classification of fractures did not provide additional prognostic information. The risk of healing problems was doubled for fractures of the distal shaft and for fractures showing a postoperative diastasis. Treatment options showed an indirect effect on outcome with the occurrence of diastasis. A model for predicting delayed healing or nonunion is proposed. We encourage the use of path analysis in orthopaedics as a powerful visual technique to interpret data from observational studies. LEVEL OF EVIDENCE: Prognostic study, Level II-1 (retrospective study). See the Guidelines for Authors for a complete description of levels of evidence.

Adolescent↗
PubMed2005

A radiological study of the intraprosthetic movements of the bipolar shoulder replacement in rheumatoid arthritis.

A radiological study of the intraprosthetic movements of a bipolar shoulder replacement was undertaken in 25 shoulders in 20 patients with rheumatoid arthritis and rotator cuff arthropathy. No significant difference was found between intraprosthetic movement and shell - glenoid movement. Some shoulders were found to exhibit paradoxical movement at the intraprosthetic interface. Repeating the measurements after an interval of three years in a subgroup of 12 shoulders showed a significant reduction in intraprosthetic movement over this time interval. In conclusion, movement of the bipolar shoulder prosthesis in shoulders affected by rheumatoid arthritis was preserved up to eight years from operation. Intraprosthetic movement was independent from shell - glenoid movement and paradoxical to glenohumeral movement.

Aged↗
PubMed2004

Systematic reviews of nonrandomized clinical studies in the orthopaedic literature.

We systematically reviewed systematic reviews of surgical orthopaedic interventions published between 1996 and 2001 to document when and how nonrandomized studies were included. From more than 10,000 citations examined in various electronic databases, 58 orthopaedic systematic reviews were eligible for inclusion based on specific criteria. Thirty of these (52%) included nonrandomized studies, 15 of which found no randomized controlled trials. Systematic reviews were more likely to include randomized controlled trials if nondistinguishable operations were compared (if participants could be blinded). Only six of the systematic reviews that included nonrandomized studies (20%) assessed the quality of primary studies. Heterogeneity of studies was a major concern. In 21 of the systematic reviews that included nonrandomized studies (70%), data for groups treated similarly were pooled across studies, and outcomes for pooled groups were compared. The conclusions of systematic reviews that included nonrandomized studies are weakened by the limitations of nonrandomized study designs. The absence of established methods for including nonrandomized studies in systematic reviews, and consequently variability in the methods adopted, also limits the comparability of such reviews. Therefore the findings of systematic reviews that include nonrandomized studies should be interpreted with caution.

Clinical Trials as Topic↗
PubMed2003

Common statistical methods in orthopaedic clinical studies.

We discuss the statistical representation and management of random error in orthopaedic clinical studies. Descriptive studies (such as case series) collect information about a sample that may be generalized to describe a population. Typically this description is in the form of summary statistics, such as means, proportions, or rates. Error in these variables may be represented by confidence intervals. Correlation and regression are techniques for investigation of the relationship between two or more variables. Descriptive statistics, comparisons of groups, especially hypothesis tests, and assessment of association including correlation and regression are important statistical concepts for clinicians involved in the conduct or appraisal of orthopaedic clinical research.

Chi-Square Distribution↗