An Assessment of Randomized Controlled Trial Quality in The Journal of Bone & Joint Surgery Update from 2001 to 2013

A total of 285 randomized controlled trials published in the Journal of Bone and Joint Surgery between 2001 and 2013 were assesses for study quality using the Detsky quality of reporting index, and a modified Cochrane Risk of bias tool. Mean transformed Detsky scores improved significantly over time (p<0.001). Categories of concern with regard to the Detsky score were 'randomization', 'eligibility criteria', and 'reasons for patient exclusion'. Studies with an epidemiologist as a first author reported statistically significantly favourable transformed Detsky scores compared to those with surgeons as the first author (p<0.001). Additionally, non-surgical trials reported statistically significantly favourable transformed Detsky scores compared to surgical trials (p<0.001). Transformed Detsky quality scores were statistically significantly better in the included studies compared to studies published between 1988 and 2000. Modified risk of bias scores for trials published between 2001 and 2013 significantly increased over time, as per regression analysis (p<0.001). Trials assessing fracture treatments reported significantly lower risk of bias scores compared to trials assessing treatments for degenerative disease (p<0.05), and trials investigating pain management (p<0.05).