Surgical fixation versus non-surgical care for children with a displaced medial epicondyle fracture of the elbow (the SCIENCE study): a multicentre, randomised controlled, superiority trial and economic evaluation

この研究はインパクトが大きい可能性があると判断されました。 OEのAIによるハイインパクト指標は、論文が掲載されたジャーナルと論文自体の科学的内容の両方からのシグナルを統合することで、論文の影響力を推定します。 最先端の自然言語処理を用いて開発されたOEハイインパクトモデルは、ジャーナルのインパクトファクターのみよりも、研究の将来の引用実績をより正確に予測します。 これにより、臨床的に意義のある研究をより早く認識することができ、読者は将来の診療を形成する可能性が最も高い論文に焦点を当てることができます。

研究概要

334 pediatric patients with displaced medial epicondyle fractures were randomized to receive surgical fracture fixation (n=168) or non-operative management (n=166). The primary outcome of interest was upper limb function at 12 months, measured using the Patient Report Outcomes Measurement System (PROMIS) Upper Extremity Score for Children. Additional outcomes of interest included pain, quality of life, disability, and complications. At 12 months, there were no significant differences in the primary outcome of upper limb function, as well as all secondary outcomes, suggesting no difference in clinical outcomes between the two groups. Cost-effectiveness analyses found surgery to be significantly more expensive (£2,435 [95% CI 1,812-3,057]), with 0% probability of being cost-effective at standard willingness-to-pay thresholds. Overall, the results of this randomized trial suggest that surgical intervention offers no clinical advantages over non-operative treatment and costs substantially more, thus making non-operative treatment the most reasonable treatment option.