PRACTICE | Jun 23, 2026
Best Practices for Secondary Analyses in Clinical Trials.
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Mohit Bhandari
FRCSC, PhD
Distinguished University Professor, Chair of Surgery, McMaster University
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Secondary analyses can extend the value of clinical trials, but only when they are planned, reported, and interpreted with methodological discipline. Framed around “Best Practices for Secondary Analyses in Clinical Trials,” this discussion uses the FIXIT trial as a case example, examining pain outcomes after modern ring external fixation versus internal fixation for severe open tibia fractures. While ring fixation showed greater pain interference at six months, differences were less apparent by 12 months. The broader message is that prespecification, adequate power, transparent reporting, and careful dissemination are essential to ensure secondary findings inform practice without overstating certainty.
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