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J Am Acad Orthop Surg, Vol 13, No 4, July/August 2005, 220-229.
© 2005 the American Academy of Orthopaedic Surgeons

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Reading and Reviewing the Orthopaedic Literature: A Systematic, Evidence-based Medicine Approach

Kurt P. Spindler, MD, John E. Kuhn, MD, MS, Warren Dunn, MD, MPH, Charles E. Matthews, PhD, Frank E. Harrell, Jr, PhD and Robert S. Dittus, MD, MPH

Dr. Spindler is Professor and Vice Chairman, Department of Orthopaedics and Rehabilitation, and Chief, Division of Sports Medicine, Vanderbilt University Medical School, Nashville, TN. Dr. Kuhn is Associate Professor and Chief, Shoulder Surgery, Vanderbilt University Medical School. Dr. Dunn is Assistant Professor, Department of Orthopaedics and Rehabilitation, and Assistant Professor, General Internal Medicine and Public Health, Health Services Research Center, Vanderbilt University Medical School. Dr. Matthews is Assistant Professor, General Internal Medicine and Public Health, Health Services Research Center, Vanderbilt University Medical School. Dr. Harrell is Professor and Chairman, Department of Biostatistics, Vanderbilt University Medical School. Dr. Dittus is the Harvie Branscomb Distinguished Professor, Albert and Bernard Werthan Professor of Medicine, Chief, Division of General Internal Medicine, and Director, Center for Health Services Research, Vanderbilt University Medical School.

Dr. Spindler or the department with which he is affiliated has received research or institutional support from Aircast and from Smith & Nephew. None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Kuhn, Dr. Dunn, Dr. Matthews, Dr. Harrell, and Dr. Dittus.

Reprint requests: Dr. Kuhn, Vanderbilt Sports Medicine, Suite 4200, Medical Center East, South Tower, 1215 21st Avenue South, Nashville, TN, 37232-8774.

The principles of evidence-based medicine are rapidly gaining acceptance in the field of orthopaedic surgery. This approach to patient care requires a careful, systematic review of the literature to appropriately value the merit of studies. Systematic review assists the orthopaedic surgeon in interpreting study results and in understanding the relative validity of these results in the hierarchy of evidence. Sufficiently valid evidence-based information ultimately will help in making decisions regarding patient care.




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