Hi Pooka1
Do you happen to have the list of articles that you are referring to, makes it easier for me to check if I actually have the full articles? I have some of Weiss articles but not all of them. Many of his papers are published in “Stud Health Technol Inform” and I do not have any of them.
You are correct in your thought that in retrospective studies there is a high chance of data selection, it is therefore of outmost importance that data selection process with criteria for inclusion/exclusion is highlighted in respective papers.
As for your third question why majority of Weiss are not conducted/published as novel research papers.
I believe that the following abstract might help to illustrate the difficulty in getting good randomized controlled trials conducted when it comes to scoliosis.
Preference assessment of recruitment into a randomized trial for adolescent idiopathic scoliosis.
Dolan LA, Sabesan V, Weinstein SL, Spratt KF.
J Bone Joint Surg Am. 2008 Dec;90(12):2594-605.
BACKGROUND: Randomized controlled trials are powerful tools to evaluate the outcomes of clinical treatments. However, these trials tend to be expensive and time-consuming, and their conclusions can be threatened by several limitations. This study estimated the strength of three common limitations (underenrollment, selective enrollment, and nonadherence to protocol) in a proposed study of adolescent idiopathic scoliosis. METHODS: Patients with scoliosis and their parents were asked to complete a web-based survey about their preferences concerning a hypothetical randomized trial. Adolescents without scoliosis and their parents also participated. Surveys included questions about treatment preference, likelihood of participation, required risk reduction, and propensity to drop out or choose a different treatment while enrolled in the study. RESULTS: Ninety adolescents and eighty-three parents participated. Observation was preferred to bracing by the majority of subjects. Overall, 33% of the parents and adolescents would both agree to participate in the hypothetical trial. Of the subjects who would not agree to participate, the majority would rather share the decision-making responsibility with the physician than have the treatment chosen in a random fashion. Many of the subjects would consider changing treatments during the course of the trial if they were not satisfied with the outcomes; the majority of parents who preferred bracing would consider crossing over to the bracing arm if their children were randomized to observation. CONCLUSIONS: Recruitment into a randomized trial of bracing compared with observation for the treatment of adolescent idiopathic scoliosis may well be problematic, considering the relatively small percentage of families who said they would consider randomization. Additionally, the threat of nonadherence to protocol may be strong and must be addressed in the protocol of the trial. Most families wanted to make the treatment decision with the physician in lieu of randomization; therefore, the role of the physician in patient recruitment and retention should not be underestimated.
These might be reasons why Weiss is not producing that much novel research and I believe that they certainly are factors for other therapies not doing it.
Do you happen to have the list of articles that you are referring to, makes it easier for me to check if I actually have the full articles? I have some of Weiss articles but not all of them. Many of his papers are published in “Stud Health Technol Inform” and I do not have any of them.
You are correct in your thought that in retrospective studies there is a high chance of data selection, it is therefore of outmost importance that data selection process with criteria for inclusion/exclusion is highlighted in respective papers.
As for your third question why majority of Weiss are not conducted/published as novel research papers.
I believe that the following abstract might help to illustrate the difficulty in getting good randomized controlled trials conducted when it comes to scoliosis.
Preference assessment of recruitment into a randomized trial for adolescent idiopathic scoliosis.
Dolan LA, Sabesan V, Weinstein SL, Spratt KF.
J Bone Joint Surg Am. 2008 Dec;90(12):2594-605.
BACKGROUND: Randomized controlled trials are powerful tools to evaluate the outcomes of clinical treatments. However, these trials tend to be expensive and time-consuming, and their conclusions can be threatened by several limitations. This study estimated the strength of three common limitations (underenrollment, selective enrollment, and nonadherence to protocol) in a proposed study of adolescent idiopathic scoliosis. METHODS: Patients with scoliosis and their parents were asked to complete a web-based survey about their preferences concerning a hypothetical randomized trial. Adolescents without scoliosis and their parents also participated. Surveys included questions about treatment preference, likelihood of participation, required risk reduction, and propensity to drop out or choose a different treatment while enrolled in the study. RESULTS: Ninety adolescents and eighty-three parents participated. Observation was preferred to bracing by the majority of subjects. Overall, 33% of the parents and adolescents would both agree to participate in the hypothetical trial. Of the subjects who would not agree to participate, the majority would rather share the decision-making responsibility with the physician than have the treatment chosen in a random fashion. Many of the subjects would consider changing treatments during the course of the trial if they were not satisfied with the outcomes; the majority of parents who preferred bracing would consider crossing over to the bracing arm if their children were randomized to observation. CONCLUSIONS: Recruitment into a randomized trial of bracing compared with observation for the treatment of adolescent idiopathic scoliosis may well be problematic, considering the relatively small percentage of families who said they would consider randomization. Additionally, the threat of nonadherence to protocol may be strong and must be addressed in the protocol of the trial. Most families wanted to make the treatment decision with the physician in lieu of randomization; therefore, the role of the physician in patient recruitment and retention should not be underestimated.
These might be reasons why Weiss is not producing that much novel research and I believe that they certainly are factors for other therapies not doing it.
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