Abstract:
:Randomized clinical trials often represent the highest level of clinical evidence available to evaluate the efficacy of an intervention in clinical medicine. Although the process of randomization serves to maximize internal validity, the external validity, or generalizability, of such studies depends on several factors determined at the design phase of the trial including eligibility criteria, study setting, and outcomes of interest. In general, explanatory trials are optimized to demonstrate the efficacy of an intervention in a highly selected patient group; however, findings from these studies may not be generalizable to the larger clinical problem. In contrast, pragmatic trials attempt to understand the real-world benefit of an intervention by incorporating design elements that allow for greater generalizability and clinical applicability of study results. In this article we describe the explanatory-pragmatic continuum for clinical trials in greater detail. Further, a well-accepted tool for grading trials on this continuum is described, and applied, to 2 recently published trials pertaining to the surgical management of lumbar degenerative spondylolisthesis.
journal_name
Clin Spine Surgjournal_title
Clinical spine surgeryauthors
Merali Z,Wilson JRdoi
10.1097/BSD.0000000000000588subject
Has Abstractpub_date
2017-11-01 00:00:00pages
404-406issue
9eissn
2380-0186issn
2380-0194pii
01933606-201711000-00004journal_volume
30pub_type
杂志文章abstract:STUDY DESIGN:Description of a navigated, single-step, minimally invasive technique for the placement of pedicle screws. OBJECTIVE:To describe a new technique for minimally invasive placement of pedicle screws in the lumbar spine using O-arm and StealthStation navigation in combination. SUMMARY OF BACKGROUND DATA:Mini...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000616
更新日期:2018-06-01 00:00:00
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journal_title:Clinical spine surgery
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doi:10.1097/BSD.0000000000000040
更新日期:2017-05-01 00:00:00
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doi:10.1097/BSD.0000000000000721
更新日期:2019-03-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章,meta分析
doi:10.1097/BSD.0000000000000763
更新日期:2019-03-01 00:00:00
abstract:STUDY DESIGN:Prospective clinical study. SUMMARY OF BACKGROUND DATA:To the authors knowledge, there are no previous prospective studies to test the feasibility of the unilateral biportal endoscopic (UBE) technique in management of lumbar canal stenosis. PURPOSE:The study was conducted to compare clinical results of t...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000001122
更新日期:2021-01-15 00:00:00
abstract:STUDY DESIGN:A method for measuring occipitocervical angle. OBJECTIVE:To develop a new method of measurement for assessing the occipitocervical angle using intraoperative fluoroscopic imaging, and to examine its reliability. SUMMARY OF BACKGROUND DATA:To avoid postoperative complications following occipitocervical fu...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000478
更新日期:2017-08-01 00:00:00
abstract:STUDY DESIGN:Cross-sectional study. OBJECTIVE:To determine the correlation between SF-36 (a measure for overall health status in patients) and Oswestry-Disability Index (ODI) or Rolland-Morris Disability Questionnaire (RMDQ) confined to spine according to the type of pain from the spine. SUMMARY OF BACKGROUND DATA:Da...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000438
更新日期:2017-07-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000968
更新日期:2020-12-01 00:00:00
abstract::As the cost of health care continues to rise, government and commercial payors are implementing strategies as a means of reducing the overall expenditure of health care dollars. The largest savings will be not just in more cost-effective treatments but in strategies that can avoid the need for treatments in the first ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000541
更新日期:2018-10-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000047
更新日期:2017-04-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000244
更新日期:2017-05-01 00:00:00
abstract:STUDY DESIGN:In vitro biomechanical study of cervical intervertebral distraction. OBJECTIVE:To investigate the forces required for distraction to different heights in an in vitro C5-C6 anterior cervical distraction model, focusing on the influence of the intervertebral disk, posterior longitudinal ligament (PLL), and ...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000160
更新日期:2017-06-01 00:00:00
abstract:STUDY DESIGN:Propensity score matched retrospective study using a nationwide longitudinal database. OBJECTIVE:To quantify the longitudinal economic impact of venous thromboembolism (VTE) complications in spinal fusion patients. SUMMARY OF BACKGROUND DATA:VTE is a rare and serious complication that may occur after spi...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000450
更新日期:2017-12-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000590
更新日期:2018-03-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000427
更新日期:2017-11-01 00:00:00
abstract:STUDY DESIGN:Retrospective cohort. OBJECTIVE:To determine whether a genetic test is associated with successful Providence bracing for adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA:Genetic factors have been defined that predict the risk of progression of AIS in a polygenic fashion. From these data,...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0b013e3182aa4ce1
更新日期:2016-04-01 00:00:00
abstract::The Spine Patient Outcomes Related Trial (SPORT) is arguably one of the most impactful and insightful studies conducted in spine surgery. Designed as a prospective, multicenter study with a randomized and observational cohort, SPORT has provided vast data on the pathogenesis, treatment effects, clinical outcomes, cost...
journal_title:Clinical spine surgery
pub_type: 杂志文章,评审
doi:10.1097/BSD.0000000000000696
更新日期:2018-11-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000695
更新日期:2018-11-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000174
更新日期:2017-10-01 00:00:00
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更新日期:2016-06-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章,多中心研究
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更新日期:2020-02-01 00:00:00
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更新日期:2016-02-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
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更新日期:2019-02-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0b013e31828984f9
更新日期:2016-02-01 00:00:00
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journal_title:Clinical spine surgery
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doi:10.1097/BSD.0000000000000930
更新日期:2020-02-01 00:00:00
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更新日期:2018-06-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
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更新日期:2016-05-01 00:00:00
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更新日期:2020-02-01 00:00:00
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更新日期:2017-04-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 临床试验,杂志文章
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更新日期:2017-11-01 00:00:00