The Fragility Index of Total Hip Arthroplasty Randomized Control Trials: A Systematic Review
Authors
Go CC, Maldonado DR, Go BC, Annin S, Saks BR, Jimenez AE, Domb BG
Journal
J Am Acad Orthop Surg, May 2022
Background
The fragility index (FI) of randomized controlled trials (RCTs) is used to measure the robustness of trial outcomes. This study examines the FI in total hip arthroplasty (THA) trials to assess the reliability of their conclusions.
Methods:
- A systematic review was conducted on RCTs published between 2015 and 2020 that focused on total hip arthroplasty.
- FI values were analyzed, and potential predictors of FI were examined.
Key Findings
- The median FI across the reviewed RCTs was 2, with six studies having an FI of 0.
- Larger sample sizes predicted higher FIs (P = 0.033), suggesting that studies with more participants may have less reliable results.
- The FI served as an additional measure to assess the reliability of RCT conclusions.
Conclusions
The FI is a useful tool for evaluating the robustness of results in THA RCTs. Incorporating FI alongside traditional statistical methods like P values can provide more comprehensive insights into the reliability of clinical trial outcomes.
What Does This Mean For Patients
When reviewing clinical trials, it’s important to consider not just P values, but also the fragility index, to better understand the reliability and potential impact of the study's conclusions on treatment decisions.