Rationalising animal research synthesis in orthopaedic literature

Abstract

Systematic reviews in orthopaedic literature are frequently criticised for offering inconsistent conclusions. On top of that, high-quality randomized human evidence on crucial orthopaedic topics is more often than not lacking. In this situation, pooling animal literature could offer an excellent insight into unanswered critical clinical questions, thus potentially improving healthcare. In this paper, we sought to present the rationale and basic principles governing meta-analysis of animal research. More specifically, we elaborated on the available evidence-based methods to achieve a scientifically sound animal data synthesis. In addition, we discussed result interpretation, strength of recommendations and clinical implications based on the results of these meta-analytic modalities.

Keywords: Animal research; Evidence synthesis; Meta-analysis; Orthopaedics; in vivo.

Figure 1

Forest plot of standardised mean differences with multiple subgroup analyses is demonstrated. The methicillin-resistant Staphylococcus aureus infection prevention potential is assessed by means pair-wise meta-analysis in inverse variance mode to consider not only continuous but also dichotomous data in the analysis. CI： Confidence interval; CSA: Cationic steroidal antimicrobial; HA: Hydroxyapatite; SMD: Standardised mean difference; IV: Inverse variance; PA: Periapatite; PLEX: Polymer-lipid encapsulation matrix; SE: Standard error; TiO2 = Titanium dioxide. Citation: Tsikopoulos K, Sidiropoulos K, Kitridis D, Hassan A, Drago L, Mavrogenis A, McBride D. Is coating of titanium implants effective at preventing Staphylococcus aureus infections? A meta-analysis of animal model studies. Int Orthop 2020. Copyright© The Author(s) 2020. Published by Springer Nature Publishing Group[5]. The authors have obtained the permission for figure using from the Springer Nature Publishing Group (Supplementary material).

Figure 2

Quantification of risk of bias assessment enables not only summarising quality appraisal results but also making judgments as to what the future studies should look at. Citation: Tsikopoulos K, Sidiropoulos K, Kitridis D, Hassan A, Drago L, Mavrogenis A, McBride D. Is coating of titanium implants effective at preventing Staphylococcus aureus infections? A meta-analysis of animal model studies. Int Orthop 2020. Copyright© The Author(s) 2020. Published by Springer Nature Publishing Group[5]. The authors have obtained the permission for figure using from the Springer Nature Publishing Group (Supplementary material).