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. 2021 May;2(5):344-350.
doi: 10.1302/2633-1462.25.BJO-2021-0007.R1.

Follow-up definitions in clinical orthopaedic research : a systematic review

Sufian S Ahmad  1   2 , Lorenz Hoos  2 , Carsten Perka  1 , Ulrich Stöckle  1 , Karl F Braun  1   3 , Christian Konrads  2
Affiliations

Follow-up definitions in clinical orthopaedic research : a systematic review

Sufian S Ahmad et al. Bone Jt Open. 2021 May.

Abstract

Aims: The follow-up interval of a study represents an important aspect that is frequently mentioned in the title of the manuscript. Authors arbitrarily define whether the follow-up of their study is short-, mid-, or long-term. There is no clear consensus in that regard and definitions show a large range of variation. It was therefore the aim of this study to systematically identify clinical research published in high-impact orthopaedic journals in the last five years and extract follow-up information to deduce corresponding evidence-based definitions of short-, mid-, and long-term follow-up.

Methods: A systematic literature search was performed to identify papers published in the six highest ranked orthopaedic journals during the years 2015 to 2019. Follow-up intervals were analyzed. Each article was assigned to a corresponding subspecialty field: sports traumatology, knee arthroplasty and reconstruction, hip-preserving surgery, hip arthroplasty, shoulder and elbow arthroplasty, hand and wrist, foot and ankle, paediatric orthopaedics, orthopaedic trauma, spine, and tumour. Mean follow-up data were tabulated for the corresponding subspecialty fields. Comparison between means was conducted using analysis of variance.

Results: Of 16,161 published articles, 590 met the inclusion criteria. Of these, 321 were of level IV evidence, 176 level III, 53 level II, and 40 level I. Considering all included articles, a long-term study published in the included high impact journals had a mean follow-up of 151.6 months, a mid-term study of 63.5 months, and a short-term study of 30.0 months.

Conclusion: The results of this study provide evidence-based definitions for orthopaedic follow-up intervals that should provide a citable standard for the planning of clinical studies. A minimum mean follow-up of a short-term study should be 30 months (2.5 years), while a mid-term study should aim for a mean follow-up of 60 months (five years), and a long-term study should aim for a mean of 150 months (12.5 years). Level of Evidence: Level I. Cite this article: Bone Jt Open 2021;2(5):344-350.

Keywords: Clinical study; Long-term; Mid-term; Outcome; Short-term; Study design.

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Figures

Fig. 1
Fig. 1
Flowchart demonstrating inclusion.
Fig. 2
Fig. 2
Follow-up intervals stated as short-term, mid-term, or long-term in articles published in the six highest ranked orthopaedic journals between 2015 to 2019.
Fig. 3
Fig. 3
Follow-up intervals defined as long-term for articles published in the six top-ranked journals in the field of orthopaedics.
Fig. 4
Fig. 4
Follow-up intervals defined as mid-term for articles published in the six top-ranked journals in the field of orthopaedics.
Fig. 5
Fig. 5
Follow-up intervals defined as short-term for articles published in the six top-ranked journals in the field of orthopaedics.
Fig. 6
Fig. 6
Follow-up intervals defined as long-term for different orthopaedic subspecialties.
Fig. 7
Fig. 7
Follow-up intervals defined as mid-term for different orthopaedic subspecialties.
Fig. 8
Fig. 8
Follow-up intervals defined as short-term for different orthopaedic subspecialties.
See this image and copyright information in PMC

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