University of Oulu

Reito A, Raittio L, Helminen O. 2019. Fragility Index, power, strength and robustness of findings in sports medicine and arthroscopic surgery: a secondary analysis of data from a study on use of the Fragility Index in sports surgery. PeerJ 7:e6813, https://doi.org/10.7717/peerj.6813

Fragility Index, power, strength and robustness of findings in sports medicine and arthroscopic surgery : a secondary analysis of data from a study on use of the Fragility Index in sports surgery

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Author: Reito, Aleksi1,2; Raittio, Lauri3; Helminen, Olli1,4
Organizations: 1Department of Surgery, Central Finland Hospital, Jyväskylä, Keski-Suomi, Finland
2Coxa Hospital for Joint Replacement Ltd, Tampere, Pirkanmaa, Finland
3Medical School, University of Tampere, Tampere, Finland
4Cancer and Translational Medicine Research Unit, Oulu University Hospital, Oulu, Pohjois-Pohjanmaa, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 2.4 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2020041618851
Language: English
Published: PeerJ, 2019
Publish Date: 2020-04-16
Description:

Abstract

Background: A recent study concluded that most findings reported as significant in sports medicine and arthroscopic surgery are not “robust” when evaluated with the Fragility Index (FI). A secondary analysis of data from a previous study was performed to investigate (1) the correctness of the findings, (2) the association between FI, p-value and post hoc power, (3) median power to detect a medium effect size, and (4) the implementation of sample size analysis in these randomized controlled trials (RCTs).

Methods: In addition to the 48 studies listed in the appendix accompanying the original study by Khan et al. (2017) we did a follow-up literature search and 18 additional studies were found. In total 66 studies were included in the analysis. We calculated post hoc power, p-values and confidence intervals associated with the main outcome variable. Use of a priori power analysis was recorded. The median power to detect small (h > 0.2), medium (h > 0.5), or large effect (h > 0.8) with a baseline proportion of events of 10% and 30% in each study included was calculated. Three simulation data sets were used to validate our findings.

Results: Inconsistencies were found in eight studies. A priori power analysis was missing in one-fourth of studies (16/66). The median power to detect a medium effect size with a baseline proportion of events of 10% and 30% was 42% and 43%, respectively. The FI was inherently associated with the achieved p-value and post hoc power.

Discussion: A relatively high proportion of studies had inconsistencies. The FI is a surrogate measure for p-value and post hoc power. Based on these studies, the median power in this field of research is suboptimal. There is an urgent need to investigate how well research claims in orthopedics hold in a replicated setting and the validity of research findings.

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Series: PeerJ
ISSN: 2167-8359
ISSN-E: 2167-8359
ISSN-L: 2167-8359
Volume: 7
Article number: e6813
DOI: 10.7717/peerj.6813
OADOI: https://oadoi.org/10.7717/peerj.6813
Type of Publication: A1 Journal article – refereed
Field of Science: 3126 Surgery, anesthesiology, intensive care, radiology
315 Sport and fitness sciences
Subjects:
Copyright information: © 2019 Reito et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.
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