Expertise of Surgeons Publishing Novel Techniques in the Journal of Wrist Surgery

Abstract

Introduction Recent efforts to standardize reporting of surgeon experience in novel technique publications have recommended reporting of Tang level of expertise (LOE).

Question/Purpose The aim of this study was to document trends in LOE reporting for novel technique articles published in the Journal of Wrist Surgery and evaluate whether author experience affects novel research outcomes.

Methods A total of 261 articles published from 2018 to 2020 were reviewed. Articles describing novel surgical techniques were included and examined for Tang LOE. Author variables were collected online.

Results Eight percent (21/261) of articles discussed novel surgical techniques and one reported LOE. Nearly half (47.6%) of articles did not conduct statistical analysis. Four (19.0%) reported insignificant statistical results and 7 (33.3%) reported significant findings. All significant statistical findings were positive. Number of prior related publications by the senior author did not affect new technique result significance (p = 0.34).

Discussion From 2018 to 2020, only one article documented LOE. Authors' variables, including number of prior related publications, were not correlated with significant results in their new publications. This may suggest that an author's established experience in a novel technique, quantified by prior publications on the topic, does not make one more likely to achieve significantly better or worse outcomes in their reviewed Journal of Wrist Surgery study.

Conclusions Tang LOE is an important way for readers to classify expertise and should be reported, and potentially modified to better define contributing variables.

Keywords

level of expertise - wrist surgery - expertise bias

Publication History

Received: 14 April 2021

Accepted: 21 April 2021

Article published online:
15 July 2021

• References

• 1 McCulloch P. Developing appropriate methodology for the study of surgical techniques. J R Soc Med 2009; 102 (02) 51-55
• 2 Tang JB. Re: Levels of experience of surgeons in clinical studies. J Hand Surg Eur Vol 2009; 34 (01) 137-138
• 3 Dowrick AS, Tornetta III P, Obremskey WT, Dirschl DR, Bhandari M. Practical research methods for orthopaedic surgeons. J Bone Joint Surg Am 2012; 94 (04) 368-374
• 4 van Oldenrijk J, Schafroth MU, Bhandari M, Runne WC, Poolman RW. Time-action analysis (TAA) of the surgical technique implanting the collum femoris preserving (CFP) hip arthroplasty. TAASTIC trial identifying pitfalls during the learning curve of surgeons participating in a subsequent randomized controlled trial (an observational study). BMC Musculoskelet Disord 2008; 9: 93
• 5 Rudicel S, Esdaile J. The randomized clinical trial in orthopaedics: obligation or option?. J Bone Joint Surg Am 1985; 67-A [phone]
• 6 Devereaux PJ, Bhandari M, Clarke M. et al. Need for expertise based randomised controlled trials. BMJ 2005; 330 (7482): 88
• 7 Scholtes VA, Nijman TH, van Beers L, Devereaux PJ, Poolman RW. Emerging designs in orthopaedics: expertise-based randomized controlled trials. J Bone Joint Surg Am 2012; 94 (Suppl. 01) 24-28
• 8 Beck JD, Deegan JH, Rhoades D, Klena JC. Results of endoscopic carpal tunnel release relative to surgeon experience with the Agee technique. J Hand Surg Am 2011; 36 (01) 61-64
• 9 Neuhaus V, Bot AG, Guitton TG, Ring DC. Influence of surgeon, patient and radiographic factors on distal radius fracture treatment. J Hand Surg Eur Vol 2015; 40 (08) 796-804
• 10 Dumartinet-Gibaud R, Bigorre N, Raimbeau G, Jeudy J, Saint Cast Y. Arpe total joint arthroplasty for trapeziometacarpal osteoarthritis: 80 thumbs in 63 patients with a minimum of 10 years follow-up. J Hand Surg Eur Vol 2020; 45 (05) 465-469
• 11 Canal C, Kaserer A, Ciritsis B, Simmen HP, Neuhaus V, Pape HC. Is there an influence of surgeon's experience on the clinical course in patients with a proximal femoral fracture?. J Surg Educ 2018; 75 (06) 1566-1574
• 12 Cahill PJ, Pahys JM, Asghar J. et al. The effect of surgeon experience on outcomes of surgery for adolescent idiopathic scoliosis. J Bone Joint Surg Am 2014; 96 (16) 1333-1339
• 13 Tang JB, Giddins G. Why and how to report surgeons' levels of expertise. J Hand Surg Eur Vol 2016; 41 (04) 365-366
• 14 Massel DH, Lezak BA, Summers SH, Yakkanti RR, Hui-Chou HG, Chen DL. Surgeon level of expertise reported in Journal of Hand Surgery (American Volume) and (European Volume) publications. J Hand Surg Eur Vol 2020; 45 (09) 904-908
• 15 Nakamura T. Surgeons' level of expertise. J Wrist Surg 2020; 9 (03) 185