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Adjudicating Outcomes: Fundamentals
Christopher Vannabouathong, BSc, MSc(C)1; Michel Saccone, BSc1; Sheila Sprague, MSc, PhD(C)1; Emil H. Schemitsch, MD, FRCSC2; Mohit Bhandari, MD, PhD, FRCSC1
1 Department of Clinical Epidemiology & Biostatistics, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON L8L 8E7, Canada. E-mail address for M. Bhandari: bhandam@mcmaster.ca
2 Orthopaedic Division, St. Michael’s Hospital, 55 Queen Street East, Suite 800, Toronto ON M5C 1R6, Canada
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Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

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Investigation performed at the Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2012 Jul 18;94(Suppl 1(E)):70-74. doi: 10.2106/JBJS.L.00190
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The adjudication of outcomes has rarely been reported in the orthopaedic literature, although this process is commonly used and reported in clinical trials of other medical disciplines. Adjudication of outcomes provides more reliable and valid outcome assessment, especially when the outcome is subjective as in the case of fracture-healing. The successful implementation of adjudication in a clinical trial is an important and complex process. The process requires a substantial infrastructure of research personnel to oversee data collection at the clinical sites. The development of an adjudication charter specific to the study is a critical aspect of adjudication as it outlines the adjudication committee membership as well as their roles and responsibilities and defines the adjudication process and the decision rules. Web-based adjudication has facilitated the process as it allows rapid, efficient, and timely adjudication. This article provides an overview of the adjudication process, along with details on the common pearls and pitfalls associated with this method of outcomes assessment.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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