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Design, Conduct, and Interpretation of Nonrandomized Orthopaedic Studies--A Practical Approach   |    
An Evidence-Based Approach to the Adoption of New Technology
Henry Ahn, MD, FRCSC1; Mohit Bhandari, MD, MSc, FRCSC2; Emil H. Schemitsch, MD, FRCSC1
1 Division of Orthopaedic Surgery, St. Michael's Hospital, 55 Queen Street East, Suite 800, Toronto, ON M5C 1R6, Canada. E-mail address for H. Ahn: ahnh@smh.toronto.on.ca
2 Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON L8L 2X2, Canada
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 May 01;91(Supplement 3):95-98. doi: 10.2106/JBJS.H.01593
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Abstract

New orthopaedic technology is constantly being developed to help improve patient care. New technology may lead to a waste of resources or lead to harm for the patient if it is not properly evaluated before it is accepted as a standard of care. The purpose of this article is to assess how new technology can be implemented safely while maintaining an environment that allows for surgical innovation through an evidence-based approach. Although randomized controlled trials (Level-I evidence) are typically seen as the so-called gold standard with regard to treatment efficacy, randomized trials may not be the most effective form of evaluating a new technology. In many circumstances, a prospective cohort series or large registry that documents outcomes and adverse events may be more effective and practical for the evaluation of a new surgical technology.

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    Accreditation Statement
    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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