RT Journal
A1 Scholtes, Vanessa A.
A1 Nijman, Thomas H.
A1 van Beers, Loes
A1 Devereaux, P.J.
A1 Poolman, Rudolf W.
T1 Emerging Designs in Orthopaedics: Expertise-Based Randomized Controlled Trials
JF The Journal of Bone & Joint Surgery
JO The Journal of Bone & Joint Surgery
YR 2012
FD July 18
VO 94
IS Suppl 1(E)
SP 24
OP 28
DO 10.2106/JBJS.K.01626
UL http://dx.doi.org/10.2106/JBJS.K.01626
AB Abstract: 
  In this article, we discuss the limitations of conventional randomized controlled trials (RCTs) in the surgical field. Surgeons are often believers in certain surgical techniques and therefore can be reluctant to learn new interventions. In expertise-based trials, the patients are randomized to surgeons with expertise in the intervention under investigation. In conventional RCTs, patients are randomized to an intervention, and surgeons will perform this intervention regardless of whether this is the surgery they typically undertake. Conventional randomization may lead to surgery performed by a less experienced or less motivated surgeon, resulting in differential expertise bias. Expertise-based trials can overcome these limitations if potential pitfalls are taken into account.