The Fragility Index of Hip Arthroscopy Randomized Controlled Trials: A Systematic Survey
Authors: Maldonado DR, Go CC, Huang BH, Domb BG
DOI: 10.1016/j.arthro.2021.01.049
Background
Randomized controlled trials (RCTs) are key for clinical evidence, but the strength of their findings varies. The Fragility Index (FI) shows how easily a study’s conclusions could change with just a few altered outcomes.
Methods
The study assessed the FI of 8 hip arthroscopy RCTs and reviewed risk of bias, dropout rates, and study design factors.
Key Findings
- The median FI was only 4, indicating results could be reversed by changing outcomes for 4 patients or fewer.
- Half the studies had dropout rates exceeding their FI, raising concerns about reliability.
Conclusions
Many hip arthroscopy RCTs have fragile results that should be interpreted cautiously, especially when dropout or subjective measures are high.
What Does This Mean for Providers
- Critically assess RCT results, especially with small sample sizes and high dropouts.
- Use FI alongside other measures of study quality before applying evidence to practice.
- Educate patients on the strengths and limitations of clinical research findings.