ReWOrth - Reproducibility and Value Within Orthopaedics and Traumatology Research

Research group | Publications

Background

The reproducibility of research results is the cornerstone of scientific research. Scientific research is based on scientific observation of phenomena and on the testing of theories and hypotheses with experimental setups. At the heart of this practice is the reproducibility of the research and its results. Science is based on the assumption that research results can be reproduced at another time and place in similar circumstances. If a research result is not reproducible, it cannot be deemed reliable.

During the last decade there has been an increasing number of texts written in medicine about reproducibility problem. It means that reported research results cannot be reproduced in subsequent, similar studies. This is a serious concern for contemporary science, because repeatability and reproducibility are the cornerstones of research. However, this is not only a recent issue: already in 1995 Douglas Altman, the pioneer in medical statistics, said: “We need less research, better research, and research done for the right reasons”. Already by then Altman worried about research waste, i.e. about research that does not benefit patients and healthcare professionals. Considering the exponential growth in the amount of scientific research being done, it is evident, that the situation has not improved since 1995.

The reproducibility problem and research waste are two sides of the same coin. The common denominator between the two is that a major part of medical research does not benefit anyone, because the studies are of poor quality and the research questions are not relevant to the treatment of patients. A major share of the reproducibility problem is due to inadequate knowledge of statistical methods and methodology. This, in turn, causes that inappropriate statistical methods are employed in research and that the results they yield are misinterpreted, which ultimately leads to the research results being useless or even incorrect.

Another widespread problem in medical research is that millions and millions of published studies do not lead to concrete improvements in patient treatment and are therefore of very little value. This is partly due to the fact that the research questions are not relevant to professional practice or the research results simply cannot be utilized in practice.

The purpose of the ReWOrth research group is to conduct orthopaedic meta-research and to strive to highlight methodological problems relevant to reproducibility through educative approach. In addition, the research group seeks to investigate how orthopaedic research provides value to patients and healthcare. The research group engages actively in critical dialogue on the quality of orthopaedic research.

The reproducibility problem and research waste in general have been talked about for decades, but the change in each specialty always starts within the field itself.

The research group

Research group leader: Aleksi Reito

Senior researchers: Ville Ponkilainen, Ilari Kuitunen, Mikko Uimonen, Lauri Raittio

Junior researcher: Rasmus Liukkonen, Matias Vaajala

Publications

  • Ponkilainen VT, Uimonen M, Raittio L, Kuitunen I, Eskelinen A, Reito A. Multivariable models in orthopaedic research: a methodological review of covariate selection and causal relationships. Osteoarthritis Cartilage. 2021 Jul;29(7):939-945. doi: 1016/j.joca.2021.03.020.
  • Raittio L, Launonen A, Mattila VM, Reito A. Estimates of the mean difference in orthopaedic randomized trials: obligatory yet obscure. BMC Med Res Methodol. 2021 Mar 24;21(1):59. doi: 1186/s12874-021-01249-2
  • Raittio L, Reito A. Assessing variability and uncertainty in orthopedic randomized controlled trials. Acta Orthop. 2020 Aug;91(4):479-484. doi: 1080/17453674.2020.1755932.
  • Kuitunen I, Ponkilainen VT, Uimonen MM, Eskelinen A, Reito A. Testing the proportional hazards assumption in cox regression and dealing with possible non-proportionality in total joint arthroplasty research: methodological perspectives and review. BMC Musculoskelet Disord. 2021 May 28;22(1):489. doi: 1186/s12891-021-04379-2.
  • Reito A, Raittio L, Helminen O. Revisiting the Sample Size and Statistical Power of Randomized Controlled Trials in Orthopaedics After 2 Decades. JBJS Rev. 2020 Feb;8(2):e0079. doi: 2106/JBJS.RVW.19.00079
  • Reito A, Raittio L, Helminen O. Fragility Index, power, strength and robustness of findings in sports medicine and arthroscopic surgery: a secondary analysis of data from a study on use of the Fragility Index in sports surgery. PeerJ. 2019 May 24;7:e6813. doi: 7717/peerj.6813.