Preventing confounding in observational studies in orthopedic trauma surgery through expert panels: a systematic review

Rolf H.H. Groenwold; L. X. van Rossenberg; D. P.J. Smeeing; R. M. Houwert; J. W. Schoones; S. P. J. Muijs; F. C. Oner; Y. de Jong; B. J.M. van de Wall

doi:10.1007/s00068-024-02690-w

Preventing confounding in observational studies in orthopedic trauma surgery through expert panels: a systematic review

Rolf H.H. Groenwold^*
, L. X. van Rossenberg
, D. P.J. Smeeing
, R. M. Houwert
, J. W. Schoones
, S. P. J. Muijs
, F. C. Oner
, Y. de Jong
, B. J.M. van de Wall
,

^*Corresponding author for this work

Research output: Contribution to journal › Review article › peer-review

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Abstract

PURPOSE: Confounding in observational studies can be mitigated by selecting only those patients, in whom equipoise of both treatments is secured by experts' disagreement over optimal therapy. METHODS: We conducted a systematic review to identify observational studies in the field of orthopedic trauma surgery that utilized expert panels for patient inclusion in order to limit the potential for confounding. RESULTS: Four studies were identified that used expert panels to select participants based on expert disagreement. Derived from these studies and our own experience, recommendations were made regarding reporting of the size and composition of the expert panel, the information the expert panel receives, criteria for disagreement, selection of patients, and statistical analysis. CONCLUSION: With this review we aim to provide insight into this study design and to stimulate discussions about the potential of expert panels to control for confounding in studies of medical treatments.

Original language	English
Article number	36
Number of pages	8
Journal	European Journal of Trauma and Emergency Surgery
Volume	51
Issue number	1
DOIs	https://doi.org/10.1007/s00068-024-02690-w
Publication status	Published - 24 Jan 2025

Keywords

Confounding
Methodology
Natural experiment
Orthopedic trauma
Study design

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Groenwold, R. H. H., van Rossenberg, L. X., Smeeing, D. P. J., Houwert, R. M., Schoones, J. W., Muijs, S. P. J., Oner, F. C., de Jong, Y., van de Wall, B. J. M. (2025). Preventing confounding in observational studies in orthopedic trauma surgery through expert panels: a systematic review. European Journal of Trauma and Emergency Surgery, 51(1), Article 36. https://doi.org/10.1007/s00068-024-02690-w

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title = "Preventing confounding in observational studies in orthopedic trauma surgery through expert panels: a systematic review",

abstract = "PURPOSE: Confounding in observational studies can be mitigated by selecting only those patients, in whom equipoise of both treatments is secured by experts' disagreement over optimal therapy. METHODS: We conducted a systematic review to identify observational studies in the field of orthopedic trauma surgery that utilized expert panels for patient inclusion in order to limit the potential for confounding. RESULTS: Four studies were identified that used expert panels to select participants based on expert disagreement. Derived from these studies and our own experience, recommendations were made regarding reporting of the size and composition of the expert panel, the information the expert panel receives, criteria for disagreement, selection of patients, and statistical analysis. CONCLUSION: With this review we aim to provide insight into this study design and to stimulate discussions about the potential of expert panels to control for confounding in studies of medical treatments.",

keywords = "Confounding, Methodology, Natural experiment, Orthopedic trauma, Study design",

author = "Groenwold, \{Rolf H.H.\} and \{van Rossenberg\}, \{L. X.\} and Smeeing, \{D. P.J.\} and Houwert, \{R. M.\} and Schoones, \{J. W.\} and Muijs, \{S. P. J.\} and Oner, \{F. C.\} and \{de Jong\}, Y. and \{van de Wall\}, \{B. J.M.\}",

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year = "2025",

month = jan,

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doi = "10.1007/s00068-024-02690-w",

language = "English",

volume = "51",

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TY - JOUR

T1 - Preventing confounding in observational studies in orthopedic trauma surgery through expert panels

T2 - a systematic review

AU - Groenwold, Rolf H.H.

AU - van Rossenberg, L. X.

AU - Smeeing, D. P.J.

AU - Houwert, R. M.

AU - Schoones, J. W.

AU - Muijs, S. P. J.

AU - Oner, F. C.

AU - de Jong, Y.

AU - van de Wall, B. J.M.

N1 - Publisher Copyright: © The Author(s) 2025.

PY - 2025/1/24

Y1 - 2025/1/24

N2 - PURPOSE: Confounding in observational studies can be mitigated by selecting only those patients, in whom equipoise of both treatments is secured by experts' disagreement over optimal therapy. METHODS: We conducted a systematic review to identify observational studies in the field of orthopedic trauma surgery that utilized expert panels for patient inclusion in order to limit the potential for confounding. RESULTS: Four studies were identified that used expert panels to select participants based on expert disagreement. Derived from these studies and our own experience, recommendations were made regarding reporting of the size and composition of the expert panel, the information the expert panel receives, criteria for disagreement, selection of patients, and statistical analysis. CONCLUSION: With this review we aim to provide insight into this study design and to stimulate discussions about the potential of expert panels to control for confounding in studies of medical treatments.

AB - PURPOSE: Confounding in observational studies can be mitigated by selecting only those patients, in whom equipoise of both treatments is secured by experts' disagreement over optimal therapy. METHODS: We conducted a systematic review to identify observational studies in the field of orthopedic trauma surgery that utilized expert panels for patient inclusion in order to limit the potential for confounding. RESULTS: Four studies were identified that used expert panels to select participants based on expert disagreement. Derived from these studies and our own experience, recommendations were made regarding reporting of the size and composition of the expert panel, the information the expert panel receives, criteria for disagreement, selection of patients, and statistical analysis. CONCLUSION: With this review we aim to provide insight into this study design and to stimulate discussions about the potential of expert panels to control for confounding in studies of medical treatments.

KW - Confounding

KW - Methodology

KW - Natural experiment

KW - Orthopedic trauma

KW - Study design

UR - https://www.scopus.com/pages/publications/85216827659

U2 - 10.1007/s00068-024-02690-w

DO - 10.1007/s00068-024-02690-w

M3 - Review article

C2 - 39853438

AN - SCOPUS:85216827659

SN - 1863-9933

VL - 51

JO - European Journal of Trauma and Emergency Surgery

JF - European Journal of Trauma and Emergency Surgery

IS - 1

M1 - 36

ER -

Preventing confounding in observational studies in orthopedic trauma surgery through expert panels: a systematic review

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