Many of us want to do shoulder research - it is engaging, holds promise for improving our understanding and care of our patients, and helps in career advancement.
Because good research requires substantial effort and funding, it is important to make good choices.
In selecting a project with high probability of success, three elements need consideration:
1. Can the question be stated clearly in quantitative terms?
2. Why is this question important?
3. Is the study doable?
Let's consider an example regarding the clinical value of 3D planning for reverse total shoulder arthroplasty for patients with primary osteoarthritis
1. Can the question be stated clearly in quantitative terms?
In a trial controlling for important confounders, does the use of preoperative CT-based planning for patients having primary reverse total shoulder arthroplasty for arthritis improve the two-year postoperative American Shoulder and Elbow Surgeons (ASES) scores by the clinically significant amount of 20.9 in comparison to comparable patients having reverse total shoulder arthroplasty without 3D CT planning.
2. Why is this question important?
Because obtaining advanced imaging and using planning software involves increased time, expense and additional radiation exposure, surgeons and patients should be able to consider the benefit of these technologies to the patient in comparison to their costs.
3. Is the study doable?
The recently published two year ASES scores for patients with cuff intact arthritis having reverse total shoulder arthroplasty averaged 83 [SD 12.6]. In that the maximum ASES score is 100, there are only 17 points of possible improvement before the ceiling is encountered. Since the minimal clinically important difference is 20.9, it would not be possible to show a clinically significant benefit to the patient of 3D CT based planning using the ASES score as the outcome of interest.
Thus while the question can be stated in quantitative terms and is clinically important, the proposed study is unlikely to provide the desired information.
Students, residents, fellows and faculty come up with ideas for research projects. We've found that tasking them with answering these three questions helps them make good choices for a productive research experience.
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Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
How to x-ray the shoulder (see this link).
The ream and run procedure (see this link).
The total shoulder arthroplasty (see this link).
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).
The smooth and move procedure for irreparable rotator cuff tears (see this link)
Shoulder rehabilitation exercises (see this link).
