User's guide to the orthopaedic literature: How to use an article about a surgical therapy

We suggest a three-step approach when using an article from the surgical literature to guide your patient care: (1) assess whether the study can provide valid results, (2) review the results, and (3) consider how the results might be applied to your patient. Randomization, concealment, intention-to-treat analysis, similarity of patients for known prognostic factors, blinding of patients and outcome assessors, and completeness of follow-up are important guides to study validity. The 95% confidence interval around the treatment effect is a measure of precision. Consider whether all of the clinically important outcomes were reported and whether the likely benefits of treatment outweigh the potential harm and costs.