Friday, December 4, 2015

The growing interest in shoulder replacement surgery. An increase of 445% between 1990s and 2000s.


There is an explosive increase in the number of publications regarding shoulder replacement surgery. The graph above shows the impressive increase. Between 1990-2000 the average number of studies published was 29.5 studies per year. After 2000 this number has increased to the astonishing number of 161 studies per year. This reflects an increase of 445%! This interest may reflect the aging population, may also reflect the increasing number of "free on line journals". One needs to be very careful in interpreting the results of a study. Without a doubt the computer era and the advanced programming techniques have contributed to the better analysis of patient databases. However, with this plethora of information it appears that the quality of information is also affected. Implant companies fund studies in an effort to promote their products. The studies funded by the implant industry are usually seen in peer reviewed journals in which the criteria for publication are no strict or scientifically correct. One needs to be particularly careful about conflicts of interest. We are in an era that the public as well as the physicians have to critically interpret the data, results and the statements made in these published studies. I fear that the pressure of the universities to publish studies, the pressure of the industry to publish studies and the well established need of the society to advance medicine may lead to an overwhelming volume of data and studies that will create more confusion than understanding of the nature of the diseases, the mechanisms of development and the best methods of treatment. In other words, it is time to read articles critically, the same way that you read an article in the newspaper.