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Fragility index may be useful in analysis of randomized controlled trials
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Results showed the fragility index may be a useful metric in analyzing the robustness of conclusions of randomized controlled trials.
Joseph J. Ruzbarsky, MD, and colleagues used a systematic search strategy to identify randomized controlled trials pertaining to clavicular fractures that involved two parallel arms, were published in English, allocated patients to treatment and control arms in a 1:1 ratio and reported statistical significance for dichotomous variables from 2007 to 2017. Based on the Fisher exact test, researchers determined the fragility index.
Among the 15 randomized controlled trials included, results showed a median fragility index of 2. Researchers found a fragility index of 2 or less in 73.3% of the studies. The number of patients lost to follow-up exceeded the fragility index in 46.7% of studies, according to results.
“The fragility index facilitates easy interpretation of the robustness vs. fragility of [randomized controlled trial] RCT results and provides a useful adjunct to other methods of quantitative analyses including P values, confidence intervals and effect sizes,” Ruzbarsky told Healio.com/Orthopedics. “Given that the median fragility index reported in the recent literature on management of clavicle fractures is only 2, future efforts are needed to increase institutional collaboration and patient recruitment in order to strengthen the robustness of RCT conclusions.” – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.
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