Evidence-Based Clinical Management of Orthopaedic Trauma: 25 Years in Retrospect, and a Forecast of 25 Years To Come

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 25 June 2025 | Viewed by 969

Special Issue Editors


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Guest Editor
BG Kliniken—Klinikverbund der Gesetzlichen Unfallversicherung gGmbH (Hospital Group of the German Social Accident Insurance), Leipziger Pl. 1, 10117 Berlin, Germany
Interests: clinical trials; systematic reviews; meta-analyses; diagnostic tests; radiological imaging; ultrasonography; multiple trauma; musculoskeletal injuries; septic surgery

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Guest Editor
Department for Trauma and Orthopaedic Surgery, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen on the Rhine, Ludwigshafen, Germany
Interests: polytrauma; joint fractures; imaging; orthogeriatrics
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Special Issue Information

Dear Colleagues,

In 2025, we look back on 25 years of evidence-based orthopaedic surgery. We will celebrate this anniversary by holding a scientific symposium with renowned guest-speakers at the BG Klinikum Unfallkrankenhaus Berlin, a leading tertiary-care trauma centre in the capital of Germany. This Special Issue is intended to accompany the event, depict the current state-of-the art, and pave the way for future research. Transferring the principles of evidence-based medicine to the surgical disciplines has already turned out to be difficult, and appeared almost impossible in the setting of orthopaedic and multiple trauma. Yet, major international consortia were formed, enabling cutting-edge multicentre trials which fundamentally changed our understanding of established care processes and improved patient outcomes. Novel clinical trial concepts, innovative methods to model large-scale routine data, molecular and personalized medicine, artificial intelligence, etc., will further boost our knowledge in future. We invite systematic reviews and meta-analyses on major issues in orthopaedic trauma, reports of randomized trials, and large-scale observational data.

We look forward to your submissions!

Prof. Dr. Dirk Stengel
Prof. Dr. Paul Alfred Grützner
Guest Editors

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Keywords

  • evidence-based medicine
  • orthopaedic surgery
  • clinical trials
  • systematic reviews
  • patient outcomes
  • multiple trauma
  • artificial intelligence
  • injuries

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Published Papers (1 paper)

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Research

11 pages, 880 KiB  
Article
Discrepancies in ChatGPT’s Hip Fracture Recommendations in Older Adults for 2021 AAOS Evidence-Based Guidelines
by Hong Jin Kim, Pil Whan Yoon, Jae Youn Yoon, Hyungtae Kim, Young Jin Choi, Sangyoon Park and Jun-Ki Moon
J. Clin. Med. 2024, 13(19), 5971; https://doi.org/10.3390/jcm13195971 - 8 Oct 2024
Viewed by 748
Abstract
Background: This study aimed to assess the reproducibility and reliability of Chat-Based GPT (ChatGPT)’s responses to 19 statements regarding the management of hip fractures in older adults as adopted by the American Academy of Orthopaedic Surgeons’ (AAOS) evidence-based clinical practice guidelines. Methods [...] Read more.
Background: This study aimed to assess the reproducibility and reliability of Chat-Based GPT (ChatGPT)’s responses to 19 statements regarding the management of hip fractures in older adults as adopted by the American Academy of Orthopaedic Surgeons’ (AAOS) evidence-based clinical practice guidelines. Methods: Nineteen statements were obtained from the 2021 AAOS evidence-based clinical practice guidelines. After generating questions based on these 19 statements, we set a prompt for both the GPT-4o and GPT-4 models. We repeated this process three times at 24 h intervals for both models, producing outputs A, B, and C. ChatGPT’s performance, the intra-ChatGPT reliability, and the accuracy rates were assessed to evaluate the reproducibility and reliability of the hip fracture-related guidelines. Regarding the strengths of the recommendation compared with the 2021 AAOS guidelines, we observed accuracy of 0.684, 0.579, and 0.632 for outputs A, B, and C, respectively. Results: The precision was 0.740, 0.737, and 0.718 in outputs A, B, and C, respectively. For the reliability of the strengths of the recommendation, the Fleiss kappa was 0.409, indicating a moderate level of agreement. No statistical differences in the strengths of the recommendation were observed in outputs A, B, and C between the GPT-4o and GPT-4 versions. Conclusion: ChatGPT may be useful in providing guidelines for hip fractures but performs poorly in terms of accuracy and precision. However, hallucinations remain an unresolved limitation associated with using ChatGPT to search for hip fracture guidelines. The effective utilization of ChatGPT as a patient education tool for the management of hip fractures should be addressed in the future. Full article
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