Evidence map›Paper›PMID 36051864›Full record

ArticleFoot & ankle orthopaedics2022

The Statistical Fragility of Platelet-Rich Plasma as Treatment for Chronic Noninsertional Achilles Tendinopathy: A Systematic Review and Meta-analysis.

Amy L Xu, Carlos Ortiz-Babilonia, Arjun Gupta, Davis Rogers, Amiethab A Aiyer, Ettore Vulcano

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Foot & ankle orthopaedics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Continuous outcomes of robotic-assisted total knee arthroplasty trials are statistically fragile.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Pooled it
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  10. Treatment of skin defects with PRP enriched with hyaluronic acid - histological aspects in rat model.Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Amy L XuDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.ORCID https://orcid.org/0000-0002-3651-2361
Carlos Ortiz-BabiloniaDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.ORCID https://orcid.org/0000-0003-0722-6937
Arjun GuptaDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Davis RogersDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Amiethab A AiyerDepartment of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ettore VulcanoDepartment of Orthopaedic Surgery, Columbia University Mount Sinai Medical Center, Miami, FL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Randomized controlled trial (RCT) outcomes reaching statistical significance, frequently determined by Methods: The present study was a systematic review and meta-analysis of RCTs comparing outcomes after PRP injection vs alternative treatment in patients with AT. Representative data sets were generated for each reported continuous outcome event using summary statistics. Fragility indices refer to the minimal number of patients whose status would have to change from a nonevent to an event to turn a statistically significant result into a nonsignificant result, or vice versa. The fragility index (FI) and continuous FI (CFI) were determined for dichotomous and continuous outcomes, respectively, by manipulating each data set until reversal of significance (a=0.05) was achieved. The corresponding fragility quotient (FQ) and continuous FQ (CFQ) were calculated by dividing FI/CFI by sample size. Results: Of 432 studies screened, 8 studies (52 outcome events) were included in this analysis. The 12 dichotomous outcomes had a median FI of 4.5 (FQ: 0.111), and the 40 continuous outcomes had a median CFI of 5 (CFQ: 0.154). All 52 outcome events included lost-to-follow-up data, and 12 (23.1%) indicated a greater number of patients lost to follow-up than the FI or CFI. Conclusion: Our findings suggest that RCTs evaluating PRP for AT therapy lack statistical robustness, because changing only a small number of events may alter outcome significance. Level of Evidence: Level II, therapeutic study.

Indexed as

Achilles tendinopathyFragility IndexFragility Quotientorthobiologicsplatelet-rich plasmarandomized controlled trialsstatistical fragility

Identifiers

PMID36051864
PMCPMC9424894

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.