Evidence map›Paper›PMID 37095233›Full record

ReviewSurgical endoscopy2023

Fragility of statistically significant findings from randomized trials in comparing laparoscopic versus robotic abdominopelvic surgeries.

Yung Lee, Yasith Samarasinghe, Lucy H Chen, Audrey Jong, Akithma Hapugall, Arshia Javidan, Tyler McKechnie, Aristithes Doumouras, Dennis Hong

Abstract readReview
PubMed Publisher
In one paragraph

Review in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

9 authors.

Yung LeeDivision of General Surgery, McMaster University, Hamilton, ON, Canada.
Yasith SamarasingheDivision of General Surgery, McMaster University, Hamilton, ON, Canada.
Lucy H ChenDivision of General Surgery, McMaster University, Hamilton, ON, Canada.
Audrey JongTemerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Akithma HapugallDivision of General Surgery, McMaster University, Hamilton, ON, Canada.
Arshia JavidanDivision of Vascular Surgery, University of Toronto, Toronto, ON, Canada.
Tyler McKechnieDivision of General Surgery, McMaster University, Hamilton, ON, Canada.
Aristithes DoumourasDivision of General Surgery, McMaster University, Hamilton, ON, Canada.
Dennis HongDivision of General Surgery, McMaster University, Hamilton, ON, Canada. dennishong70@gmail.com.ORCID 0000-0003-1792-1255

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUtility of robotic over laparoscopic approach has been an area of debate across all surgical specialties over the past decade. The fragility index (FI) is a metric that evaluates the frailty of randomized controlled trials (RCTs) findings by altering the status of patients from an event to non-event until significance is lost. This study aims to evaluate the robustness of RCTs comparing laparoscopic and robotic abdominopelvic surgeries through the FI.

methodsA search was conducted in MEDLINE and EMBASE for RCTs with dichotomous outcomes comparing laparoscopic and robot-assisted surgery in general surgery, gynecology, and urology. The FI and reverse fragility Index (RFI) metrics were used to assess the strength of findings reported by RCTs, and bivariate correlation was conducted to analyze relationships between FI and trial characteristics.

resultsA total of 21 RCTs were included, with a median sample size of 89 participants (Interquartile range [IQR] 62-126). The median FI was 2 (IQR 0-15) and median RFI 5.5 (IQR 4-8.5). The median FI was 3 (IQR 1-15) for general surgery (n = 7), 2 (0.5-3.5) for gynecology (n = 4), and 0 (IQR 0-8.5) for urology RCTs (n = 4). Correlation was found between increasing FI and decreasing p-value, but not sample size, number of outcome events, journal impact factor, loss to follow-up, or risk of bias.

conclusionRCTs comparing laparoscopic and robotic abdominal surgery did not prove to be very robust. While possible advantages of robotic surgery may be emphasized, it remains novel and requires further concrete RCT data.

Indexed as

GynecologyLaparoscopyRobotic Surgical ProceduresHumansRandomized Controlled Trials as TopicSample SizeAbdominal surgeriesFragility indexLaparoscopic surgeriesRobotic surgeries

Identifiers

PMID37095233

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.