Evidence map›Paper›PMID 39799405›Full record

SynthesisThe American journal of sports medicine2025

The Continuous Fragility Index of Statistically Significant Findings in Studies Based on High Levels of Evidence Comparing Interventions for Femoroacetabular Impingement Syndrome.

Juan Bernardo Villarreal-Espinosa, Zeeshan A Khan, Kyleen Jan, Rodrigo Saad Berreta, Michael J Murray, Felicitas Allende, Shane J Nho, Jorge Chahla

Abstract readMeta-Analysis
In one paragraph

Synthesis in The American journal of sports medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

8 authors.

Juan Bernardo Villarreal-EspinosaDepartment of Orthopaedics, Rush University Medical Center, Rush University Medical College, Chicago, Illinois, USA.ORCID 0009-0006-8272-592X
Zeeshan A KhanDepartment of Orthopaedics, Rush University Medical Center, Rush University Medical College, Chicago, Illinois, USA.
Kyleen JanDepartment of Orthopaedics, Rush University Medical Center, Rush University Medical College, Chicago, Illinois, USA.ORCID 0000-0002-4303-365X
Rodrigo Saad BerretaDepartment of Orthopaedics, Rush University Medical Center, Rush University Medical College, Chicago, Illinois, USA.
Michael J MurrayDepartment of Orthopaedics, Rush University Medical Center, Rush University Medical College, Chicago, Illinois, USA.
Felicitas AllendeDepartment of Orthopaedics, Rush University Medical Center, Rush University Medical College, Chicago, Illinois, USA.ORCID 0000-0001-9319-2571
Shane J NhoDepartment of Orthopaedics, Rush University Medical Center, Rush University Medical College, Chicago, Illinois, USA.
Jorge ChahlaDepartment of Orthopaedics, Rush University Medical Center, Rush University Medical College, Chicago, Illinois, USA.

Funding

Pre and Post-Doctoral Training in Joint HealthT32AR073157 · NIAMS · RUSH UNIVERSITY MEDICAL CENTER · PI D Rick Sumner · 2019 to 2026
$2.3M
NIAMS NIH HHS T32 AR073157
6 · The paper itself

Abstract

backgroundCritical analysis of studies with high level of evidence has relied on the significance set by the reported PURPOSE: To calculate the CFI of high-level quality studies reporting significant continuous outcomes on comparison of treatment modalities for management of femoroacetabular impingement syndrome. STUDY

designMeta-analysis; Level of evidence, 2.

methodsThree databases (PubMed, Embase, Cochrane) were queried from inception to February 2024 utilizing Boolean operators to combine variations of the following search terms: "femoroacetabular impingement, randomized controlled trials or prospective cohort." Studies were included if level of evidence 1 or 2, and a statistically significant outcome was reported for any continuous outcome. CFI calculation was performed for all significant outcomes to obtain a study-specific mean CFI and also for the primary outcome of each study. Mean CFI was also calculated for outcomes reported to be significant in >3 studies. Additionally, multivariable linear regression was utilized for assessment of variables associated with achievement of a higher CFI.

resultsThirteen studies totaling 1316 patients were included for analysis: 11 level of evidence 1 and 2 level of evidence 2 studies. A total of 48 outcomes reaching significance were extracted, with 8 representing primary outcomes. Study-specific mean (SD) CFI was 8 (9.3), whereas primary outcome mean CFI was 12.5 (12). In 4 of the 13 studies, the number of hips lost to follow-up was greater than the study CFI. Outcome-specific mean CFI was obtained for 5 outcomes reported in >3 studies. Multivariable linear regression revealed that larger sample size and greater journal impact factor had a significant positive association with a higher overall CFI value (

conclusionThe mean (SD) number of patient outcome events needed to reverse the significance of a continuous outcome (ie, CFI) was 8.0 (9.3). Nearly one-third of studies had a CFI less than the reported loss to follow-up, reflecting the need for better patient compliance to attain less fragile statistical results. Larger sample size and greater journal impact factor were both predictive of a higher CFI.

Indexed as

Femoracetabular ImpingementHumansRandomized Controlled Trials as TopicFAISfragility indexprospective studiessignificant outcomes

Identifiers

PMID39799405
PMCPMC13007318

What OpenQuestion holds

Textmetadata
LicenceTDM
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.