Journal Club Summary
Pellatt R, et al. Ann Emerg Med. 2019 Mar 7. pii: S0196-0644(19)30059-9.
Methodology Score: 3/5
Usefulness Score: 3.5/5
Question and Methods: Randomized control trial of 97 adult emergency department patients comparing buddy taping vs. ulnar gutter splinting, in acute, uncomplicated neck of 5th metacarpal (Boxer) fractures.
Findings: At 12 weeks the median quickDash (Disabilities of the Arm, Shoulder and Hand) score for both groups was 0. The buddy tape cohort missed less work.
Limitations: Unclear why many patients not included in initial enrollment, around 20% in each group lost to follow up.
Interpretation: There does not appear to be a difference in outcomes between patients treated with buddy tape compared to ulnar gutter splinting for uncomplicated Boxer fractures.
By: Dr. Dan Beamish
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Epi Lesson
Most statistical software discard cases where data is missing, potentially leading to biased results if missingness is not random. Imputation methods allow to keep all cases in the analyses by replacing missing data with an estimated value based on all other available information. Data imputation can be done for predictor variables, but it isn’t appropriate to impute missing data for main outcomes.
By: Dr. Christian Vaillancourt
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