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The Journal of Bone and Joint Surgery 81:1454-60 (1999)
© 1999 The Journal of Bone and Joint Surgery, Inc.

Current Concepts Review

Current Concepts Review - Sample Size and Statistical Power in Clinical Orthopaedic Research*

KEVIN B. FREEDMAN, M.D., M.S.C.E.{dagger} and JOSEPH BERNSTEIN, M.D., M.S.{dagger}, PHILADELPHIA, PENNSYLVANIA

Investigation performed at the Sports Medicine Service, University of Pennsylvania School of Medicine and Veterans' Hospital, Philadelphia


   Introduction
 
Classic principles of treatment in orthopaedic surgery—the immobilization of fractures or the draining of infected wounds, for example—were not first established in prospective clinical trials or laboratory experiments. Rather, they were derived from perceptive observation: the methods were seen to work in practice, and they were retained. Observation has a noble history in medicine and science. Still, the modern reader is at least intuitively aware of the limitations of mere observation. Imagine if an investigator were to claim that prophylaxis against deep-vein thrombosis after hip replacement is not needed simply because only two thromboses were observed in ten patients who did not receive prophylaxis compared with three thromboses in ten patients who did. Such a study, were it to be published, would be the object of ridicule.

A single clinical observation is actually a sample of the entire set of possible observations, and methods of statistical inference are needed to . . . [Full Text of this Article]


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