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Research

Three week versus six week immobilisation for stable Weber B type ankle fractures: randomised, multicentre, non-inferiority clinical trial

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.k5432 (Published 23 January 2019) Cite this as: BMJ 2019;364:k5432

When not knowing poses a risk: when layperson’s approach to understanding research is not enough

Dear Editors

I refer to Dr Timm’s rapid response, which seems to treat different terminologies as having the same meaning.

Please see these resources for the difference between non-inferiority vs equivalence vs superiority trials:

http://hjdbulletin.org/files/archive/pdfs/431.pdf

https://www.nps.org.au/australian-prescriber/articles/making-sense-of-eq...

https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-017-2024-2

https://www.certara.com/2011/01/01/trial-designs-non-inferiority-vs-supe...

https://rpsychologist.com/d3/equivalence/

It is important to understand different comparative goals lead to different needs in research setups.

As healthcare professionals in the age of Evidence Based Medicine, it is important that we all remain current in our understanding of similarities and differences in clinical research rather than simply relying on guidelines and recommendations to dictate our practice.

Revalidation and reaccreditation of healthcare professionals should involve adequate understanding of the science behind Evidence Based Medicine, to create the thinking clinician who is not just following governmental directions.

Competing interests: No competing interests

30 January 2019
Shyan Goh
Orthopaedic Surgeon
Sydney, Australia