Tools

ORG-LOC (Level of Confidence) Grading for Randomised Controlled Trials based on Spin in their Abstracts

Grading Criteria Inference
High No or one
non-critical spin		 The abstract provides an accurate and comprehensive summary of the study
Moderate More than one
non-critical spin*		 The abstract may provide an accurate summary of the study
Low One critical spin
with or without
non-critical spin		 The abstract has a critical flaw and may not provide an accurate and comprehensive summary of the study
Critically Low More than one critical spin
with or without
non-critical spin		 The abstract has more than one critical flaw and should not be relied on to provide an accurate and comprehensive summary of the study

* Multiple non-critical spin may diminish confidence in the abstract and it may be appropriate to move the overall appraisal down from moderate to low confidence.




Categorisation of Spin in the Abstracts of Randomised Controlled Trials

Domain Section of Abstract Spin
Critical Title Title claims unsupported benefit
Result Selective reporting of efficacy of outcomes
Selective reporting of harm outcomes
Results focussing on statistically significant within group comparison
Results focussing on statistically significant secondary outcome
Results focussing on statistically significant subgroup analysis
Results focussing on statistically significant modified population analysis
Conclusion Conclusion formulating recommendation not supported by findings
Conclusion claiming safety based on insignificant findings with wide confidence intervals
Conclusion claiming safety based on results without statistical analysis
Conclusion extrapolating findings to different intervention
Conclusion claiming equivalence/comparable effectiveness for insignificant results with wide confidence interval
Conclusion claiming equivalence/comparable effectiveness based results without statistical analysis
Conclusion extrapolating findings of surrogate marker to global disease improvement
Non-Critical Results Focus on relative effect when absolute effect is small
Inadequate focus on magnitude of p value
Conclusion Conclusion focusing selectively on statistically significant outcome
Conclusion extrapolating findings to different population/setting
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ORG Cartilage Treatment Classifier Tool

Cartilage regeneration category:

MFX group

  • First-generation microfracture (MFX-I): Traditional microfracture technique
  • Second-generation microfracture (MFX-II): MFX-I combined with acellular additives such as PRP, HA, collagen
  • Third-generation microfracture (MFX-III): MFX-I combined with cellular additives such as MSCs, BMAC, and SVF

ACI group

  • First-generation ACI (ACI-I): Traditional autologous chondrocyte implantation covered with periosteum
  • Second-generation ACI (ACI-II): Autologous chondrocyte implantation covered with a collagen membrane
  • Third-generation ACI (ACI-III): Autologous chondrocyte implantation using matrix-induced autologous chondrocyte implantation (MACI) techniques as in Cartipatch®, Kartigen® or Neo-cart®

Cartilage restoration category:

OAT group

  • First-generation Osteochondral Auto/Allo-graft transfer (OAT-I): Autologous or allogeneic osteochondral transfer techniques
  • Second-generation Osteochondral Auto/Allo-graft transfer (OAT-II): Multiple autologous or allogeneic osteochondral transfer techniques as in mosaicplasty

Cartilage substitution category:

Implants:

  • Acellular implants such as carbon fiber rods, collagen HA hydrogels, synthetic acellular cartilage analogs such as Cartiva®

* MFX - Microfracture; PRP - Platelet-rich plasma; HA - Hyaluronic Acid; MSC - Mesenchymal Stromal Cell; BMAC - Bone Marrow Aspiate Concentrate; SVF - Stromal Vascular Fraction; ACI - Autologous Chondrocyte Implantation