Health economic quality of life the bane of genuine outcomes

As Douglas Adams famously said, the answer to life, the universe and everything is “42”. (Question of course as yet unknown). I was taught as a trainee and a young academic that the perennial problem in conducting research is asking the right question – a point Adams makes very eloquently. If you don’t ask the correct question you clearly will not get a reasonable answer – “garbage in – garbage out”. Over the last few years the quality of orthopaedic research in terms of methodology has skyrocketed. Randomised controlled trials abound and there doesn’t seem to be an edition of 360 that goes by without a number of excellent randomised controlled trials to comment upon. Controversially I have become however increasingly concerned about the RCT. Whilst methodologically better at addressing biases there is a risk in the orthopaedic community that …