Closing in on the Truth About Recombinant Human Bone Morphogenetic Protein-2: Evidence Synthesis, Data Sharing, Peer Review, and Reproducible Research

摘要

Readers may think they are seeing double. They are not. This issue includes 2 systematic reviews (1,2) that use the same data to address the same question: Compared with iliac crest bone grafting, does recombinant human bone morphogenetic protein-2 (rhBMP-2) safely improve outcomes of spinal fusion surgery? The Yale University Open Data Access Project commissioned the reviews, believing that confidence in the findings would be greatest if both reached the same conclusions. Both include patient-level meta-analyses of data from randomized, controlled trials (RCTs) obtained from Medtronic (Minneapolis, Minnesota), the manufacturer of rhBMP-2 (3-5). Annals' review involved 2 internal teams of physician and statistical editors and distinct sets of external reviewers. Each team handled 1 manuscript, and neither had access to the other manuscript or associated reviews until both were accepted for publication. The clinical question is of great interest to orthopedic surgeons and relevant to internists who encounter patients who have had or are considering having spinal fusion. Yet, beyond the clinical issues, these dual reviews spotlight the power of evidence synthesis, data sharing, peer review, and reproducible research.