A trial of Japanese versus English translations of orthopaedic evidence reports

Abstract

Background: The gap between evidence and practice is an important problem that may, in part, be exacerbated by language barriers. Methods: We surveyed members of the Japanese Society for Fracture Repair regarding their self-perceived familiarity with evidence-based medicine, and barriers to keeping up with evidence relevant to their practice. We subsequently enrolled these same orthopedic surgeons in a randomized trial to explore the impact of providing 20 electronic links to English or Japanese OrthoEvidence summaries on whether surgeons accessed the link. Results: A total of 106 participants were enrolled in the study, and 105 completed the pre-trial survey. Fifty-seven participants acknowledged barriers to adopting EBM; the three most prominent reasons were lack of time (77%), lack of training in critical appraisal (100%), and language barriers (95%). The mean EBM familiarity score on a 4-point scale, higher scores indicating greater familiarity, was 2.59 (standard deviation [SD] 0.38, 95% confidence interval [CI] 2.52 to 2.66). Our randomized trial found no significant difference in the number of evidence summaries that were accessed whether they were provided in Japanese (median 9, interquartile range[IQR] 5 to 15; n = 52) or English (median 3, IQR 2 to 15; n = 53) (p=0.06). Conclusion: Although most Japanese orthopaedic surgeons acknowledge barriers in adopting EBM into clinical practice, and highlighted language as a key barrier, providing evidence summaries in Japanese did not significantly increase the number that were accessed.