Vertebroplasty, research design, and critical analysis.

RECENT statements from the Association of American Medical Colleges and the Howard Hughes Medical Institute urge medical schools to design a major overhaul of educational curricula with the goal of achieving greater scientific competency of physicians-in-training (1). Interventional radiologists, like all physicians, must be able to critically analyze the medical literature and draw conclusions relevant to their practice. In particular, readers should be able to critically appraise published trials for their research design, results, validity, and generalizability (2–4). Two recent trials on vertebroplasty published by the New England Journal of Medicine (5,6) illustrate these issues quite well. The studies by Buchbinder et al (5) and Kallmes et al (6) represent a useful addition to the growing body of literature analyzing vertebroplasty. However, as is often the case, these first published randomized trials of a relatively new treatment are the starting point for the discussion, and are by no means the final word on the proce-