Arthroscopic subacromial decompression versus placebo surgery for subacromial pain syndrome: 10 year follow-up of the FIMPACT randomised, placebo surgery controlled trial.

Name: Αlpha¹ Rigor Record — Arthroscopic subacromial decompression versus placebo surgery for subacromial pain syndrome: 10 year follow-up of the FIMPACT randomised, placebo surgery controlled trial.
Item: Arthroscopic subacromial decompression versus placebo surgery for subacromial pain syndrome: 10 year follow-up of the FIMPACT randomised, placebo surgery controlled trial.
Rating: 100
Author: Αlpha¹

Kanto K, Bäck M, Ibounig T, Björkenheim R, Malmivaara A, Czuba T, Inkinen J, Kalske J, Savolainen V, Sinisaari I, Toivonen P, Taimela S, Järvinen TLN, Paavola M, Finnish Shoulder Impingement Arthroscopy Controlled Trial (FIMPACT) Investigators

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Αlpha¹ Rigor Review — 2.5★ (Weak), 0 critical, 3 high issues for “Arthroscopic subacromial decompression versus placebo surgery for subacromial pain syndrome: 10 year follow-up of the FIMPACT randomised, placebo surgery controlled trial.”

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Αlpha¹ Editorial

This rigor review was examined and confirmed by Αlpha¹ Editorial · August 15, 2026

Αlpha¹ Rigor Review

Rigor Reviewed

2.5 / 5

Weak — serious problems found

Interventional Study

Critical

High-priority

How this rating was calculated▸

Started at 5★ — deductions

IntegrityIntegrity concern ×2−1★
ClaimsOverstated claim−0.5★
ClaimsEfficacy rests on an unvalidated surrogate endpoint−0.5★
ClaimsTreatment effect not shown to be clinically meaningful−0.5★

Model-reported confidence: highReviewer agreement: highEngine: 7.39.0Source: full text

Not verified in this report

Statistics were not checked: no recomputable values were found in this text — no test statistic reported with its degrees of freedom, no effect estimate printed with both a 95% CI and a p-value, and no percentage printed with both its count and its denominator.
The numeric-impossibility checks (GRIM/GRIMMER/DEBIT/SPRITE) did not run: 24 reported means were read, and their group size is not stated where the values are printed (this source has no machine-readable table structure). These checks need the count the mean was averaged over, so none was performed.

Problems surfaced5 types

Numerical inconsistencies1

Values that contradict each other or are impossible for the stated sample: recomputed p-values and test statistics, GRIM/GRIMMER checks on summary numbers, percentages against their own counts, totals against their parts, and estimates against their own confidence intervals.

Internal contradictions in the reported numbersAssessed

Overstated conclusions3

Conclusions that reach past what the paper's own results support — including a significance claim that no longer holds when the statistic is recomputed, and efficacy resting on an unvalidated surrogate endpoint.

Efficacy rests on an unvalidated surrogate endpointAssessed
Treatment effect not shown to be clinically meaningfulAssessed
Conclusions overstated beyond the evidenceAssessed

Data authenticity concerns1

An adversarial read for patterns associated with data that may not be genuine: results that look too clean, implausibly large effects, duplicated data or images, and methods that do not match the results reported.

Other integrity concernAssessed

This Αlpha¹ Rigor Review uses AI Rigor Reviewers trained on a curated corpus of high-fidelity and retracted papers, with expert supervision and curation. It can still make mistakes; verify each finding against the source before relying on it.

This is a rigorously designed and transparently reported randomized placebo-surgery-controlled trial with 10-year follow-up. The paper demonstrates strong methodology across all eight dimensions, with minor reporting gaps (outlier handling, retrospective registration) and a small arithmetic inconsistency in the abstract.

Both reviewers independently scored all dimensions as pass, with only minor divergence on outlier handling (one rated it inadequate). The study type is interventional, agreed by both. Non-applicable criteria (e.g., animal housing, cell line authentication) were excluded. The statistics verification could not recompute any tests due to limited coverage, so statistical correctness is not fully confirmed.

3 major claims checked against the paper's own evidence: 1 not fully backed by the presented evidence (unsupported or overstated).

Premise concern: surrogate not validated for clinical benefit; effect size not shown to be clinically meaningful.

2 integrity concerns flagged (0 high).

Reporting

Eight Dimensions8 pass

The introduction cites eight RCTs and a Cochrane review, acknowledging the consistency of short-term null results and the lack of long-term data. The rationale for the trial is clearly linked to the gap in long-term evidence. Limitations of prior work (e.g., short follow-up, open-label designs) are implicitly addressed by the trial's design and placebo control.

Sub-criteria

prior work citedADEQUATE

premise rationaleADEQUATE

limitations addressedADEQUATE

Per reviewer (2) — the votes behind the verdict

PASSReviewer 1· 90% conf

The paper establishes a clear scientific premise by citing prior RCTs and systematic reviews showing no short-term benefit of ASD, and justifies the need for long-term follow-up.

Evidence

direct quote[Introduction, paragraph 1]

“Yet eight randomised controlled trials have shown with notable consistency that ASD provides no short term (12 to 24 months) or medium term (≤5 years) advantage over placebo surgery or non-surgical management”