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althcare burden that should be considered when forming treatment guidelines and commissioning services. Cite this article Bone Joint J 2021;103-B(5)864-871. This study reviews the past 30 years of research from the Canadian Orthopedic Trauma Society (COTS), to identify predictive factors that delay or accelerate the course of randomized controlled trials in orthopaedic trauma. We conducted a methodological review of all papers published through the Canadian Orthopaedic Trauma Society or its affiliates. Data abstracted included year of