Mellema JJ, Janssen S, Schouten T, et al. - This study was attempted to assess variation in the surgical treatment of stable (A1) and unstable (A2) trochanteric hip fractures among an international group of orthopedic surgeons and determined the influence of patient, fracture, and surgeon characteristics on choice of the implant (intramedullary nailing (IMN) vs sliding hip screw (SHS)). Researchers enrolled a total of 128 orthopedic surgeons in the Science of Variation Group to assess radiographs of 30 patients with Type A1 and A2 trochanteric hip fractures and indicated their preferred treatment: IMN or SHS. They applied multivariate logistic regression models to evaluate if patient, fracture, and surgeon characteristics were independently associated with the choice of implant. There was a large variation in implant preference for patients with A1 and A2 trochanteric fractures in an international cohort of orthopedic surgeons. This is due to surgeon bias (country of practice and aspects of training). For optimizing patient outcomes and promoting value-based healthcare, the observation that surgeons favored the more expensive implant in the absence of convincing evidence of its superiority implies that surgeon de-biasing strategies may be a beneficial.