Each dot is one simulated patient: how well the ankle worked, against how well the soft tissue held. Hover a dot, or resample the cohort to watch the shape hold.
Simulated — the dots are invented, not measured. A real geometric analysis of clinical outcomes needs each patient's function paired with that same patient's harm. The paper reports group means and event counts, so no patient-level data exists to plot. The cloud below is generated from the published complication counts (5 of 109 versus 21 of 103) and the published functional difference (standardised mean difference 0.11); the soft-tissue axis and the correlation between the two axes are assumed. Press resample and every dot moves — the counts and the centres are real, the dots never were. It is a way of seeing the idea, not a measurement.
A risk ratio has no units a patient can feel. Its absolute value depends entirely on how much risk you brought to the table.
The slider is a teaching device, not a prediction. It carries one pooled risk ratio across baseline risks it was never measured at. The source paper states that this risk ratio may not be generalisable and does not reflect the baseline risk of the patients analysed, and that the sample may not represent the high-risk population the nail was designed for. It also notes that some complications may have been delayed beyond the 12-month window rather than prevented. The 37% preset is the comparator risk assumed in the paper's own GRADE table; the paper does not explain where it came from, and it matches no control rate in the study.
What is real: 5 of 109 versus 21 of 103 complications; Olerud–Molander standardised mean difference 0.11 (−0.17 to 0.39); complication risk ratio 0.30 (0.12–0.74); bony union 1.00 (0.96–1.04). Three randomised trials, 12-month follow-up, I² = 0%. What is invented: every dot, the soft-tissue axis, and the pairing between the two axes. Source: Walsh JP, Hsiao MS, LeCavalier D, McDermott R, Gupta S, Watson TS, “Clinical outcomes in the surgical management of ankle fractures: a systematic review and meta-analysis of fibular intramedullary nail fixation vs. open reduction and internal fixation in randomized controlled trials,” Foot and Ankle Surgery 2022;28(7):836–844. — OrthoScenius