Scientific quality of COVID-19 and SARS CoV-2 publications in the highest impact medical journals during the early phase of the pandemic: A case control study

Background A debate about the scientific quality of COVID-19 themed research has emerged. We explored whether the quality of evidence of COVID-19 publications is lower when compared to nonCOVID-19 publications in the three highest ranked scientific medical journals. Methods We searched the PubMed Database from March 12 to April 12, 2020 and identified 559 publications in the New England Journal of Medicine, the Journal of the American Medical Association, and The Lancet which were divided into COVID-19 (cases, n = 204) and nonCOVID-19 (controls, n = 355) associated content. After exclusion of secondary, unauthored, response letters and non-matching article types, 155 COVID-19 publications (including 13 original articles) and 130 nonCOVID-19 publications (including 52 original articles) were included in the comparative analysis. The hierarchical level of evidence was determined for each publication included and compared between cases and controls as the main outcome. A quantitative scoring of quality was carried out for the subgroup of original articles. The numbers of authors and citation rates were also compared between groups. Results The 130 nonCOVID-19 publications were associated with higher levels of evidence on the level of evidence pyramid, with a strong association measure (Cramer’s V: 0.452, P <0.001). The 155 COVID-19 publications were 186-fold more likely to be of lower evidence (95% confidence interval [CI] for odds ratio, 7.0–47; P <0.001). The quantitative quality score (maximum possible score, 28) was significantly different in favor of nonCOVID-19 (mean difference, 11.1; 95% CI, 8.5–13.7; P <0.001). There was a significant difference in the early citation rate of the original articles that favored the COVID-19 original articles (median [interquartile range], 45 [30–244] vs. 2 [1–4] citations; P <0.001). Conclusions We conclude that the quality of COVID-19 publications in the three highest ranked scientific medical journals is below the quality average of these journals. These findings need to be verified at a later stage of the pandemic.

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Whole Body Vibration Exercises and the Improvement of the Flexibility in Patient with Metabolic Syndrome

Rehabilitation Research and Practice ◽

10.1155/2014/628518 ◽

2014 ◽

Vol 2014 ◽

pp. 1-10 ◽

Cited By ~ 7

Author(s):

Danúbia da Cunha Sá-Caputo ◽

Pedro Ronikeili-Costa ◽

Rafaelle Pacheco Carvalho-Lima ◽

Luciana Camargo Bernardo ◽

Milena Oliveira Bravo-Monteiro ◽

...

Keyword(s):

Metabolic Syndrome ◽

Muscle Power ◽

Whole Body Vibration ◽

Whole Body ◽

Mineral Density ◽

Level Of Evidence ◽

Body Vibration ◽

Pubmed Database ◽

Number Of Publications

Vibrations produced in oscillating/vibratory platform generate whole body vibration (WBV) exercises, which are important in sports, as well as in treating diseases, promoting rehabilitation, and improving the quality of life. WBV exercises relevantly increase the muscle strength, muscle power, and the bone mineral density, as well as improving the postural control, the balance, and the gait. An important number of publications are found in the PubMed database with the keyword “flexibility” and eight of the analyzed papers involving WBV and flexibility reached a level of evidence II. The biggest distance between the third finger of the hand to the floor (DBTFF) of a patient with metabolic syndrome (MS) was found before the first session and was considered to be 100%. The percentages to the other measurements in the different sessions were determined to be related to the 100%. It is possible to see an immediate improvement after each session with a decrease of the %DBTFF. As the presence of MS is associated with poorer physical performance, a simple and safe protocol using WBV exercises promoted an improvement of the flexibility in a patient with MS.

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A Meta-Analysis of Complication Rates Among Different SMAS Facelift Techniques

Aesthetic Surgery Journal ◽

10.1093/asj/sjz045 ◽

2019 ◽

Vol 39 (9) ◽

pp. 927-942 ◽

Cited By ~ 15

Author(s):

Andrew A Jacono ◽

A Sean Alemi ◽

Joseph L Russell

Keyword(s):

Facial Nerve ◽

Nerve Injury ◽

Meta Analysis ◽

Complication Rates ◽

Level Of Evidence ◽

Facial Nerve Injury ◽

Significant Difference ◽

Meta Analyses ◽

Smas Flap

AbstractBackgroundSub-superficial musculo-aponeurotic system (SMAS) rhytidectomy techniques are considered to have a higher complication profile, especially for facial nerve injury, compared with less invasive SMAS techniques. This results in surgeons avoiding sub-SMAS dissection.ObjectivesThe authors sought to aggregate and summarize data on complications among different SMAS facelift techniques.MethodsA broad systematic search was performed. All included studies: (1) described a SMAS facelifting technique categorized as SMAS plication, SMASectomy/imbrication, SMAS flap, high lateral SMAS flap, deep plane, and composite; and (2) reported the number of postoperative complications in participants. Meta-analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsA total 183 studies were included. High lateral SMAS (1.85%) and composite rhytidectomy (1.52%) had the highest rates of temporary nerve injury and were the only techniques to show a statistically significant difference compared with SMAS plication (odds ratio [OR] = 2.71 and 2.22, respectively, P < 0.05). Risk of permanent injury did not differ among techniques. An increase in major hematoma was found for the deep plane (1.22%, OR = 1.67, P < 0.05) and SMAS imbrication (1.92%, OR = 2.65, P < 0.01). Skin necrosis was higher with the SMAS flap (1.57%, OR = 2.29, P < 0.01).ConclusionsThere are statistically significant differences in complication rates between SMAS facelifting techniques for temporary facial nerve injury, hematoma, seroma, necrosis, and infection. Technique should be selected based on quality of results and not the complication profile.Level of Evidence: 2

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Level of Evidence as a Future Gold Standard for the Content Quality of Health Resources on the Internet

Methods of Information in Medicine ◽

10.1055/s-0038-1634354 ◽

2003 ◽

Vol 42 (03) ◽

pp. 220-225 ◽

Cited By ~ 4

Author(s):

E. Amsallem ◽

M. Haugh ◽

B. Lukacs ◽

V. Leroux ◽

B. Thirion ◽

...

Keyword(s):

Health Resources ◽

French Language ◽

Medical Decision ◽

The Internet ◽

Sensitive Information ◽

Level Of Evidence ◽

Content Quality ◽

Internet Resources ◽

Significant Difference

Summary Objective: An assessment of the quality of health information on the Internet is an absolute necessity. In this study ‘sensitive’ information was defined as information found in documents published on the Internet, which could be used in a medical decision. For sensitive information, the main criterion chosen for the quality of the information was an indication of the level of evidence. A survey was conducted using the CISMeF health catalogue to assess how often a score of the level of evidence is mentioned in the information accessible on the Internet in French-language health resources. Methods: Since 1999, members of the CISMeF team have systematically been searching for all documents containing ‘sensitive’ information and verifying whether the level of evidence was explicitly indicated as a score at least once in the document. Results: As of June 2001, 10,190 resources were included in CISMeF; including 2964 textual ‘sensitive’ resources (29.1%). Out of all these resources, only 4.7% (95% confidence interval: 4.0 - 5.5%) indicated the level of evidence. A statistically significant difference in the prevalence of indicating the level of evidence according to resource types (e.g., 18.1% for guidelines compared to 0.0% for teaching material), year of publication (almost three times greater in 1997-2001 compared with 1990-1996) and publishers was observed. Conclusion: As the number of people accessing the growing amount of information on the Internet is increasing daily, publishers have an ethical obligation to inform their readers about the validity of ‘sensitive’ information their sites contain. However, the vast majority of the French language Internet resources that were surveyed do not mention a score of the level of evidence for their sensitive information.

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The Use of Statistics in Medical Research: A Comparison of Wiener Klinische Wochenschrift andWiener Medizinische Wochenschrift

Austrian Journal of Statistics ◽

10.17713/ajs.v36i2.327 ◽

2016 ◽

Vol 36 (2) ◽

Author(s):

Alexander M. Strasak ◽

Qamruz Zaman ◽

Gerhard Marinell ◽

Karl P. Pfeiffer ◽

Hanno Ulmer

Keyword(s):

Statistical Methods ◽

Original Research ◽

Inferential Statistics ◽

Medical Journals ◽

Statistical Quality ◽

Wide Range ◽

Significant Difference ◽

Item Checklist ◽

Published Research

To evaluate the quantity and quality of the use of statistics in Austrian medical journals, all “original research” papers in No. 116/1-12 of Wiener Klinische Wochenschrift (WKW) and 153/1-24, 154/1-24 of Wiener Medizinische Wochenschrift(WMW) were screened for their statistical content. Types, frequencies and complexity of statistical methods applied weresystematically recorded. A 46-item checklist was used to evaluate statistical quality for a subgroup of papers. 74.3% of WKW papers contained inferential methods beyond descriptive statistics. Only 43.7% of WMW papers employed methods of inferential statistics. There was a statistical significant difference regarding the use of statistical methods between the two journals (p = 0:009). In addition, complexity and sophistication of statistical analysis was considerable higher for WKW papers (p = 0:02). Statistical errorsand deficiencies were identified in a large proportion of papers. Although inferential statistics were frequently identified in papers from WKW, only a minority of WMW research had analytical character. Types and frequencies of statistical errors identified, did not vary meaningful from findings of similar studies for a wide range of medical journals. There is reason to assume, that the journal impact-factor does not seem to be a powerful predictor for the statistical quality of published research.

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Computer analysis of the emotional modality of 20 million publications in PUBMED database indicates ways to increase the effectiveness of pharmacotherapy by identifying pseudoscientific publications aimed at negative emotional "pumping" of doctors

Pharmacokinetics and Pharmacodynamics ◽

10.37489/2587-7836-2020-4-19-40 ◽

2021 ◽

pp. 19-40

Author(s):

V. A. Maximov ◽

I. Yu. Torshin ◽

O. A. Gromova ◽

A. N. Galustyan ◽

I. V. Gogoleva ◽

...

Keyword(s):

Evidence Based Medicine ◽

Clinical Medicine ◽

International Standards ◽

Scientific Quality ◽

Evidence Based ◽

Treatment Standards ◽

Pronounced Increase ◽

Pubmed Database ◽

Based Medicine

The search for original publications on fundamental and clinical medicine that would produce results of the highest scientific quality represents an urgent need for every medical researcher. Such publications are essential, in particular, for the development of reliable treatment standards. The Englishlanguage resources PUBMED and EMBASE are essential to help in solving this problem. However, there is an obvious problem in assessing the quality of the studies found. The paper formulates a method for analyzing the texts of biomedical publications, which is based on an algorithmic assessment of the emotional modality of medical texts (so-called sentiment analysis). The use of the topological theory of data analysis made it possible to develop a set of high-precision algorithms for identifying 16 types of sentiments (manipulative turns of speech, research without positive results, propaganda, falsification of results, negative personal attitude, aggressiveness of the text, negative emotional background, etc.). On the basis of the developed algorithms, a point scale for assessing the sentiment quality of research was obtained, which we called the "β-score": the higher the β-score, the less the evaluated text contains manipulative language constructions. As a result, the ANTIFAKE system (http://antifake-news.ru) was developed to analyze the sentiment-quality of Englishlanguage scientific texts. An analysis of ~ 20 million abstracts from PUBMED showed that publications with low sentiment quality (β-score <0, that is, that the prevalence of manipulative constructions over meaningful ones) is only 19 %. In the overwhelming majority of thematic headings (27,090 out of 27,840 headings of the MESH system PUBMED), a positive dynamics of sentiment quality of the texts of publications is shown by years). At the same time, as a result of the study, 249 headings were identified with sharply negative dynamics of sentiment quality and with a pronounced increase in manipulative sentiments characteristic of the "yellow" English-language press. These headings include tens of thousands of publications in peer-reviewed journals, which are aimed at (1) legalizing ethically unacceptable practices (euthanasia, perversions, so-called "population control", etc.), (2) discrediting psychiatry as a science, (3) media the war against micronutrients and (4) discrediting evidence-based medicine under the guise of developing the so-called "international standards of evidence-based medicine". In general, the developed system of artificial intelligence allows researchers to filter out pseudoscientific publications, the text of which is overloaded with emotional manipulation and which are published under the guise of "evidence-based standards".

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Female-to-Male Gender-Confirming Drainless Mastectomy May Be Safe in Obese Males

Aesthetic Surgery Journal ◽

10.1093/asj/sjz335 ◽

2019 ◽

Vol 40 (3) ◽

pp. NP85-NP93

Author(s):

Eric M Pittelkow ◽

Stephen P Duquette ◽

Farrah Rhamani ◽

Corianne Rogers ◽

Sidhbh Gallagher

Keyword(s):

Gender Dysphoria ◽

Medical Condition ◽

Perioperative Outcomes ◽

Morbidly Obese ◽

Level Of Evidence ◽

Transgender People ◽

Super Obese ◽

Significant Difference ◽

Transgender Men

Abstract Background Gender dysphoria is a medical condition associated with suicidality. Transgender men who have undergone female-to-male (FTM) chest reconstruction report higher quality of life and reduced gender dysphoria. It has been reported that transgender men are at higher risk of obesity. Objectives The objective of this study was to compare perioperative outcomes and complications between different classes of obesity in FTM transgender patients who underwent chest masculoplasty. Methods A retrospective review of 145 consecutive patients who underwent mastectomy with free nipple graft was conducted. Postoperative outcomes and complications were collected. Patients were divided into nonobese (body mass index [BMI] <30 kg/m2), obese (BMI 30-39.9 kg/m2), morbidly obese (BMI 40-49.9 kg/m2), and super obese (BMI >50 kg/m2) groups. Results Sixty-six of the 145 patients were not obese, 52 were obese, 22 were morbidly obese, and 5 were super obese. There was a statistically significant increase in amount of breast tissue resected between each of the 4 groups (866.8 g vs 1672.4 g vs 3157.1 g vs 4827.6 g; P ≤ 0.0005) as BMI increased, respectively. There was a significant difference in operative time between the nonobese and obese groups (128.7 vs 134.6 vs 150.5 vs 171 minutes; P = 0.026). A significant increase in postoperative infections was observed between the morbidly obese, super obese, and the nonobese group (P = 0.048). Conclusions Chest wall reconstruction in FTM and nonbinary transgender people is important in relieving gender dysphoria. Postoperative complications were not significantly increased in obese patients (30-39.9 kg/m2). Delaying surgery for weight loss may not be necessary unless patients are morbidly obese. Level of Evidence: 4

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Incidence of and Functional Significance of Floating Toe After Weil Osteotomy

Foot & Ankle Orthopaedics ◽

10.1177/2473011419891956 ◽

2019 ◽

Vol 4 (4) ◽

pp. 247301141989195

Author(s):

Emilio Wagner ◽

Luis A. O’Connell ◽

Ruben Radkievich ◽

Nathaly Caicedo ◽

Pablo Mococain ◽

...

Keyword(s):

Clear Correlation ◽

Functional Scale ◽

Level Of Evidence ◽

Patient’S Satisfaction ◽

Significant Difference ◽

The Mean ◽

American Orthopaedic ◽

Toe Deformity

Background: The most frequent complication after Weil osteotomies is a floating toe deformity, but there are no reports about its effect on the patient. In this study, we analyzed the consequences of floating toe deformities after the performance of a modified Weil osteotomy (MWO) or a modified Weil osteotomy with interphalangeal fixation (MWOIF). Methods: We performed a retrospective review with a prospective follow-up of 50 patients (98% women, 120 rays) who underwent MWO (65 rays) or MWOIF (55 rays), with a mean age of 54 ± 12 years and a minimum follow-up of 4 years (mean of 6 years). We analyzed the presence of floating toe deformity in MWO and MWOIF and the outcomes measured by the subjective satisfaction, Lower Extremity Functional Scale (LEFS), American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, and quality of prehension force between patients with or without floating toe deformity. Results: The mean floating toe incidence was of 57%, with no significant difference between operative techniques (48% MWO, 67% MWOIF; P = .053). Our analysis did not show differences in satisfaction, LEFS and AOFAS scores, or grip strength between the group of patients with or without floating toes. Conclusion: The presence of a floating toe deformity was more frequent than generally believed but did not have a meaningful impact on the patient’s satisfaction or functional outcomes measured by the AOFAS and LEFS scales. There was no clear correlation between operative technique, floating toe, and quality of prehension force. Level of Evidence: Level III, retrospective comparative series.

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SURGICAL CORRECTION OF POST-TRAUMATIC KYPHOSIS WITH OSTEOTOMIES IN THE SPINE

Coluna/Columna ◽

10.1590/s1808-185120191801215074 ◽

2019 ◽

Vol 18 (1) ◽

pp. 60-63 ◽

Cited By ~ 1

Author(s):

José María Jiménez Avila ◽

Omar Sánchez García ◽

Paula Aranguren Vergara ◽

Arelhi Catalina González Cisneros

Keyword(s):

Sagittal Balance ◽

The Body ◽

Level Of Evidence ◽

Significant Difference ◽

Before And After ◽

Spinopelvic Balance ◽

Post Traumatic ◽

L1 And L2 ◽

Indications And Complications

ABSTRACT Objective: To analyze the clinical and radiological evolution, indications and complications of the types of osteotomies in patients with disturbed sagittal balance (SB) resulting from post-traumatic kyphosis. The SB can be measured with a plumb line from the center of the body of C7 to S1, which allows recognizing the misalignment. The imbalance can be corrected by osteotomy. Methods: Thirty patients with SB loss due to post-traumatic kyphosis were studied from January 2014 to December 2017. SPO, PSO and VCR were performed to evaluate the degree of kyphosis before and after surgery, the Oswestry questionnaire was applied and the degree of correction, the days of hospital stay and transoperative bleeding were assessed. Results: Age, 50 years, SD = 14, follow-up time: 2-3 years. We performed 11 (36.7%) osteotomies of S-P, 17 (56.7%) pedicle subtractions and 2 (6.6%) vertebrectomies. Most of the lesions were found between levels L1 and L2; the complications were dehiscence of the surgical wound in 4 patients (13.3%) and infection in 2 (6.6%). The minimum surgical time was 3 hours; the Oswestry questionnaire did not showed statistically significant difference during the preoperative period, however, considerable improvement was observed 2 years after surgery. Conclusions: The use of corrective vertebral osteotomies significantly re-establishes the spinopelvic balance altered by different pathologies. It allows correcting in a single surgery the sagittal balance, achieving corrections from 10° to 40°, depending on the type of osteotomy performed, being a safe and effective procedure, which allows to restore the spinopelvic balance, improving the quality of life of the patients. Level of Evidence IIb; Prospective cohort study.

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The Evidence Base of Neuropsychological Rehabilitation in Acquired Brain Impairment (ABI): How Good is the Research?

Brain Impairment ◽

10.1375/brim.7.2.119 ◽

2006 ◽

Vol 7 (2) ◽

pp. 119-132 ◽

Cited By ~ 19

Author(s):

Michael Perdices ◽

Regina Schultz ◽

Robyn Tate ◽

Skye McDonald ◽

Leanne Togher ◽

...

Keyword(s):

Research Design ◽

Methodological Quality ◽

Case Series ◽

Evidence Base ◽

Speech Disorders ◽

Single Subject ◽

Target Area ◽

Level Of Evidence ◽

Significant Difference

AbstractIn the context of evidence-based clinical practice (EBCP), the reliability of empirical data is largely determined by the methodological quality of research design. PsycBITE™ (Psychological Database of Brain Impairment Treatment Efficacy) is a web-based database listing all published, empirical reports on the effectiveness of nonpharmacological interventions for the psychological consequences of acquired brain impairment (ABI). The aim of this study was to survey the listings of PsycBITE™ and examine the methodological quality of the reports it contains. Reports listed in PsycBITE™ include systematic reviews (SRs), randomised controlled trials (RCTs), non-RCTs, case series (CSs) and single-subject designs (SSDs). They are indexed according to research design, neurological group, patient age group, target area and intervention type. The PEDro Scale is used to rate the methodological quality of RCTs, nonRCTs and CSs, with maximum obtainable methodological quality rating (MQR) of 10/10, 8/10 and 2/10 respectively. A search identified 1298 reports indexed in PsycBITE™. The largest proportion was SSDs (39%), followed by CSs (22%), RCTs (21%), non-RCTs (11%) and SRs (7%). The majority of reports was concerned with stroke (41%), traumatic brain injury (29%) and Alzheimer's and related dementias (22%). The most frequently investigated deficits were communication/language/speech disorders (24%); independent/self-care activities (19%); behaviour problems (17%); memory impairments (17%); anxiety, depression, stress, adjustment (15%). Approximately half of the RCTs, non-RCTs and CSs were rated for methodological quality. Mean MQR scores for RCTs, non-RCTs and CSs were 4.49, 2.85 and 1.15 respectively. While some PEDro criteria were met by a high proportion of RCTs and non-RCTs (≥ 70%), other criteria were only met by a small proportion of reports (as low as 1.6%). There was no significant difference in MQR scores between RCTs focusing on different neurological groups or target areas. Furthermore, there was no discernible improvement in MQR score for RCTs published over the last three decades. The methodological quality of studies investigating the efficacy of rehabilitation interventions in ABI has been consistently modest over several decades. This is largely attributable to poor adherence to fundamental tenets of research design, and requires urgent remediation. RCTs (and to a lesser extent, non-RCTs) are research methodologies which can potentially yield a high level of evidence, but only if they are adequately designed. PsycBITE™ has the facility to raise awareness of these issues and be instrumental in promoting EBCP in the field of ABI.

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Standards for reporting randomized controlled trials in neurosurgery

Journal of Neurosurgery ◽

10.3171/2010.8.jns091770 ◽

2011 ◽

Vol 114 (2) ◽

pp. 280-285 ◽

Cited By ~ 33

Author(s):

Erin N. Kiehna ◽

Robert M. Starke ◽

Nader Pouratian ◽

Aaron S. Dumont

Keyword(s):

New England ◽

Randomized Controlled Trials ◽

Controlled Trials ◽

Jadad Score ◽

Quality Of Reporting ◽

Medical Journals ◽

Journal Editors ◽

Randomized Controlled ◽

Neurosurgical Patients

Object The Consolidated Standards for Reporting of Trials (CONSORT) criteria were published in 1996 to standardize the reporting and improve the quality of clinical trials. Despite having been endorsed by major medical journals and shown to improve the quality of reported trials, neurosurgical journals have yet to formally adopt these reporting criteria. The purpose of this study is to evaluate the quality and reporting of randomized controlled trials (RCTs) in neurosurgery and the factors that may affect the quality of reported trials. Methods The authors evaluated all neurosurgical RCTs published in 2006 and 2007 in the principal neurosurgical journals (Journal of Neurosurgery; Neurosurgery; Surgical Neurology; Journal of Neurology, Neurosurgery, and Psychiatry; and Acta Neurochirurgica) and in 3 leading general medical journals (Journal of the American Medical Association, Lancet, and the New England Journal of Medicine). Randomized controlled trials that addressed operative decision making or the treatment of neurosurgical patients were included in this analysis. The RCT quality was evaluated using the Jadad score and the CONSORT checklist. Results In 2006 and 2007, 27 RCTs relevant to intracranial neurosurgery were reported. Of these trials, only 59% had a Jadad score ≥ 3. The 3 major medical journals all endorsed the CONSORT guidelines, while none of the neurosurgical journals have adopted these guidelines. Randomized controlled trials published in the 3 major medical journals had a significantly higher mean CONSORT score (mean 41, range 39–44) compared with those published in neurosurgical journals (mean 26.4, range 17–38; p < 0.0001). Jadad scores were also significantly higher for the major medical journals (mean 3.42, range 2–5) than neurosurgical journals (mean 2.45, range 1–5; p = 0.05). Conclusions Despite the growing volume of RCTs in neurosurgery, the quality of reporting of these trials remains suboptimal, especially in the neurosurgical journals. Improved awareness of the CONSORT guidelines by journal editors, reviewers, and authors of these papers could improve the methodology and reporting of RCTs in neurosurgery.

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