scholarly journals Has the Level of Evidence in Orthopaedic Trauma and Nontrauma Publications Improved? A Publication Review of 3 Major Orthopaedic Journals

2020 ◽  
Author(s):  
Kitchai Luksameearunothai ◽  
Yash Paul Chaudhry ◽  
Sorawut Thamyongkit ◽  
Xiaofeng Jia ◽  
Erik A. Hasenboehler
Keyword(s):  
Biomedical Research ◽  
Trauma Studies ◽  
Orthopaedic Trauma ◽  
Level Of Evidence ◽  
Related Research ◽  
Research Level ◽  
Orthopaedic Literature ◽  
Level I ◽  
High Level

Abstract Background In biomedical research, level of evidence (LOE) indicates the quality of a study. Recent studies evaluating orthopaedic trauma literature between 1998-2013 have indicated that LOE in this field has improved. The objective of this study was to determine the validity of one such study by 1) comparing our results and how they relate to more recent years of publications; and 2) assessing how our findings may be used to estimate future changes. Methods A total of 3,449 articles published from 2013 to 2018 in The Journal of Orthopaedic Trauma (JOT); Journal of Bone and Joint Surgery, American Volume (JBJS-Am); and Clinical Orthopaedics and Related Research (CORR) were evaluated for their LOE. Articles published in JBJS-Am or CORR were classified as trauma or nontrauma studies; articles published in JOT were considered trauma studies. Articles were assigned a LOE using guidance published by JBJS-Am in 2015. Results The percentage of total high-level (level I or II) trauma and nontrauma articles published in JOT, JBJS-Am, and CORR decreased from 2013 to 2018 (trauma 23.1% to 19.2%, p = 0.190; nontrauma 28.8% to 24.9%, p = 0.037). JBJS-Am published the highest percentage of level-I trauma studies, and CORR published the lowest percentage of level-IV studies. JBJS-Am and CORR published higher percentages of level-I trauma studies and lower percentages of level-IV nontrauma studies than all trauma studies. Conclusions Based on our results we cannot validate the findings of previous studies as we found the overall LOE of both trauma and nontrauma orthopaedic literature has decreased in recent years. JBJS-Am published a greater percentage of high-level studies than did JOT and CORR. Although the number and percentage of high-level studies published in JOT increased during the study period, it still lagged behind JBJS-Am and CORR.

scholarly journals Quality of information of websites dedicated to obesity: a systematic search to promote high level of information for Internet users and professionals

2021 ◽  
Author(s):  
Alessandra Perra ◽  
Antonio Preti ◽  
Valerio De Lorenzo ◽  
Antonio Egidio Nardi ◽  
Mauro G. Carta
Keyword(s):  
Poor Quality ◽  
Quality Of Information ◽  
Level Of Evidence ◽  
Flesch Reading Ease ◽  
Internet Users ◽  
Treatment Support ◽  
Technological Quality ◽  
Level I ◽  
High Level

Abstract Background The Internet is increasingly used as a source of information. This study investigates with a multidimensional methodology the quality of information of websites dedicated to obesity treatment and weight-loss interventions. We compared websites in English, a language that it is used for the international scientific divulgation, and in Italian, a popular local language. Methods Level of Evidence: Level I, systematic review search on four largely used search engines. Duplicated and unrelated websites were excluded. We checked: popularity with PageRank; technological quality with Nibbler; readability with the Flesch Reading Ease test or the Gulpease readability index; quality of information with the DISCERN scale, the JAMA benchmark criteria, and the adherence to the Health on the Net Code. Results 63 Italian websites and 41 English websites were evaluated. English websites invested more in the technological quality especially for the marketing, experience of the user, and mobile accessibility. Both the Italian and English websites were of poor quality and readability. Conclusions These results can inform guidelines for the improvement of health information and help Internet users to achieve a higher level of information. Users must find benefits of treatment, support to the shared decision-making, the sources used, the medical editor's supervision, and the risk of postponing the treatment.

scholarly journals Safety of Outpatient Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis

Neurosurgery ◽  
2019 ◽  
Vol 86 (1) ◽  
pp. 30-45 ◽  
Author(s):  
Ketan Yerneni ◽  
John F Burke ◽  
Pranathi Chunduru ◽  
Annette M Molinaro ◽  
K Daniel Riew ◽  
...  
Keyword(s):  
Safety Profile ◽  
Meta Analysis ◽  
Anterior Cervical Discectomy ◽  
Complication Rates ◽  
Outpatient Basis ◽  
Level Of Evidence ◽  
Cervical Discectomy ◽  
Significant Difference ◽  
Level I ◽  
High Level

ABSTRACT BACKGROUND Anterior cervical discectomy and fusion (ACDF) is being increasingly offered on an outpatient basis. However, the safety profile of outpatient ACDF remains poorly defined. OBJECTIVE To review the medical literature on the safety of outpatient ACDF. METHODS We systematically reviewed the literature for articles published before April 1, 2018, describing outpatient ACDF and associated complications, including incidence of reoperation, stroke, thrombolytic events, dysphagia, hematoma, and mortality. A random-effects analysis was performed comparing complications between the inpatient and outpatient groups. RESULTS We identified 21 articles that satisfied the selection criteria, of which 15 were comparative studies. Most of the existing studies were retrospective, with a lack of level I or II studies on this topic. We found no statistically significant difference between inpatient and outpatient ACDF in overall complications, incidence of stroke, thrombolytic events, dysphagia, and hematoma development. However, patients undergoing outpatient ACDF had lower reported reoperation rates (P < .001), mortality (P < .001), and hospitalization duration (P < .001). CONCLUSION Our meta-analysis indicates that there is a lack of high level of evidence studies regarding the safety of outpatient ACDF. However, the existing literature suggests that outpatient ACDF can be safe, with low complication rates comparable to inpatient ACDF in well-selected patients. Patients with advanced age and comorbidities such as obesity and significant myelopathy are likely not suitable for outpatient ACDF. Spine surgeons must carefully evaluate each patient to decide whether outpatient ACDF is a safe option. Higher quality, large prospective randomized control trials are needed to accurately demonstrate the safety profile of outpatient ACDF.

Quality of Research and Level of Evidence in Foot and Ankle Publications

2012 ◽  
Vol 33 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Heather L. Barske ◽  
Judith Baumhauer
Keyword(s):  
Clinical Research ◽  
Medical Profession ◽  
Research Articles ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Ankle Surgery ◽  
Ankle Research ◽  
Level I ◽  
Quality Of Research

Background: The quality of research and evidence to support medical treatments is under scrutiny from the medical profession and the public. This study examined the current quality of research and level of evidence (LOE) of foot and ankle surgery papers published in orthopedic and podiatric medical journals. Methods: Two independent evaluators performed a blinded assessment of all foot and ankle clinical research articles (January 2010 to June 2010) from seven North American orthopedic and podiatric journals. JBJS-A grading system was used for LOE. Articles were assessed for indicators of study quality. The data was stratified by journal and medical credentials. Results: A total of 245 articles were published, 128 were excluded based on study design, leaving 117 clinical research articles. Seven (6%) were Level I, 14 (12%) Level II, 18 (15%) Level III, and 78 (67%) Level IV. The orthopedic journals published 78 studies on foot and ankle topics. Of the podiatric journals, the Journal of the American Podiatric Medical Association (JAPMA) published 12 clinical studies and the Journal of Foot and Ankle Surgery (JFAS) published 27, 21 (78%) of which were Level IV studies. When the quality of research was examined, few therapeutic studies used validated outcome measures and only 38 of 96 (40%) gathered data prospectively. Thirty (31%) studies used a comparison group. Eighty-seven articles (74%) were authored by a MD and 22 (19%) by a DPM. Conclusion: Foot & Ankle International (FAI) published higher quality studies with a higher LOE as compared to podiatry journals. Regardless of the journal, MDs produced the majority of published clinical foot and ankle research. Although improvements have been made in the quality of some clinical research, this study highlights the need for continued improvement in methodology within foot and ankle literature.

scholarly journals PO 18213 - Evaluation of hallux valgus treatment through percutaneous

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 46S
Author(s):  
Jorge Eduardo De Schoucair Jambeiro ◽  
Antero Tavares Cordeiro Neto ◽  
Fernando Delmonte Moreira ◽  
José Augusto De Oliveira ◽  
Clara Cristiane Miguelino Sousa ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Surgical Trauma ◽  
Complication Rates ◽  
Percutaneous Surgery ◽  
Aofas Score ◽  
Level Of Evidence ◽  
Percutaneous Procedures ◽  
High Level

Introduction: Hallux valgus (HV) is characterized by the lateral deviation of the first finger, associated with pain and medial exostosis of the first metatarsus. The cause is usually multifactorial. The treatment varies with the degree of deformity and can be conservative or surgical. Percutaneous techniques have gained interest, offering less surgical trauma, fewer complications and faster recovery. The present study aims to evaluate the results of the surgical treatment of hallux valgus through percutaneous surgery.  Methods: A search was performed in PubMed / Medline and BVS, from 2013 to 2018, using as descriptors "hallux valgus" and "percutaneous surgery". Original articles in English, Portuguese and Spanish were included. We excluded systematic reviews, descriptions of surgical technique and publications older than 5 years. The quality of the methodology was evaluated with the help of the STROBE tool, with an emphasis on hallux valgus (HVA), intermetatarsal angle (IMA) and the AOFAS score.  Results: We found 185 references. After applying the inclusion and exclusion criteria, and STROBE tool, 5 articles were eligible, comprising a total of 290 percutaneous procedures. The follow-up time ranged from 6 months to 10 years. We found a reduction of IMA between 3.9º and 9.5º and a reduction of HVA between 12.5º and 26.8º. The AOFAS score ranged from 85 to 97.1 points in the evaluated works.  Discussion: In general, we found a good correction of HV deformity with improvement of HVA, IMA, DMAA and clinical improvement by the postoperative AOFAS score, with low complication rates. However, the heterogeneity of the studies, with variation of techniques and samples did not allow us to generalize the findings. Conclusion: It was possible to note that percutaneous surgery for HV treatment produces good outcomes with low complication rates, but few studies had a high level of evidence demonstrating the efficacy of these techniques, despite encouraging preliminary results.

scholarly journals RELATION BETWEEN IMPACT FACTOR IN ORTHOPEDIC JOURNALS AND LEVEL OF EVIDENCE

2018 ◽  
Vol 26 (4) ◽  
pp. 275-277
Author(s):  
Mauricio Pandini Monteiro de Barros ◽  
Fabio Teruo Matsunaga ◽  
Marcel Jun Sugawara Tamaoki
Keyword(s):  
Impact Factor ◽  
Orthopedic Surgery ◽  
Randomized Clinical Trials ◽  
Point Of View ◽  
Impact Factors ◽  
Level Of Evidence ◽  
High Level ◽  
The Impact ◽  
Source Of Information

ABSTRACT Objective: This study aims to assess the quality of articles published in the leading orthopedic surgery journals, by measuring the relation between the impact factor and the number studies with a high level of evidence. Methods: A literature review was performed of articles published in four previously selected journals. A score of journal evidence (RER - Relation between Randomized clinical trials and Systematic reviews) was calculated, considering the number of RCTs and SR published and the total number of full-text articles. Results: The selected journals were JBJS-Am, ASMJ, BJJ-Br and Arthroscopy, with Impact factors of 5.280, 4.362, 3.309 and 3.206 respectively in 2015. In the study, the RER Scores, in the same order, were 9.408, 6.153, 7.456 and 7.779. Conclusion: The journal JBJS-Am is the best available source of information on orthopedic surgery from this point of view. It has the highest Impact Factor and clearly the highest RER Score. On the other hand, we could conclude that the number of published RCT and good quality SR is very low, with less than 10% of all the articles. Level of evidence III, Analyses based on limited alternatives and costs, and poor estimates.

scholarly journals Trends in Publication and Levels of Evidence in Foot and Ankle International From 2000-2015

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0023
Author(s):  
Matthew Griffith ◽  
Edward Han ◽  
Joshua Hattaway ◽  
Jeannie Huh
Keyword(s):  
Scientific Quality ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Levels Of Evidence ◽  
Publication Rates ◽  
Orthopaedic Literature ◽  
Chi Squared ◽  
Commercial Sources ◽  
Level I ◽  
Study Type

Category: Other Introduction/Purpose: As the movement towards evidence-based medicine grows and publication rates rise each year, critical analysis of the orthopaedic literature has become increasingly important. To aid readers in assessing the scientific quality of published research, Foot and Ankle International (FAI) began assigning levels of evidence to all clinical articles in 2008. The purpose of this study was to analyze trends in the characteristics and levels of evidence of articles published in FAI between 2000 and 2015. Methods: All articles published in FAI from 2000, 2005, 2010, and 2015 were reviewed and categorized into article type (clinical, basic science, review, or technical tip). Each clinical article was assigned a level of evidence (I-V) and study type (prognostic, therapeutic, economic, or diagnostic). Descriptive information was gathered pertaining to: country of origin, authorship, and funding. Statistical analysis was performed using chi-squared tests to detect any trends in levels of evidence and publication characteristics. Results: 647 articles were reviewed from 2000 to 2015. There was a statistically significant increase in the publication of clinical articles (70% to 83%; p=0.013). The publication of levels I and II evidence significantly increased (2.44% to 13.53%; p=0.002). Although levels III-V evidence also increased (65% to 70.6%, p=1.014), this was not statistically significant. Publications originated from 39 countries, with a significant increase in the proportion of international papers (32.8% to 48%%; p=0.007). The proportion of articles authored by Podiatrists during the study period significantly decreased (3.73% to 1.74%, p=0.035). Finally, there was an increase in funding disclosures during the study period; funding from grants or professional groups rose from 2.44% to 15.9% (p<0.001) and reported funding from commercial sources rose from 0% to 9.41% (p=0.002). Conclusion: The proportion of level I and II studies published in FAI significantly increased from 2000 to 2015. The publication of clinical research rose, with a majority being therapeutic studies. There was a significant increase in articles published by international authors and a significant decrease in articles published by DPMs. During the same time period, there was a rise in the proportion of articles reporting the use of outside funding, both professional and commercial.

scholarly journals Publication characteristics of studies published in the The Spine Journal from 2005 to 2015

2019 ◽  
Author(s):  
Joseph Park ◽  
Joseph A. Gil ◽  
Justin Kleiner ◽  
Adam E.M. Eltorai ◽  
Alan H. Daniels
Keyword(s):  
Clinical Decision Making ◽  
Fold Increase ◽  
Clinical Decision ◽  
Funding Source ◽  
Chi Square ◽  
Level Of Evidence ◽  
Level I ◽  
High Level ◽  
Study Type ◽  
Number Of Citations

BACKGROUND CONTEXT: There is a growing demand for evidence-based- practices and informed clinical decision making supported by reliable, high-quality research.PURPOSE: To analyze trends in the level of evidence of publications and to evaluate the publication characteristics that influence the quality of research in The Spine Journal (TSJ)STUDY DESIGN: Comprehensive publication assessment.SAMPLE: All studies published in TSJ from the years 2005, 2007, 2009, 2011, 2013, and 2015 were reviewed and analyzed.OUTCOME MEASURES: Level of evidence, study type, funding source, author country, author department, and number of citations.METHODS:  Multivariable logistic regression, and multivariable linear regression analyses, and chi square tests were used to analyze the trends of published studies level of evidence, study type, the specialties of authors, author countries, number of citations, and funding sources.RESULTS: A total of 1,456 articles were evaluated. There was a decrease in the percentage of high level evidence (level 1 and 2) studies from 73.6% in 2005 to 49.8% in 2015 (p=0.0045). There was a significant increase in the percentage studies with reporting funding support (p<0.0001). Funded studies were more likely to have a higher level of evidence (p<0.0001). The percentage of studies from international authors increased from 17.8% in 2005 to 69.1% in 2015 (p<0.0001). The percentage of studies with orthopedic authors decreased from 67% in 2005 to 44.9% in 2015 with a corresponding increase in the percentage of studies with neurosurgeon authors from 14.4% in 2005 to 23.2% by 2015, as well as an increase in the percentage of studies with a collaboration of authors from both specialties from 5.1% in 2005 to 8.7% in 2015 (p = 0.0007). Orthopedic and neurosurgery collaboration in authorship did not affect the level of evidence of the studies nor the number of citations of the studies (p=0.7583). Earlier studies had a higher SCOPUS citation number but were not affected by the level of evidence (p=0.2515) nor the department of the author(s) (p=0.9107).CONCLUSIONS: The publication characteristics of articles in TSJ have evolved between 2005 and 2015 with a 3.9-fold increase in International authorship and a 32% decrease in the proportion of Level I and Level II studies. Inter-departmental collaboration, funding source, and country of origin may affect level of evidence and number of citations. Continued efforts to increase level of evidence should be considered.

scholarly journals Effectiveness of nursing interventions in preventing and treating radiotherapy side effects in cancer patients: a systematic review

2021 ◽  
Vol 55 ◽  
Author(s):  
Aline Moraes de Abreu ◽  
Duan Renato da Silva Fraga ◽  
Bruna Bastos Giergowicz ◽  
Rosália Borges Figueiró ◽  
Roberta Waterkemper
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Oral Care ◽  
Nursing Interventions ◽  
Patient Centered ◽  
Level Of Evidence ◽  
Centered Care ◽  
Recommendation Grade ◽  
High Level

ABSTRACT Objective: To synthesize the best available evidence on the effectiveness of nursing interventions in radiotherapy patient care and to summarize the evidence on the experience and acceptability of interventions reported by health professionals involved in the prevention and treatment of side effects. Method: A mixed-method systematic review. Quantitative and qualitative studies are presented. Results: Twelve studies published between 2013 and 2017 were included. Most interventions found focused on skin care, oral care, nausea and vomiting and nursing consultation. In accordance with high level of evidence and recommendation grade of the studies, the use of Calendula officinalis and thyme honey were considered effective for preventing and treating radiodermatitis and mucositis, respectively. Conclusion: The quality of evidence of nursing interventions is weak. Although there are studies with a strong design and a high level of evidence, publication of nursing interventions is not enough and does not present a high quality to support practice to plan an effective patient-centered care.

scholarly journals Modern approaches to the prevention and correction of complications caused by systemic treatment of severe acne forms

2019 ◽  
Vol 95 (2) ◽  
pp. 87-93 ◽  
Author(s):  
M. M. Tlish ◽  
M. E. Shavilova
Keyword(s):  
Systemic Treatment ◽  
Life Quality ◽  
Skin Condition ◽  
Level Of Evidence ◽  
Severe Acne ◽  
Therapy Assessment ◽  
Treatment And Prevention ◽  
Comparison Groups ◽  
High Level

Background. According to European and RF clinical guidelines, only the systemic use of isotretinoin in severe acne has a high level of evidence. However, this therapy is frequently associated with the development of retinoid dermatitis, the prevention and correction of which requires the application of emollients. Aim. To evaluate the efficacy and tolerability of the Perfectoin cream during treatment and prevention of retinoid dermatitis in patients with severe acne receiving systemic treatment with isotretinoin.Materials and methods. Two groups of patients each comprising 38 people with moderate, severe and resistant to standard therapy forms of acne were observed. Each group included 22 patients with retinoic dermatitis manifestations and 16 without such symptoms. The patients in the main and comparison groups were prescribed the Perfectoin cream and the dexpanthenol cream, respectively. Control of the skin condition was performed prior to the study and following 1, 3 and 6 months of therapy. Assessment parameters were the main symptoms of retinoid dermatitis (erythema, lichenification, excoriation, itching, feeling of dryness/tightness of the skin), indicators of the hydration of the horny layer of the epidermis and the transepidermal loss of moisture, as well as the dermatology life quality index.Results. The study has shown that the Perfectoin cream in patients with acne receiving isotretinoin therapy helps to restore skin hydration and leads to a rapid regression of the main dermatological symptoms of retinoid dermatitis, thus improving the overall quality of patients’ life.

Talar osteochondral size influences outcome after bone marrow stimulation: a systematic review

2017 ◽  
Vol 2 (6) ◽  
pp. 318-324
Author(s):  
Vincenzo Candela ◽  
Umile Giuseppe Longo ◽  
Mauro Ciuffreda ◽  
Giuseppe Salvatore ◽  
Alessandra Berton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Marrow ◽  
Clinical Outcomes ◽  
Lesion Size ◽  
Osteochondral Lesions ◽  
Level Of Evidence ◽  
Bone Marrow Stimulation ◽  
Marrow Stimulation ◽  
Level I ◽  
High Level

ImportanceNo accepted definition of lesion size exists to treat osteochondral defects (OCD) of talus with bone marrow stimulation.ObjectiveThe aim of this study is to establish a relationship between the clinical outcomes and size of OCD lesion to identify the area or diameter best suited to be treated with arthroscopic bone marrow stimulation.Evidence reviewA search was conducted of level I through IV studies from January 2000 to August 2017, to identify studies reporting on talus OCDs treated with bone marrow stimulation. 21 articles were identified. The overall quality of evidence was fair.Findings21 articles were included in which 1303 ankles with OCD of talus were evaluated. Patients were assessed at a median follow-up period of 38.1 months, ranging from 6.3 to 217 months. Considering a cut-off of an area <1.5 cm2 or with a diameter ≤1.5 cm, the mean postoperative AOFAS (American Orthopaedic Foot and Ankle Society) value was 89.1±3 and 84.65±2.7, respectively (p=0.016).Conclusions and relevanceDespite the current lack of high-level evidence, our results suggest that bone marrow stimulation techniques provide an effective and reliable means to treat small to mid-sized OCD. Arthroscopic bone marrow stimulation for isolated osteochondral lesions of the talus is a safe and effective procedure that provides good clinical outcomes for lesions with an area less than 1.5 cm2 or with a diameter less than 1.5 cm. The attempt to find a new cut-off value to identify more precisely good outcome lesions was unsuccessful. However, the long-term benefits of bone marrow stimulation techniques should be tested in larger cohort of patients with longer term evaluations.Level of evidenceSystematic review, level III.

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