Introducing Levels of Evidence to the Journal

Wright, James G.; Swiontkowski, Marc F.; Heckman, James D.

doi:10.2106/00004623-200301000-00001

Cited by 1,078 publications

(294 citation statements)

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“…Level of evidence was assigned to each article where this applied [38]. Traditional quantification of clinical studies cannot be performed because the variability of studies conducted ranged from patient studies to cadaveric models to anthropomorphic models that mimic the human body, also known as phantoms.…”

Section: Search Strategy and Criteriamentioning

confidence: 99%

Does Less Invasive Spine Surgery Result in Increased Radiation Exposure? A Systematic Review

Khan

2014

Clinical Orthopaedics &Amp; Related Research

104

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Section: Search Strategy and Criteriamentioning

confidence: 99%

Does Less Invasive Spine Surgery Result in Increased Radiation Exposure? A Systematic Review

Khan

2014

Clinical Orthopaedics &Amp; Related Research

104

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“…In recent years, orthopaedic surgery has moved toward evidence-based patient management [3,12,15]. Numerous articles and reviews explore the basics of research methodology to provide a sound understanding of proper design and conduct of studies [1,2,5,7,8,11,15].…”

Section: Introductionmentioning

confidence: 99%

“…Numerous articles and reviews explore the basics of research methodology to provide a sound understanding of proper design and conduct of studies [1,2,5,7,8,11,15]. Associations found in trials, however, may derive from four sources: chance, bias, confounding, or a true effect.…”

Section: Introductionmentioning

confidence: 99%

Management of Confounding in Controlled Orthopaedic Trials

Vavken

Culen

Dorotka

2008

Clinical Orthopaedics &Amp; Related Research

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Confounding occurs when the effect of an exposure on an outcome is distorted by a confounding factor and will lead to spurious effect estimates in clinical studies. Although confounding can be minimized at the design stage, residual confounding may remain. An argument therefore can be made for controlling for confounding during data analysis in all studies. We asked whether confounding is considered in controlled trials in orthopaedic research and hypothesized the likelihood of doing so is affected by participation of a scientifically trained individual and associated with the magnitude of the impact factor. We performed a cross-sectional study of all controlled trials published in 2006 in eight orthopaedic journals with a high impact factor. In 126 controlled studies, 20 (15.9%; 95% confidence interval, 9.5%-22.3%) studies discussed confounding without adjusting in the analysis. Thirty-eight (30.2%; 95% confidence interval, 22.2%-38.2%) controlled for confounding, although we suspect the true proportion might be somewhat higher. Participation of a methodologically trained researcher was associated with (odds ratio, 3.85) controlling for confounding, although there was no association between impact factor and controlling for confounding. The question remains to what extent the validity of published findings is affected by failure to control for confounding.

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“…The two reviewers independently assigned levels of evidence to each eligible study using the Centre for EvidenceBased Medicine in Oxford guidelines for therapeutic studies [36]. The reviewers used a sample of five studies graded by the senior author (MG) for training.…”

Section: Levels Of Evidencementioning

confidence: 99%

“…Reviewers were not blinded to authors, publication information, or any published level of evidence descriptions. Retrospective controlled studies were graded as Level III and retrospective uncontrolled studies were classified as ''case series'' and graded Level IV [36]. Case reports were included in the analysis and graded as Level V [13,38].…”

Section: Levels Of Evidencementioning

confidence: 99%