Level of evidence in hand surgery

Rosales, Roberto S.; Reboso-Morales, Luis; Martin-Hidalgo, Yolanda; Lastra-Bosch, Isabel Diez de la

doi:10.1186/1756-0500-5-665

Cited by 21 publications

(27 citation statements)

References 9 publications

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“…Compared with other medical subspecialties, the percentage of studies with high-level evidence (levels I and II) in auricular defects (<1%) was lower than that of aesthetic surgery (16.2%), 12 hand surgery (10.9%), 19 pediatric orthopedics (8.7%), 20 facial plastic surgery (5.8%), 9 and voice literature (4.6%). 21 The ratios of higher level evidence in other subspecialties ranged from 16.2% to 4.6%, yet the percentage in auricle defects was <1%.…”

Section: Comparison With Other Medical Subspecialtiescontrasting

confidence: 46%

“…Evidence-based practice has progressed in the field of auricular defects, but the proportion of high-level studies in auricular defects year of publication(discretized) research (0.41%) was much lower than those of aesthetic surgery, 12 hand surgery, 19 pediatric orthopedics, 20 facial plastic surgery, 9 and voice literature. 21 However, the study period for these other specialties was approximately lasted for 10 years begun in the early 2000s, whereas our 32-year study period began in the early 1980s.…”

Section: Discussionmentioning

confidence: 93%

“…Although an important form of level I evidence in therapeutic research, randomized controlled trials represent a relatively small percentage of studies in most surgical specialties. 7,19,20 Evidence-based practice has not been implemented in surgery to the extent it has in other medical specialties because of ethical issues in surgical trials and difficulty in determining all details of a given procedure in advance. In addition, patient enrollment, loss to follow-up, and high cost make it difficult to conduct randomized controlled trials.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the majority were case series, this also supported the findings of other medical and surgical studies. 9,12,[19][20][21] The numerous level V studies consisted primarily of case reports, expert opinions, and basic science research. Despite the low strength of recommendation for level IV and V studies, they can provide valuable patient care information.…”

Section: Discussionmentioning

confidence: 99%

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A Systematic Review of Levels of Evidence in Auricular Defects Literature

Zhang

2015

Journal of Craniofacial Surgery

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Section: Comparison With Other Medical Subspecialtiescontrasting

confidence: 46%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Systematic Review of Levels of Evidence in Auricular Defects Literature

Zhang

2015

Journal of Craniofacial Surgery

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“…7 These data 7 are in accordance with other findings in other settings. 8 Bibliometric analyses, as performed in these two studies, 7,8 are important because they can potentially have an impact on research policies and academic actions and can pinpoint unnecessary or unethical studies.…”

Section: Introductionmentioning

confidence: 99%

Evidence hierarchies relating to hand surgery: current status and improvement. A bibliometric analysis study

et al. 2017

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BACKGROUND: Hierarchy of evidence is an important measurement for assessing quality of literature. Information regarding quality of evidence within the Brazilian hand surgery setting is sparse, especially regarding whether research has improved in either quality or quantity. This study aimed to identify and classify hand surgery studies published in the two most important Brazilian orthopedics journals based on hierarchy of evidence, with comparisons with previously published data. DESIGN AND SETTING: Bibliometric analysis study performed in a federal university. METHODS: Two independent researchers conducted an electronic database search for hand surgery studies published between 2010 and 2016 in Acta Ortopédica Brasileira and Revista Brasileira de Ortopedia. Eligible studies were subsequently classified according to methodological design, based on the Haynes pyramid model (HP) and the JBJS/AAOS levels of evidence and grades of recommendations (LOR). Qualitative and quantitative data were gathered regarding all studies. Previous data were considered to assess whether the proportion of high-quality studies had improved over time (2000-2009 versus 2010-2016). RESULTS: The final analysis included 123 studies, mostly originating from the southeastern region (78.8%) and private institutions (65%), with self-funding (91.8%). Methodological assessment showed that 15.4% were classified as level I/II using HP and 16.4% using LOR. No significant difference in proportions of highquality studies was found between the two periods of time assessed (5% versus 12%; P = 0.13).CONCLUSION: Approximately 15% of hand surgery studies published in two major Brazilian journals were likely to be classified as high-quality through two different systems. Moreover, no trend towards qualityof-evidence improvement was found over the last 15 years.

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Arthroplasty studies with greater than 1000 participants: analysis of follow-up methods

et al. 2019

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Background The use of patient-reported outcome measures (PROMs) has become a mainstay of orthopedic joint arthroplasty research. Large studies with >1000 participants are vital to orthopedic research, as they allow for comprehensive multivariable analysis. Achieving high follow-up rates minimizes potential response bias. Maintaining adequate follow-up rates becomes more challenging as sample size increases. We aimed to systematically review the present literature to determine the follow-up rates of large cohorts/registries of total joint arthroplasty patients and to identify factors associated with successful collection of PROMs. Methods A comprehensive literature search of PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria were: ≥1000 participants, ≥6 months of postoperative follow-up, and use of validated PROMs postoperatively. Results Of 720 abstracts screened, 21 studies met inclusion criteria. Only 2 studies reported achieving a PROM follow-up rate ≥80%, but neither collected PROMs preoperatively. The median rate of follow-up was 70%, and the median number of patients was 2970. Only 38% (8 of 21) of studies collected baseline PROMs prior to surgery. Conclusions Very few studies in the present literature have collected validated PROMs on ≥1000 patients with ≥80% follow-up; these parameters are conducive to comprehensive multivariable analysis, while maintaining study validity and avoiding follow-up bias. Federal funding and a central coordinating site may be helpful in achieving follow-up in studies of this magnitude. Level of Evidence Level III, systematic review of studies with Level of Evidence I-III.

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Level of evidence in hand surgery

Cited by 21 publications

References 9 publications

A Systematic Review of Levels of Evidence in Auricular Defects Literature

A Systematic Review of Levels of Evidence in Auricular Defects Literature

Evidence hierarchies relating to hand surgery: current status and improvement. A bibliometric analysis study

Arthroplasty studies with greater than 1000 participants: analysis of follow-up methods

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