Levels of Evidence in Plastic and Reconstructive Surgery Research: Have We Improved Over the Past 10 Years?

Sugrue, Conor M.; Joyce, Christopher; Carroll, Sean M.

doi:10.1097/gox.0000000000002408

Cited by 33 publications

(23 citation statements)

References 16 publications

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“…The methodology of this study was similar to that used in various assessments of the levels of evidence in other medical disciplines. Literature searches in other studies have ranged from a single journal at discrete time points to multiple databases with no publication date limitations ( 5 , 7 – 9 , 15 , 16 ). Because there is no “gold-standard” literature search, it is impossible to know the sensitivity and specificity of this sample of small animal dentistry and oral surgery publications.…”

Section: Discussionmentioning

confidence: 99%

“…Statistical analysis based on kappa coefficients revealed good agreement between reviewers, which was consistent with findings from another study that investigated intra-observer reliability when assigning study type and level of evidence ( 8 ). Although collecting data on subdiscipline was not novel ( 7 ), to the authors' knowledge, this was the first study on EBM that also collected data on authorship affiliation and funding sources. Journal impact factor has been compared between levels of evidence in other EBM studies ( 15 , 16 ).…”

Section: Discussionmentioning

confidence: 99%

“…Within several disciplines in both human and veterinary medicine, levels of evidence have been considered and assessed. For example, several articles on evidence-based medicine have been published in plastic and reconstructive surgery journals ( 5 – 7 ), pediatric orthopedics ( 8 ), and veterinary surgery ( 9 , 10 ) and the American Society of Plastic Surgeons has adopted a series of evidence rating scales to guide clinicians in assessing the quality of published results ( 11 ). Some categorization systems are limited by the type of research questions allowed: studies comparing treatment outcomes are inherently different than studies investigating prognosis, diagnosis, or economic analysis.…”

Section: Introductionmentioning

confidence: 99%

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Levels of Evidence in Small Animal Dentistry and Oral Surgery Literature Over 40 Years

et al. 2020

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Veterinary dentistry and oral surgery are relatively new clinical disciplines that have rapidly evolved in the last few decades. Although clinical standards of care are supported by a growing body of literature, the extent to which peer-reviewed, evidence-based studies have contributed to advancing the practice of dentistry and oral surgery has not been assessed. The purpose of this study was to survey literature on the clinical practice of small animal dentistry and oral surgery published over the past 40 years to evaluate the levels of evidence over time, authorship affiliation, funding, and clinical subdisciplines within the field. A literature search was conducted in PubMed and the identified articles were screened for inclusion. A total of 1,083 articles were included for final analysis. Three reviewers independently assessed and assigned each article to one of nine predetermined study design categories. Systematic reviews and meta-analyses were considered the highest level of evidence, whereas expert opinion and experimental (ex vivo, in vitro, or in silico) studies were deemed the lowest levels of evidence. For statistical analysis and interpretation, study type was dichotomized into high evidence designs from which causal inference and/or associations could be derived, and low evidence designs which were purely descriptive or non-clinical experiments. No statistically significant difference in the distribution of study type was seen over time, with the majority of research in the last 5 years being largely at high risk of bias and descriptive in nature: 80.6% of articles published between 2014 and 2019 were assigned to the low evidence design tier. The type of study was found to differ by author affiliation: high evidence study designs were found more often than expected when author affiliation was multiinstitutional or industrial, whereas private practice authorship was underrepresented in the high evidence design tier. To meet the increasing demand for evidence-based studies on the practice of dentistry and oral surgery in dogs and cats, researchers are encouraged to consider study design when testing hypotheses to improve the quality of research.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Levels of Evidence in Small Animal Dentistry and Oral Surgery Literature Over 40 Years

et al. 2020

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“…These levels have been modified and refined over the years, starting from (Sackett 1989), and adapted to both the intervention (therapeutic phase) and the diagnosis (for an overview, see Burns et al 2011), leading to a 5-level scale ordered from the strongest to the least reliable source of evidence (see for instance the guidelines provided for plastic surgery: Evidence-based clinical practice guideline: breast reconstruction with expanders and implants, 2013; these levels are taken for granted in all medical studies, see Sugrue et al 2019). The common feature of these distinctions and ordering is the principle underlying the assessment of evidence, namely the so-called resistance to certain biases, such as selection bias and observer bias (Upshur 2009, p. 266).…”

Section: Levels Of Evidence In Medical Studiesmentioning

confidence: 99%

The Role of Evidence in Chronic Care Decision-Making

Macagno

Bigi

2020

Topoi

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In the domain of medical science, factual evidence is usually considered as the criterion on which to base decisions and construct hypotheses. Evidence-based medicine is the translation of this approach into the field of patient care, and it means providing only the type of care that is based on evidence that proves its effectiveness and appropriateness. However, while the literature has focused on the types and force of evidence used to establish the recommendation and treatment guidelines, the problem of how evidence is used in doctor-patient interactions to motivate, or refuse, treatment or habit change has been almost completely neglected. In this specific context, characterized by the epistemic unbalance between the interlocutors and a specific conversational goal (making a decision shared by the patient), the scientific categories of evidence are often irrelevant. The goal of this paper is to address this challenge by analyzing the role evidence plays in doctor-patient interactions in diabetes care. After introducing an analytical distinction between the epistemic and the pragmatic aspect of evidence, we will propose a classification of the types and functions of evidence in chronic care communication, and illustrate its possible uses through its application to our corpus of diabetes-care consultations. From our qualitative analyses, it is possible to observe how in this communicative context a crucial role is played by the conflicts of evidence, in which providers correct patients' uses of evidence leading them to using less defeasible levels of evidence.

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“…A level of evidence is also often designated to published articles to denote the quality of study design. 5 …”

Section: Introductionmentioning

confidence: 99%

The 100 Most-cited Articles in Abdominoplasty: A Bibliometric Analysis

Khajuria

Charles

Dutt

et al. 2021

Plastic and Reconstructive Surgery - Global Open

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Background: Abdominoplasty is one of the most common aesthetic procedures performed globally. Research in this field is evolving, with recent emphasis on evidence-based surgery optimizing informed consent. This bibliometric analysis aimed to characterize emerging research trends and to assess the methodological quality of the highest impact abdominoplasty research. Methods: The 100 most-cited articles in abdominoplasty were identified on Web of Science, across all available journals and years (1950–2019). Study details, including the citation count, main subject, and outcome measures, were extracted from each article by 2 independent reviewers. The level of evidence of each study was also assessed. Results: The 100 most-cited articles in abdominoplasty were cited by a total of 2545 articles. Citations per article ranged from 206 to 34 (mean 65). Overall, 50 articles were assessed to be level of evidence 3, which is representative of the large number of cohort studies (n = 59) on the list. Similar numbers achieved levels 2, 4, and 5 (n = 16, 20, and 14), though none reached level 1. The main subject was operative technique in 50 articles, followed by outcomes in 34 articles. Only 7 articles utilized objective cosmetic outcome measures. Patient-reported outcome measures were employed in 25 articles, though only 5 incorporated validated questionnaires. Conclusions: The most-cited research in abdominoplasty largely comprised low-to-moderate quality studies, with no article achieving the highest level of evidence. Contemporary high-quality evidence incorporating validated outcome measures is crucial to enhance shared decision-making, particularly in aesthetic procedures.

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Levels of Evidence in Plastic and Reconstructive Surgery Research: Have We Improved Over the Past 10 Years?

Cited by 33 publications

References 16 publications

Levels of Evidence in Small Animal Dentistry and Oral Surgery Literature Over 40 Years

Levels of Evidence in Small Animal Dentistry and Oral Surgery Literature Over 40 Years

The Role of Evidence in Chronic Care Decision-Making

The 100 Most-cited Articles in Abdominoplasty: A Bibliometric Analysis

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