Trends in randomized controlled trials in ENT: a 30-year review

Abstract

There is a growth in the demand for clinical practice to be evidence based. Recent years have seen a rise in the number of randomized controlled clinical trials (RCTS). Such trials while acknowledged as the gold standard for evidence can be difficult to perform in surgical specialities. We have recently identified a low proportion of RCTS in the otolaryngology literature. Our aim was to identify any trend in the number of published RCTS within the ENT literature over a 30-year period and to identify which areas of our speciality lend themselves to this form of study design. A Medline search of 10 prominent journals published between 1966 and 1995 was performed. Two hundred and ninety-six RCTS were identified. Only five were published before 1980. Two hundred (71 per cent) of RCTS were in the areas of otology and rhinology. An encouraging trend is seen in RCTS within ENT literature.

Levels of Evidence in the Voice Literature

“…A review of RCTs in the ear, nose, and throat (ENT) literature between 1966 and 1995 in 10 prominent otolaryngology journals identified 296 RCTs, but only five were published before 1980. 6 There also has been a gradual increase in the number of MAs in the ENT literature, although the quality of these studies is variable. 1 Despite the assessments of the general ENT literature, there has not been an evaluation of the quality of evidence in the voice literature.…”

Trends in turbinate surgery literature: a 35-year review

“…The most effective means of assessing treatment modalities is by randomised controlled trials 2 . Although there has been an increase in the number of randomised controlled trials in otolaryngology in the last 30 years, 3 these still only make up a small percentage of all articles published 4 . In otolaryngology, there are a number of procedures that have been practised for many years and yet have limited or contradictory evidence supporting their use 2 .…”

Evidence‐Based Medicine in Otolaryngology, Part 2

“…Between 1998 and 2008, however, the number of systemic reviews increased 15-fold (unpublished data, 2 independent raters evaluated the data according to a previously published protocol). 10 There was 99.5% interrater agreement for RCTs (Kappa 0.85, P < .00001) and 97.0% agreement for systematic reviews (Kappa 0.73, P < .00001). The journals have also featured articles describing the process underlying systematic reviews and featured descriptions of published compendiums of these data.…”

“…10,11 A 11 Thus, a similar number of RCTs were published in less than half the number of journals over one-fifth the amount of time, a 10-fold increase in this type of research publication. Data from a number of published studies and updates suggest that there has been a steady acceleration in both the RCT number and percentage of total studies over time, [10][11][12] as well as an increase in numbers of other prospective study designs. [10][11][12] The randomized and prospective evidence base in otolaryngology rivals and even surpasses that of some other fields.…”