Abstract
BackgroundIn biomedical research, level of evidence (LOE) indicates the quality of a study. Recent studies evaluating orthopaedic trauma literature between 1998 and 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.MethodsA total of 3449 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.ResultsThe 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.ConclusionsBased 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.
Highlights
In biomedical research, level of evidence (LOE) indicates the quality of a study
Journal selection Articles from the 3 most commonly used Englishlanguage journals publishing orthopaedic trauma and nontrauma research were evaluated for the LOE of their articles: the Journal of Orthopaedic Trauma (JOT) and Journal of Bone and Joint Surgery, American Volume (JBJS-Am) and Clinical Orthopaedics and Related Research (CORR)
LOE of trauma vs. nontrauma studies in JBJS-am and CORR In JBJS-Am, we found a significant difference in the LOE between trauma and nontrauma studies (P = 0.029), with trauma (54 articles; 22.2%) demonstrating a higher percentage of level-I articles than nontrauma (166 articles; 16.1%)
Summary
Level of evidence (LOE) indicates the quality of a study. Recent studies evaluating orthopaedic trauma literature between 1998 and 2013 have indicated that LOE in this field has improved. The concept of level of evidence (LOE) was introduced in 1979 by the Canadian Task Force on the Periodic Health Examination [1] and was designed to support EBM, stratifying research designs according to their validity. The Oxford Centre for Evidence-Based Medicine (OCEBM) published the guidelines for LOE for prognostic, diagnostic, and therapeutic studies in 2009 [2]. The Journal of Bone and Joint Surgery, American Volume (JBJS-Am) was the first orthopaedic journal to apply the classification system and has assigned LOE for all studies it has published since 2003 [4]
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