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Do orthopaedic journals provide high-quality evidence for clinical practice?
E Kiter1, V Karatosun, I Günal
1Department of Orthopaedics, Pamukkale University Hospital, Denizli, Turkey.
Archives of Orthopaedic and Trauma Surgery
|May 2, 2003
Summary
High-quality evidence in orthopaedics is scarce. This study found a low proportion of randomized controlled trials and meta-analyses in major journals, highlighting a need for more high-grade evidence to support evidence-based orthopaedic practice.
Area of Science:
- Orthopaedic research
- Evidence-based medicine
Background:
- Randomized controlled trials (RCTs) and meta-analyses represent the highest grade of scientific evidence.
- Scientific journals are primary sources for disseminating research findings.
Purpose of the Study:
- To assess the prevalence of RCTs and meta-analyses in core orthopaedic journals.
- To evaluate the quantity and focus of high-grade evidence in orthopaedic literature.
Main Methods:
- Searched Medline database for RCTs and meta-analyses published between 1966 and 1999.
- Included journals from the Science Citation Index (1999) focused on orthopaedics.
- Independently reviewed and classified abstracts by year, journal, and subject.
Main Results:
- Out of 36,293 articles, only 1.85% were RCTs (671) and 0.03% were meta-analyses (12).
- A rising trend in RCTs was observed, with 81.9% concentrated in four journals.
- Arthroplasty, particularly hip and knee, dominated RCT topics (66% of RCTs, 90.7% of arthroplasty RCTs).
Conclusions:
- Despite an increasing trend, the volume of high-quality evidence (RCTs and meta-analyses) in major orthopaedic journals remains low.
- There is a significant need for more RCTs and meta-analyses to advance evidence-based orthopaedic practice.
- The current evidence base may be insufficient for comprehensive evidence-based decision-making in orthopaedics.