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Level of evidence in hand surgery
Roberto S Rosales1, Luis Reboso-Morales, Yolanda Martin-Hidalgo
1Unit for Hand & Microsurgery, GECOT, Maria del Cristo Ossuna 20, La Laguna, Tenerife, 38204, Spain. titorosales@telefonica.net
BMC Research Notes
|December 4, 2012
Summary
This study analyzed the level of evidence in hand surgery journals. The American Journal of Hand Surgery (JHSA) published the highest level of evidence, followed by the European Journal of Hand Surgery (JHSE) and Ibero-American Journal of Hand Surgery (RICMA).
Area of Science:
- Orthopedics
- Hand Surgery
- Clinical Research Methodology
Background:
- Limited research exists on the evidence levels within hand surgery journals.
- This study addresses this gap by evaluating hand surgery publications.
Purpose of the Study:
- To assess and compare the level of evidence in three key hand surgery journals: Ibero-American (RICMA), European (JHSE), and American (JHSA).
Main Methods:
- Reviewed 932 clinical research papers from 2005-2009 across RICMA, JHSE, and JHSA.
- Classified evidence levels using the Oxford International Classification (Level 1 highest, Level 5 lowest).
- Employed chi-square tests to compare observed and expected frequencies, with significance at p<0.05.
Main Results:
- High agreement observed between and within independent reviewers (Kappa 0.617-0.751).
- RICMA and JHSE predominantly featured Level 4 evidence (>80%), while JHSA had 67.6%.
- RICMA published no Level 1 or 2 studies, contrasting with JHSE (5.9% combined) and JHSA (18.3% combined). RICMA had a higher percentage of Level 3 studies (16.7%) compared to JHSE (11.1%) and JHSA (14.1%).
- All findings were statistically significant (χ2=63.945; p<0.001).
Conclusions:
- The level of evidence in hand surgery research varies significantly by journal.
- The American Journal of Hand Surgery (JHSA) demonstrates the highest evidence level, followed by JHSE, then RICMA.
- Understanding current evidence levels is crucial for advancing the quality of hand surgery clinical research.
