Ten-Year Trends in Level of Evidence in Hand Surgery

Area of Science:

• Orthopedics
• Hand Surgery
• Medical Literature Analysis

Background:

• Analysis of evidence quality in hand surgery literature is crucial for understanding research trends.
• The Oxford Level of Evidence (LOE) is a standard for assessing study quality.
• Journal Impact Factor (IF) and SCImago Journal Rank (SJR) are key metrics for journal influence.

Purpose of the Study:

• To analyze trends in Oxford Level of Evidence (LOE) in hand surgery journals from 2009-2018.
• To examine the relationship between LOE, journal impact factor (IF), and SCImago Journal Rank (SJR).
• To assess the LOE of most-cited articles in prominent hand surgery publications.

Main Methods:

• A 10-year review (2009-2018) of articles published in HAND, Journal of Hand Surgery (American Volume) (JHS), and Journal of Hand Surgery (European Volume) (JHSE).
• Data collection included assigned or available LOE for all publications.
• Analysis of trends in LOE, association between LOE and journal metrics (IF, SJR), and citation density.

Main Results:

• A total of 3921 publications were analyzed; Level V evidence was most common (43%), Level I was least common (4%).
• No significant change in Level I studies frequency was observed over the decade.
• HAND and JHS showed trends toward higher LOE, while JHSE trended toward decreased LOE.
• Annual article count and average LOE predicted IF and SJR; citation density correlated with LOE for JHS and HAND.

Conclusions:

• The prevalence of higher-quality evidence in hand surgery literature has increased over the past decade.
• Annual publications, average LOE, and specific evidence levels (I, II, IV) are significant predictors of increasing journal IF and SJR.
• These findings highlight the growing importance of robust evidence in shaping the impact of hand surgery research.