Clinical studies in surgical journals--have we improved?

Area of Science:

• Medical research methodology
• Surgical study design evaluation
• Clinical trial analysis

Background:

• Assessing the evolution of clinical study designs and quality in surgical literature.
• Examining research trends in Diseases of the Colon and Rectum (DCR), Surgery (SURG), and the British Journal of Surgery (BJS) over a decade.
• Classifying clinical studies into case studies and comparative studies, including randomized controlled trials (RCTs).

Observation:

• Comparative studies represented 16% in 1980 and 17% in 1990 of all clinical studies.
• Randomized controlled trials (RCTs) constituted 7% of comparative studies in both 1980 and 1990.
• The British Journal of Surgery (BJS) published 68% of all RCTs reviewed.

Findings:

• The overall proportion of comparative studies and RCTs showed no significant increase between 1980 and 1990.
• The quality score for comparative studies marginally increased from 5.49 to 6.04, and for RCTs from 7.06 to 7.70, though not statistically significant.
• Diseases of the Colon and Rectum (DCR) showed a significant improvement in comparative study quality from 1.67 to 5.47, surpassing its previous lower standard.

Implications:

• Despite a decade of research, there was no substantial shift towards more robust clinical trial methodologies in prominent surgical journals.
• While overall study quality saw a slight, non-significant increase, specific journals demonstrated improvements, suggesting potential for targeted enhancements.
• The findings highlight a need for greater emphasis on rigorous research designs to advance evidence-based surgical practice.