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Neurosurgical Review

, Volume 26, Issue 4, pp 257–261 | Cite as

Level of evidence and citation index in current neurosurgical publications

  • Ralf D. Rothoerl
  • Joerg Klier
  • Chris Woertgen
  • A. Brawanski
Original Article

Abstract

Systematic clinical reviews or meta-analyses offer scientifically valid sources of clinical information. They provide information in a concise form and can contribute to clinical quality management. Such studies, however, are only able to reflect the quality of the articles reviewed. The aim of this study was to evaluate the quality of the neurosurgical literature according to evidence-based medicine (EBM) standards. We reviewed all articles published in 1999 in three major neurosurgical journals. These articles were subdivided according to the level of evidence (LOE) scale (from 0 to V), article type, and citation index. Nine hundred eighty-two articles were published in these journals in 1999. Of these, 346 (35%) were clinical studies, 287 (29%) case reports, 153 (16%) experimental studies, 122 (13%) technical reports, and 74 ( 8%) other types. Subdivision according to LOE was: Ia 0.3%, Ib 2.5%, IIa 0.2%, IIb 4.3%, IIc 9.5%, IIIa 0.1%, IIIb 3.9%, IV 22.4%, and V 1.6%. Fifty-five percent of all published studies were case reports, experimental studies, technical reports, or others and thus could not be subdivided according to the EBM standards. The number of articles published with high LOE seems to be rather low in 1999. If these data reflect overall publication practice, it seems unclear whether enough articles with high LOE are published to propose scientifically sound clinical treatment suggestions according to EBM standards.

Keywords

Citation index Evidence-based medicine Literature review 

References

  1. 1.
    Cook DJ, Guyatt GH, Laupacis A, Sackett DL, Goldberg RJ (1995) Clinical recommendations using levels of evidence for antithrombotic agents. Chest 108 [Suppl 4]:227S–230SGoogle Scholar
  2. 2.
    Yusuf S, Cairns JA, Camm AJ, Fallen EL, Gersh BJ (1998) Evidence-based cardiology. BMJ, LondonGoogle Scholar
  3. 3.
    Canadian Task Force on the Periodic Health Examination (1979) The periodic health examination. CMAJ 121:1193–1254Google Scholar
  4. 4.
    Sackett DL (1986) Rules of evidence and clinical recommendations on use of antithrombotic agents. Chest 89 [Suppl]:2S–3SGoogle Scholar
  5. 5.
    Horton R (1996) Surgical research or comic opera: questions, but few answers. Lancet 347:984–985PubMedGoogle Scholar
  6. 6.
    Maas AIR, Steyerberg EW, Murray GD, Bullock R, Baethmann A, Marschall L, Teasdale GM (1999) Why have recent trials of neuroprotective agents in head injury failed to show convincing efficacy? A pragmatic analysis and theoretical consideration. Neurosurgery 44:1286–1298PubMedGoogle Scholar
  7. 7.
    Bullock MR, Lyeth BG, Muizelaar JP (1999) Current status of neuroprotection trials for traumatic brain injury: lessons from animal models and clinical studies. Neurosurgery 45:207–220PubMedGoogle Scholar
  8. 8.
    Amar AP, Levy ML (1999) Pathogenesis and pharmacological strategies for mitigating secondary damage in acute spinal cord injury. Neurosurgery 44:1027–1040PubMedGoogle Scholar
  9. 9.
    Bell PR (1997) Surgical research and randomized trials. Br J Surg 84:737–738PubMedGoogle Scholar
  10. 10.
    Hindman J, Todd MM, Gelb AW, Loftus CM, Craen RA, Schubert A, Mahala ME, Torner JC (1999) Mild hypothermia as a protective therapy during intracranial aneurysm surgery: a randomized prospective pilot trial. Neurosurgery 44:23–33PubMedGoogle Scholar
  11. 11.
    Qureshi AI, Sung GY, Suri MAK, Straw RN, Guterman LR, Hopkins LN (1999) Prognostic value and determinants of ultraearly angiographic vasospasm after aneurysmal subarachnoid hemorrhage. Neurosurgery 44:967–974PubMedGoogle Scholar
  12. 12.
    Milhorat TH, Chou MW, Trinidad EM, Kula RW, Mandell M, Wolpert C, Speer MC (1999) Chiari I malformation redefined: clinical and radiographic findings for 364 symptomatic patients. Neurosurgery 44:1005–1017PubMedGoogle Scholar
  13. 13.
    Laureau E, Marciniak B, Hebrard A, Herbaux B, Guieu JD (1999) Comparative study of propofol and midazolam effects on somatosensory evoked potentials during surgical treatment of scoliosis. Neurosurgery 45:69–75PubMedGoogle Scholar
  14. 14.
    Karinen P, Koivukangas P, Ohinmaa A, Koivukangas J, Lohman J (1999) Cost-effectiveness analysis of nimodipine treatment after aneurysmal subarachnoid hemorrhage and surgery. Neurosurgery 45:780–785PubMedGoogle Scholar
  15. 15.
    Boulis NM, Bobek MP, Schmaier A, Hoff JT (1999) Use of factor IX complex in warfarin-related intracranial hemorrhage. Neurosurgery 45:1113–1119PubMedGoogle Scholar
  16. 16.
    Burchiel KJ, Anderson VC, Favre J, Hammerstad JP (1999) Comparison of pallidal and subthalamic nucleus deep brain stimulation for advanced Parkinson's disease: results of a randomized, blinded pilot study. Neurosurgery 45:1375–1384PubMedGoogle Scholar
  17. 17.
    Pollack IF, Albright AL, Adelson PD (1999) A randomized, controlled study of a programmable shunt valve versus a conventional valve for patients with hydrocephalus. Neurosurgery 45:1399–1411PubMedGoogle Scholar
  18. 18.
    Feldkamp MM, Lala P, Lau N, Roncari L, Guha A (1999) Expression of activated epidermal growth factor receptors, Ras-guanosine triphosphate, and mitogen-activated protein kinase in human glioblastoma multiforme specimens. Neurosurgery 45:1442–1153PubMedGoogle Scholar
  19. 19.
    Chadduck JB, Sneyd R, Pobereskin LH (1999) The role of bupivacaine in early postoperative pain control after lumbar decompression. J Neurosurg 90:67–72PubMedGoogle Scholar
  20. 20.
    Filippi R, Laun J, Jage J, Perneczky A (1999) Postoperative pain therapy after lumbar disc surgery. Acta Neurochir (Wien) 141:613–618Google Scholar
  21. 21.
    Hurlbert RJ, Theodore N, Drabier JB, Magwood AM, Sonntag VKH (1999) A prospective randomized double-blind controlled trial to evaluate the efficacy of an analgesic epidural paste following lumbar decompressive surgery. J Neurosurg 90:191–197PubMedGoogle Scholar
  22. 22.
    Le Roux PD, Samudrala S (1999) Postoperative pain after lumbar disc surgery: a comparison between parenteral Ketorolac and narcotics. Acta Neurochir (Wien) 141:261–267Google Scholar
  23. 23.
    Kristof RA, Stoffel-Wagner B, Klingmüller D, Schramm J (1999) Does octreotide treatment improve the surgical results of macro-adenomas in acromegaly? A randomized study. Acta Neurochir (Wien) 141:399–405Google Scholar
  24. 24.
    Cjiou S-M, Chen S-C (1999) Sensitivity, specificity and predictive value of intra-operative elevation of hand temperature to ensure a successful T2-sympathectomy in patients with palmar hyperhidrosis. Acta Neurochir (Wien) 141:855–859Google Scholar
  25. 25.
    Abd-Alrahman N, Dokmak AS, Abou-Madawi A (1999) Anterior cervical discectomy (ACD) versus anterior cervical fusion (ACF) clinical and radiological outcome study. Acta Neurochir (Wien) 141:1089–1092Google Scholar
  26. 26.
    Dowd GC, Wirth FP (1999) Anterior cervical discectomy: is fusion necessary? Spine 90:8–12Google Scholar
  27. 27.
    Lanzino G, Kassell NF (1999) Double-blind, randomized, vehicle-controlled study of high-dose tirilazad mesylate in a woman with aneurysmal subarachnoid hemorrhage. Part II. A cooperative study in North America. J Neurosurg 90:1018–1024PubMedGoogle Scholar
  28. 28.
    Kelly DF, Goodale DB, Williams J, Herr DL, Chappell T, Rosener MJ, Jacobson J, Levy ML, Croce MA, Maniker AH, Fulda GJ, Lovett JV, Mohan O, Narayan RK (1999) Propofol in the treatment of moderate and severe head injury: a randomized, prospective double-blinded pilot trial. J Neurosurg 90:1042–1052PubMedGoogle Scholar
  29. 29.
    Hirega S, Arita N, Ohnishi T, Kohmura E, Yamamoto K, Oku Y, Taki T, Sato M, Aozasa K, Yoshimine T (1999) Rapid infusion of high-dose methotrexate resulting in enhanced penetration into cerebrospinal fluid and intensified tumor response in primary central nervous system lymphomas. J Neurosurg 91:221–230PubMedGoogle Scholar
  30. 30.
    Shiozaki T, Kato A, Taneda M, Hayakata T, Hashiguchi N, Tanaka H, Shimazu T, Sugimoto H (1999) Little benefit from mild hypothermia therapy for severely head injured patients with low intracranial pressure. J Neurosurg 91:185–191PubMedGoogle Scholar
  31. 31.
    Haltiner AM, Newell DW, Temkin NR, Dikmen SS, Winn HR (1999) Side effects and mortality associated with use of phenytoin for early posttraumatic seizure prophylaxis. J Neurosurg 91:588–592PubMedGoogle Scholar
  32. 32.
    Temkin NR, Dikmen SS, Anderson GD, Wilensky AJ, Holmes MD, Cohen W, Newell DW, Nelson P, Awan A, Winn HR (1999) Valproate therapy for prevention of posttraumatic seizures: a randomized trial. J Neurosurg 91:593–600PubMedGoogle Scholar
  33. 33.
    Morris GF, Bullock R, Marshall SB, Marmarou A, Maas A (1999) Failure of the competitive N-methyl-D-aspartate antagonist Selfotel (CGS 19755) in the treatment of severe head injury: result of two phase III clinical trials. J Neurosurg 91:737–743Google Scholar
  34. 34.
    Mori T, Katayama Y, Kawamata T, Hirayama T (1999) Improved efficiency of hypervolemic therapy with inhibition of natriuresis by fluorocortisone in patients with aneurysmal subarachnoid hemorrhage. J Neurosurg 91:947–952PubMedGoogle Scholar
  35. 35.
    Hall WA, Martin AJ, Liu H, Nussbaum ES, Maxwell RE, Truwit CL (1999) Brain biopsy using high-field strength interventional magnetic resonance imaging. Neurosurgery 44:807–814PubMedGoogle Scholar
  36. 36.
    Barth RF, Soloway AH, Goodman JH, Gahbauer RA, Gupta N, Blue TE, Yang W, Tjarks W (1999) Baron neutron capture therapy of brain tumors: an emerging therapeutic modality. Neurosurgery 44:433–451PubMedGoogle Scholar
  37. 37.
    Byrne JV, Sohn M-J, Molyneux J (1999) Five-year experience in using coil embolization for ruptured intracranial aneurysms: outcomes and incidence of late rebleeding. J Neurosurg 90:656–663PubMedGoogle Scholar
  38. 38.
    Hopf N, Grunert P, Fries G, Resch KDM, Perneczky A (1999) Endoscopic third ventriculostomy: outcome analysis of 100 consecutive procedures. Neurosurgery 44 795–806Google Scholar
  39. 39.
    Murayama Y, Vinuela F, Duckwiler GR, Gobin YP, Guglielmi G (1999)Embolization of incidental cerebral aneurysms by using the Gugliemi detachable coil system. J Neurosurg 90:207–214PubMedGoogle Scholar
  40. 40.
    Thakur A, Wang EC, Chiu TT, Chen W, Ko CY, Chang JT, Atkinson JB, Fonkalsrud EW, Grosfeld JL (2001) Methodology standards associated with quality reporting in clinical studies in pediatric surgery journals. J Pediatr Surg 36:1160–1164CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Ralf D. Rothoerl
    • 1
  • Joerg Klier
    • 1
  • Chris Woertgen
    • 1
  • A. Brawanski
    • 1
  1. 1.Department of NeurosurgeryClinic of the University of RegensburgRegensburgGermany

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