Skip to main content

Advertisement

Log in

Do orthopaedic journals provide high-quality evidence for clinical practice?

  • Original Article
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

In the hierarchy of research designs, randomized controlled trials and meta-analyses are considered to be evidence of the highest grade, and scientific journals are the main source of scientific information.

Methods

Using the National Library of Medicine Medline database, all randomized controlled trials and meta-analyses from 1966 to 1999 were retrieved from the journals indexed in the core list of the Science Citation Index in 1999, dedicated primarily to orthopaedics. The abstracts of the articles were reviewed independently by each author and classified by the year, journal name and subject.

Results

The total number of articles was 36,293, of which only 671 were randomized controlled trials (1.85%) and 12 were meta-analyses (0.03%). Although there was a progressively increasing trend for randomized controlled trials, more than half of them (81.9%) were published in four journals. Of the randomized controlled trials, 66% was about arthroplasty, and hip and knee arthroplasties covered 90.7%.

Conclusion

Although the number of randomized controlled trials and meta-analyses is tending to increase, the conclusion of this study is that the high-quality evidence provided by the major orthopaedic journals is quite low, and more randomized controlled trials and meta-analyses are needed for evidence-based orthopaedic practice.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1.

Similar content being viewed by others

References

  1. Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, Ritkin R, Dennie D, Schulz KF, Simel D, Stroup DF (1996) Improving the quality of reporting of randomized controlled trials. The CONSORT statement. J Am Med Assoc 276:637–639

    CAS  Google Scholar 

  2. Bhandari M, Guyatt GH, Swiontkowski ME (2001) User's guide to the orthopaedic literature: how to use an article about a surgical therapy. J Bone Joint Surg Am 83:916–926

    Google Scholar 

  3. Bhandari M, Morrow F, Kulkarni AV, Tornetta P III (2001) Meta-analyses in orthopaedic surgery. A systemic review of their methodologies. J Bone Joint Surg Am 83:15–24

    Google Scholar 

  4. Boerger TO, Limb T, Dickson TA (2000) Does 'canal clearance' affect neurological outcome after thoracolumbar burst fractures? J Bone Joint Surg Br 82:629–635

    CAS  PubMed  Google Scholar 

  5. Chalmers TC, Smith H Jr, Blackburn B, Silverman B, Schroeder B, Reitman D, Ambroz A (1981) A method for assessing the quality of a randomized control trial. Controlled Clin Trials 2:31–49

    Article  CAS  PubMed  Google Scholar 

  6. Concato J, Shah N, Horwitz RI (2000) Randomized controlled trials, observational studies and the hierarchy of research designs. N Engl J Med 342:1987–1992

    Article  Google Scholar 

  7. Hardin WD, Lally KP (1999) Evidence-based practice in pediatric surgery. J Pediatr Surg 34:908–913

    Google Scholar 

  8. Heinegard D, Johnell O, Lidgren L, Nilsson O, Rydevik B, Wollheim F, Akesson K (1998) The bone and joint decade 2000–2010. Acta Orthop Scand 69:219–220

    CAS  PubMed  Google Scholar 

  9. Labella H, Guibert R, Joncas J, Newman N, Fallaha M, Rivard C-H (1992) Lack of scientific evidence for the treatment of lateral epicondylitis. An attempted meta-analysis. J Bone Joint Surg Br 74:646–651

    PubMed  Google Scholar 

  10. LeLorier J, Gregoire G, Benhaddad A, Lapierre J, Derdevian F (1997) Discrepancies between meta-analyses and subsequent large randomized controlled trials. N Engl J Med 337:536–542

    CAS  PubMed  Google Scholar 

  11. Lomas J, Anderson GM, Dominick-Pierre K, Wajda E, Enkin MW, Hannah WJ (1989) Do practice guidelines guide practice? The effect of consensus statement on the practice of physicians. N Engl J Med 321:306–311

    Google Scholar 

  12. Rudicel S, Esdale J (1985) The randomized clinical trial in orthopaedics: obligation or option? J Bone Joint Surg Am 67:1284–1293

    CAS  PubMed  Google Scholar 

  13. Sackett DL (1998) Evidence-based medicine. Spine 23:1085–1086

    Article  CAS  PubMed  Google Scholar 

  14. Sacks HS, Berrier J, Reitman D, Ancona-Berk VA, Chalmers TC (1987) Meta-analyses of randomized controlled trials. N Engl J Med 316:450–455

    CAS  PubMed  Google Scholar 

  15. Walsh EF, Weinstein JN (1998) Spine: scientific citation index and its impact factor. Spine 23:1087–1090

    Article  CAS  PubMed  Google Scholar 

  16. Wennberg JE, Gittelsohn A (1982) Variations in medical care among small areas. Sci Am 246:120–135

    CAS  PubMed  Google Scholar 

  17. Whimster WF (1997) Biomedical research. How to plan, publish and present it. Springer, Berlin Heidelberg New York

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to I. Günal.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kıter, E., Karatosun, V. & Günal, I. Do orthopaedic journals provide high-quality evidence for clinical practice?. Arch Orthop Trauma Surg 123, 82–85 (2003). https://doi.org/10.1007/s00402-003-0501-4

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-003-0501-4

Keywords

Navigation