Hierarchy of evidence referring to the central nervous system in a high-impact radiation oncology journal: a 10-year assessment. Descriptive critical appraisal study

Abstract

CONTEXT AND OBJECTIVE: To the best of our knowledge, there has been no systematic assessment of the classification of scientific production within the scope of radiation oncology relating to central nervous system tumors. The aim of this study was to systematically assess the status of evidence relating to the central nervous system and to evaluate the geographic origins and major content of these published data.DESIGN AND SETTING: Descriptive critical appraisal study conducted at a private hospital in São Paulo, Brazil.METHODS: We evaluated all of the central nervous system studies published in the journal Radiotherapy & Oncology between 2003 and 2012. The studies identified were classified according to their methodological design and level of evidence. Information regarding the geographical location of the study, the institutions and authors involved in the publication, main condition or disease investigated and time of publication was also obtained.RESULTS: We identified 3,004 studies published over the 10-year period. Of these, 125 (4.2%) were considered eligible, and 66% of them were case series. Systematic reviews and randomized clinical trials accounted for approximately 10% of all the published papers. We observed an increase in high-quality evidence and a decrease in low-quality published papers over this period (P = 0.036). The inter-rater reliability demonstrated significant agreement between observers in terms of the level of evidence.CONCLUSIONS: Increases in high-level evidence and in the total number of central nervous system papers were clearly demonstrated, although the overall number of such studies remained relatively small.

External beam re-irradiation, combination chemoradiotherapy, and particle therapy for the treatment of recurrent glioblastoma

“…However, physicians must discuss with patients that GBM is almost uniformly fatal, and retreatment is not always advised. Despite increasing publications, there is little high-quality evidence toward best practices in recurrent disease[44]. …”

The Characteristics and Level of Evidence of Clinical Studies Published in 5 Leading Orthodontic Journals

“…In addition, despite the aforementioned advantages of Oxford 2011 LOE, most previous LOE related studies either used an obsolete version [16][17][18] or did not consider the effect sizes when assessing observational studies. 11,12,19 Therefore, the primary objective of this study was to assess the characteristics and LOE of recently published clinical research articles in leading orthodontic journals, using the Oxford 2011 LOE accompanied with the rating up standards of GRADE. A secondary objective was to investigate and explore the association between LOE and potentially related factors, such as funding status, geographic origin and type of institution.…”

Emerging radiotherapy technology in a developing country: A single Brazilian institution assessment of stereotactic body radiotherapy application

“…This might be related to the disease prevalence, as well as with the wide and well-established literature of SBRT for pulmonary lesions. 11,12 The second most treated site was spine, which has low/moderate level of evidence publications and some available protocols. 13,14 Prostate and liver neoplasms were less frequent; however, there are also many studies reporting the use of SBRT in these sites and feasible protocols available.…”