An Update on Level of Evidence Trends in Facial Plastic Surgery Research

Abstract

Background: Knowledge of the quality of evidence in facial plastic surgery research is essential for the implementation of evidence-based practices. The purpose of this study is to provide an update over the past decade as to whether the level of evidence in leading journals featuring topics in facial plastic surgery has changed in comparison with prior reports. Materials and Methods: This study is a systematic review, designed to evaluate the level of evidence observed in the facial plastic surgery literature over time. Five journals were queried using facial plastic surgery keywords for four selected years for a 10-year period. After screening, articles were assessed for the presence of various methodological traits and were evaluated for overall level of evidence. These variables were compared across the years studied to evaluate trends in level of evidence. Results: A total of 826 articles were included for final review. For all selected years, level IV or level V evidence was the most prevalent level of evidence. Over time, significantly less level IV (p = 0.009) and significantly more level II (p = 0.007) evidence was published. The proportion of studies reporting confidence intervals (p < 0.001) and p-values (p = 0.02) were significantly greater in later years. Conclusions: The level of evidence of facial plastic surgery literature has increased over time, as demonstrated by an increased proportion of level II evidence, decreased proportion of level IV evidence, and increased use of p-values and confidence intervals. The absolute number of randomized controlled trials continues to remain low.

Evaluating Strength of Evidence of Pediatric Otolaryngology Research Literature: A 20‐Year Review

“…In otology, there was an increasing proportion of high‐level evidence studies between 1997 and 2017, from 11.4% to 24.3% 12 . The subspecialty of facial plastics and reconstructive surgery reported an increase in the proportion of level II evidence, from 10.6% to 18.1%, and a decrease in the proportion of level IV evidence, from 47.7% to 35.8%, among articles published between 2008 and 2019 11,22 . However, the current study focusing on pediatric OTL‐HNS found that articles from 1996 to 2016 do not follow this same trend as the proportion of high‐quality publications remained stable at approximately 30%.…”

“…However, the current study focusing on pediatric OTL‐HNS found that articles from 1996 to 2016 do not follow this same trend as the proportion of high‐quality publications remained stable at approximately 30%. As with other otolaryngology subspecialties, the current study also identified that high‐quality papers continue to represent a minority of total research 10–12,22 …”

“…12 The subspecialty of facial plastics and reconstructive surgery reported an increase in the proportion of level II evidence, from 10.6% to 18.1%, and a decrease in the proportion of level IV evidence, from 47.7% to 35.8%, among articles published between 2008 and 2019. 11,22 However, the current study focusing on pediatric OTL-HNS found that articles from 1996 to 2016 do not follow this same trend as the proportion of highquality publications remained stable at approximately 30%. As with other otolaryngology subspecialties, the current study also identified that high-quality papers continue to represent a minority of total research.…”

“…This journal's goal is to emphasize the importance of grading the level of the published literature, to encourage authors who may publish within their journal to produce studies with strong methodologies, and to help readers identify high‐quality research 9 . Some OTL‐HNS subspecialties have explored the trends in their publication quality, including rhinology, facial plastics, and otology and all note greater quality over their study periods 10–12 …”

“…9 Some OTL-HNS subspecialties have explored the trends in their publication quality, including rhinology, facial plastics, and otology and all note greater quality over their study periods. [10][11][12] The pediatric OTL-HNS subspecialty literature has yet to be investigated. It is imperative to distinguish this population from adults because research in pediatrics presents a unique set of challenges.…”