Evidence-Based Medicine in Plastic Surgery

Leal, Daniel Gouvea; Rodrigues, Maria Amélia; Tedesco, Ana Carolina B.; Nahas, Fábio Xerfan; Ferreira, Lydia Masako; Roxo, Ana Cláudia Weck; Castro, Cláudio Cardoso de; Aboudib, José Horácio

doi:10.1097/sap.0000000000001179

Cited by 11 publications

(6 citation statements)

References 23 publications

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“…As the literature strongly suggests, performing RCTs in surgery is difficult due to the lack of standardized techniques, variability of skills, ethical issues surrounding placebo groups in surgical procedures, and lack of industry funding. 6,13,[20][21][22] As Loiselle et al suggested, we support the use of including a well-defined comparison group to improve the level of evidence of a given study. 6 To further support our focus on the trends in levels of evidence, we analyzed the use of p-values and confidence intervals as a simple measure of quality of research.…”

Section: Discussionsupporting

confidence: 72%

“…19 Leal et al reported a total of 35 (2.9%) RCTs out of 1223 original articles published in 2011 from four plastic surgery journals. 20 Among otolaryngology articles focusing on treatment efficacy, Yao et al found 202 (3.7%) of 5467 articles from 2000 to 2005 were RCTs. Rohrich and Cho in 2016 performed a MEDLINE search of all RCTs in aesthetic plastic surgery and identified 133 articles, and similarly found that of these, 41% of studies were double blinded, 32% performed a power analysis, and 21% comprised level I evidence.…”

Section: Discussionmentioning

confidence: 99%

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

Eggerstedt

Shay

Brown

et al. 2020

Facial Plastic Surgery & Aesthetic Medicine

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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.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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

Eggerstedt

Shay

Brown

et al. 2020

Facial Plastic Surgery & Aesthetic Medicine

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“…Research plays an essential role in furthering the discipline of plastic surgery. Research articles that are repeatedly cited guide the direction of the scientific discipline by eliciting more questions to answer 9,21,22 . Nevertheless, while the factors that affect authorship and citation have been examined in other fields, there is a dearth of studies focused on the plastic surgery literature.…”

Section: Discussionmentioning

confidence: 99%

“…Article citations count is a common and established method to quantify the influence of a research article. Articles that have accrued more citations are likely to have high relevance to the field and serve as a foundation for other research endeavors 9,21 . The factors that influence article citations has been studied by other fields in their respective literature 2,1617 .…”

Section: Introductionmentioning

confidence: 99%

Differences in Highly-Cited and Lowly-Cited Manuscripts in Plastic Surgery

Boyd

Patel

Soto

et al. 2020

Journal of Surgical Research

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“…Despite the implementation of LOE classification systems by plastic surgery journals, the percentage of level I/II studies remains low. 20,21 An analysis of studies published in Plastic and Reconstructive Surgery in 2013 found that only 3% of the studies were level I and 15% were level II. 20 The paucity of level I plastic surgery publications has been attributed to the difficulty of conducting RCTs to address clinical questions in surgery compared with other fields.…”

Section: Introductionmentioning

confidence: 99%

Reading between the Lines: A Plastic Surgeon’s Guide to Evaluating the Quality of Evidence in Research Publications

Gabriel

Maxwell

2019

Plastic and Reconstructive Surgery - Global Open

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Summary: An important component of practicing evidence-based medicine (EBM) in plastic surgery is staying current with published research, an increasingly difficult task given the rapid growth of the literature. This article reviews the methodological aspects specific to the aesthetic surgery field that should be considered when evaluating the quality of evidence in research publications in the context of the level of evidence (LOE) grading scales that are currently used by plastic surgery journals. Reporting the LOE in a research publication can help to highlight the quality of the research and the potential for bias so that the reader may prioritize information accordingly. However, LOE classifications are not an absolute index of the quality of evidence and do not preclude careful evaluation of the study’s methods and results in the context of the authors’ conclusions. As the application of evidence-based medicine expands in the plastic surgery community, surgeons must be mindful of how to appropriately interpret research findings and assess the utility of applying results to their practice.

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Evidence-Based Medicine in Plastic Surgery

Abstract: The articles with a higher level of evidence are, on average, cited more often than those with low levels of evidence in the leading journals of plastic surgery.

Cited by 11 publications

References 23 publications

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

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

Differences in Highly-Cited and Lowly-Cited Manuscripts in Plastic Surgery

Reading between the Lines: A Plastic Surgeon’s Guide to Evaluating the Quality of Evidence in Research Publications

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