Evidence-based surgery – evidence from survey and citation analysis in orthopaedic surgery

Abstract

INTRODUCTIONThe results of a survey on evidence-based surgery (EBS) among members of the American Academy of Orthopedic Surgeons (AAOS) and the British Orthopaedic Association (BOA) are presented. The study also analyzes the citations earned by articles with different levels of evidence (LOE) to see if LOE have any bearing on the importance attached to the articles by authors and contributors to the journals. SUBJECTS AND METHODS The questionnaire was e-mailed to 1000 randomly chosen consultant orthopaedic surgeons who were members of either the AAOS or the BOA. Participants were provided with the option of responding through web-based entry. For citation analysis, citation data were gathered from the Journal of Bone and Joint Surgery (American volume) between the years 2003 and 2007 (5-year period). RESULTS The survey showed that awareness and access to EBS have improved greatly over the years. At the present time, these factors are not important barriers to the implementation of EBS in clinical practice in developed countries. There was a statistically significant difference in those with and without additional qualifications with regard to the approach to EBS. However, an equal percentage of surgeons with and without additional qualifications felt that it was difficult to adhere to EBS guidelines in daily clinical practice. Citation analysis showed that readers of professional journals attach importance to LOE category of the article and tend to cite level-I evidence articles more than other articles.

Factors Affecting the Number of Citations to Clinical Therapeutic Articles Mentioning Level of Evidence

“…Understanding the citation bias in articles is important because this type of bias can influence the dissemination of information in primary and secondary literature and the attitude of the medical community. In some studies examining the citation of scientific articles in the medical and health sciences, higher levels of evidence have been associated with positive citation bias (4,(6)(7)(8). Jamshidi Orak et al examined the level of evidence of theses and dissertations of nursing dissertations of Iran University of Medical Sciences from 1991 to 2010.…”