Hierarchy of evidence relating to hand surgery in Brazilian orthopedic journals

Moraes, Vinícius Ynoe de; Belloti, João Carlos; Moraes, Fábio Ynoe de; Galbiatti, José Antônio; Palácio, Evandro Pereira; Santos, João Baptista Gomes dos; Faloppa, Flávio

doi:10.1590/s1516-31802011000200007

Cited by 22 publications

(21 citation statements)

References 21 publications

(32 reference statements)

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“…7 These data 7 are in accordance with other findings in other settings. 8 Bibliometric analyses, as performed in these two studies, 7,8 are important because they can potentially have an impact on research policies and academic actions and can pinpoint unnecessary or unethical studies.…”

Section: Introductionsupporting

confidence: 92%

Evidence hierarchies relating to hand surgery: current status and improvement. A bibliometric analysis study

et al. 2017

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BACKGROUND: Hierarchy of evidence is an important measurement for assessing quality of literature. Information regarding quality of evidence within the Brazilian hand surgery setting is sparse, especially regarding whether research has improved in either quality or quantity. This study aimed to identify and classify hand surgery studies published in the two most important Brazilian orthopedics journals based on hierarchy of evidence, with comparisons with previously published data. DESIGN AND SETTING: Bibliometric analysis study performed in a federal university. METHODS: Two independent researchers conducted an electronic database search for hand surgery studies published between 2010 and 2016 in Acta Ortopédica Brasileira and Revista Brasileira de Ortopedia. Eligible studies were subsequently classified according to methodological design, based on the Haynes pyramid model (HP) and the JBJS/AAOS levels of evidence and grades of recommendations (LOR). Qualitative and quantitative data were gathered regarding all studies. Previous data were considered to assess whether the proportion of high-quality studies had improved over time (2000-2009 versus 2010-2016). RESULTS: The final analysis included 123 studies, mostly originating from the southeastern region (78.8%) and private institutions (65%), with self-funding (91.8%). Methodological assessment showed that 15.4% were classified as level I/II using HP and 16.4% using LOR. No significant difference in proportions of highquality studies was found between the two periods of time assessed (5% versus 12%; P = 0.13).CONCLUSION: Approximately 15% of hand surgery studies published in two major Brazilian journals were likely to be classified as high-quality through two different systems. Moreover, no trend towards qualityof-evidence improvement was found over the last 15 years.

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Section: Introductionsupporting

confidence: 92%

Evidence hierarchies relating to hand surgery: current status and improvement. A bibliometric analysis study

et al. 2017

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“…Despite the well-established merit of randomized controlled trials in evidence-based medicine, incorporating randomization and blinding into a study’s design is wrought with challenges and often is not feasible or ethical in the field of orthopaedic surgery[15]–[17]. Therefore, the results from high-quality observational studies are often the best source of evidence to be considered in clinical decision-making within orthopaedic medicine[16]–[19]. This recognition that observational studies have a critical place within evidence-based medicine is supported extensively in the literature [16], [17], [20], [21].…”

Section: Introductionmentioning

confidence: 99%

Workers’ Compensation Status: Does It Affect Orthopaedic Surgery Outcomes? A Meta-Analysis

et al. 2012

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IntroductionPrevious reviews have demonstrated that patient outcomes following orthopaedic surgery are strongly influenced by the presence of Workers’ Compensation. However, the variability in the reviews’ methodology may have inflated the estimated strength of this association. The main objective of this meta-analysis is to evaluate the influence of Workers’ Compensation on the outcomes of orthopaedic surgical procedures.MethodsWe conducted a systematic search of the literature published in this area from 1992–2012, with no language restrictions. The following databases were used MEDLINE (Ovid), Embase (Ovid), CINAHL, Google Scholar, LILACS and Pubmed. We also hand-searched the reference sections of all selected papers. We included all prospective studies evaluating the effect of compensation status on outcomes in adult patients who had undergone surgery due to orthopaedic conditions or diseases. Outcomes of interest included disease specific, region specific and/or overall quality of life scales/questionnaires and surgeons’ personal judgment of the results. We used an assessment tool to appraise the quality of all included studies. We used Review Manager to create forest plots to summarize study data and funnel plots for the assessment of publication bias.ResultsTwenty studies met our eligibility criteria. The overall risk ratio for experiencing an unsatisfactory result after orthopaedic surgery for patients with compensation compared to non-compensated patients is 2.08 (95% CI 1.54–2.82). A similar association was shown for continuous data extracted from the studies using assessment scales or questionnaires (Standard Mean Difference = −0.70 95% CI -0.97- −0.43).ConclusionsAmong patients who undergo orthopaedic surgical procedures, those receiving Workers’ Compensation experience a two-fold greater risk of a negative outcome. Our findings show a considerably lower estimate of risk compared to previous reviews that include retrospective data. Further research is warranted to determine the etiological explanation for the influence of compensation status on patient outcomes.Systematic Review Registration NumberCRD42012002121

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“…The study focus in the recognition of a Brazilian “primer” regarding to SA motivations and its epidemiological profile. This research is an initiative that could encourage a rationale for an evidence-based national agenda [12], which is relevant for policy-makers, physicians and workers.…”

Section: Introductionmentioning

confidence: 99%

Occupational musculoskeletal and mental disorders as the most frequent associations to worker’s sickness absence: A 10-year cohort study

et al. 2012

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BackgroundSickness absence (SA) is a complex phenomenon influenced by the health of the worker and socio-economic factors. An epidemiological study of SA has never been conducted for Brazilian university workers. This study aimed to determine the main diseases that are associated with SA and find out the average length of SA duration, and its variation among different staff members and between sexes over the 10-year study period.MethodsWe identified the main diseases responsible for SA in workers at a Brazilian federal university (UNIFESP) from January 1998 to August 2008 and grouped them according to the International Classification of Diseases (ICD10). Independent researchers assessed data collected from expert reports of the university Worker’s Health Division.ResultsDuring the period of our study, 1176 workers experienced sickness absence. After evaluating 7579 consultations, ICD10 distribution showed that musculoskeletal and connective tissue disorders (“M” axis) and mental and behavioral diseases (“F” axis) were the most important causes of SA, occurring in 47.3% (IC 95%; 44.15-49.8) of workers aged 46.2 (SD 10.1) years. Female workers represented 78.1% (IC 95%; 76-80.7) of all workers with SA, but men had higher proportional rates (Chi-square; p = 0.044). Longer SA periods were observed for illnesses related to neoplasms and infectious diseases.ConclusionsMusculoskeletal and connective tissue disorders and mental and behavioral diseases were the most frequent cause of sickness absence. Men had an increased frequency of SA, and neoplasms and infectious disorders were associated with longer absences. Mostly, these are occupational disorders. A preventative research-focused agenda is desirable for a more accurate depiction of this population in the scope of policy-making. Our results for SA in Brazilian workers correspond with those of other studies worldwide.

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Hierarchy of evidence relating to hand surgery in Brazilian orthopedic journals

Cited by 22 publications

References 21 publications

Evidence hierarchies relating to hand surgery: current status and improvement. A bibliometric analysis study

Evidence hierarchies relating to hand surgery: current status and improvement. A bibliometric analysis study

Workers’ Compensation Status: Does It Affect Orthopaedic Surgery Outcomes? A Meta-Analysis

Occupational musculoskeletal and mental disorders as the most frequent associations to worker’s sickness absence: A 10-year cohort study

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