Level of evidence in four selected rehabilitation journals.

OBJECTIVE: To investigate the methodologic quality and level of evidence of publications in major peer-reviewed general rehabilitation journals (Archives of Physical Medicine and Rehabilitation [APMR], American Journal of Physical Medicine and Rehabilitation [AJPMR], Clinical Rehabilitation [CR], and Physical Therapy [PT]). DESIGN: Descriptive, comparative. MAIN OUTCOME MEASURES: All the articles published in AJPMR, APMR, CR, and PT between January 2005 and December 2009 were investigated. Type of study and level of evidence were recorded for all articles. Selection and assessment of articles were based on the title and abstract by 2 independent raters. RESULTS: The most frequently published reports were randomized controlled trials (12.7%), followed by cross-sectional studies (12.1%), case reports/case series (10.3%), validation studies (9.3%), cohort studies (8.9%), clinical trials (7.5%), case-control studies (6.8%), and other study types (32.4%). When the articles were classified according to their level of evidence, level I studies most frequently appeared in CR (29.1%), followed by PT (11.0%), APMR (10.5%), and AJPMR (7.1%). Most of the meta-analyses (10) were in APMR, and there were none in AJPMR. CONCLUSIONS: Randomized controlled trials and meta-analyses form only a small proportion of articles published in the current rehabilitation literature. The numbers of randomized controlled trials and meta-analysis are comparable with those in other fields

Do orthopaedic journals provide high-quality evidence for clinical practice?

BACKGROUND: In the hierarchy of research designs, randomized controlled trials and meta-analyses are considered to be evidence of the highest grade, and scientific journals are the main source of scientific information. METHODS: Using the National Library of Medicine Medline database, all randomized controlled trials and meta-analyses from 1966 to 1999 were retrieved from the journals indexed in the core list of the Science Citation Index in 1999, dedicated primarily to orthopaedics. The abstracts of the articles were reviewed independently by each author and classified by the year, journal name and subject. RESULTS: The total number of articles was 36,293, of which only 671 were randomized controlled trials (1.85%) and 12 were meta-analyses (0.03%). Although there was a progressively increasing trend for randomized controlled trials, more than half of them (81.9%) were published in four journals. Of the randomized controlled trials, 66% was about arthroplasty, and hip and knee arthroplasties covered 90.7%. CONCLUSION: Although the number of randomized controlled trials and meta-analyses is tending to increase, the conclusion of this study is that the high-quality evidence provided by the major orthopaedic journals is quite low, and more randomized controlled trials and meta-analyses are needed for evidence-based orthopaedic practice

practice?

Background: In the hierarchy of research designs, randomized controlled trials and meta-analyses are considered to be evidence of the highest grade, and scientific journals are the main source of scientific information. Methods: Using the National Library of Medicine Medline database, all randomized controlled trials and meta-analyses from 1966 to 1999 were retrieved from the journals indexed in the core list of the Science Citation Index in 1999, dedicated primarily to orthopaedics. The abstracts of the articles were reviewed independently by each author and classified by the year, journal name and subject. Results: The total number of articles was 36,293, of which only 671 were randomized controlled trials (1.85%) and 12 were meta-analyses (0.03%). Although there was a progressively increasing trend for randomized controlled trials, more than half of them (81.9%) were published in four journals. Of the randomized controlled trials, 66% was about arthroplasty, and hip and knee arthroplasties covered 90.7%. Conclusion: Although the number of randomized controlled trials and meta-analyses. is tending to increase, the conclusion of this study is that the high-quality evidence provided by the major orthopaedic journals is quite low, and more randomized controlled trials and meta-analyses are needed for evidence-based orthopaedic practice

Level of Evidence in Four Selected Rehabilitation Journals

Objective: To investigate the methodologic quality and level of evidence of publications in major peer-reviewed general rehabilitation journals (Archives of Physical Medicine and Rehabilitation [APMR], American Journal of Physical Medicine and Rehabilitation [AJPMR], Clinical Rehabilitation [CR], and Physical Therapy [PT]).Design: Descriptive, comparative.Main Outcome Measures: All the articles published in AJPMR, APMR, CR, and PT between January 2005 and December 2009 were investigated. Type of study and level of evidence were recorded for all articles. Selection and assessment of articles were based on the title and abstract by 2 independent raters.Results: The most frequently published reports were randomized controlled trials (12.7%), followed by cross-sectional studies (12.1%), case reports/case series (10.3%), validation studies (9.3%), cohort studies (8.9%), clinical trials (7.5%), case control studies (6.8%), and other study types (32.4%). When the articles were classified according to their level of evidence, level I studies most frequently appeared in CR (29.1%), followed by PT (11.0%), APMR (10.5%), and AJPMR (7.1%). Most of the meta-analyses (10) were in APMR, and there were none in AJPMR.Conclusions: Randomized controlled trials and meta-analyses form only a small proportion of articles published in the current rehabilitation literature. The numbers of randomized controlled trials and meta-analysis are comparable with those in other fields