CONTEXT AND OBJECTIVE: There is no systematic assessment of the quality of scientific production in the specialty of hand surgery in our setting. This study aimed to systematically assess the status of evidence generation relating to hand surgery and to evaluate the reproducibility of the classification method based on an evidence pyramid. DESIGN AND SETTING: Secondary study conducted at Universidade Federal de São Paulo (UNIFESP) and Faculdade Estadual de Medicina de Marília (Famema). METHODS: Two researchers independently conducted an electronic database search for hand surgery studies published between 2000 and 2009 in the two main Brazilian orthopedic journals (Acta Ortopédica Brasileira and Revista Brasileira de Ortopedia). The studies identified were subsequently classified according to methodological design (systematic review of the literature, randomized clinical trial, cohort study, case-control study, case series and other studies) and evidence level (I to V). RESULTS: A total of 1,150 articles were evaluated, and 83 (7.2%) were included in the final analysis. Studies with evidence level IV (case series) accounted for 41 (49%) of the published papers. Studies with evidence level V (other studies) accounted for 12 (14.5%) of the papers. Only two studies (2.4%) were ranked as level I or II. The inter-rater reproducibility was excellent (k = 0.94). CONCLUSIONS: Hand surgery articles corresponded to less than one tenth of Brazilian orthopedic production. Studies with evidence level IV were the commonest type. The reproducibility of the classification stratified by evidence level was almost perfect.
展开▼
机译:背景与目的:在我们的背景下,目前尚无对手外科专业科学生产质量的系统评估。这项研究旨在系统地评估与手外科手术有关的证据产生的状态,并评估基于证据金字塔的分类方法的可重复性。设计与环境:在圣保罗联邦大学(UNIFESP)和玛丽亚玛丽亚医学中心(Famema)进行的中学研究。方法:两位研究人员独立地进行了电子数据库搜索,研究了2000年至2009年之间发表在巴西两种主要骨科学期刊(ActaOrtopédicaBrasileira和Revista Brasileira de Ortopedia)上的手外科研究。随后,根据方法学设计(文献的系统评价,随机临床试验,队列研究,病例对照研究,病例系列和其他研究)和证据水平(I至V)对确定的研究进行分类。结果:总共评估了1,150篇文章,最终分析中包括83篇(7.2%)。证据等级为IV(案例系列)的研究占已发表论文的41(49%)。证据等级为V的研究(其他研究)占论文总数的12(14.5%)。只有两项研究(2.4%)被列为I级或II级。评分者之间的可重复性极好(k = 0.94)。结论:手外科文章占不到巴西骨科产品的十分之一。证据级别为IV的研究是最常见的类型。按证据水平分层的分类的可重复性几乎是完美的。
展开▼