Kiter E, Karatosun V, Günal I
Department of Orthopaedics, Pamukkale University Hospital, Denizli, Turkey.
Arch Orthop Trauma Surg. 2003 Apr;123(2-3):82-5. doi: 10.1007/s00402-003-0501-4. Epub 2003 Mar 22.
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.
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.
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%.
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.
在研究设计的层次体系中，随机对照试验和荟萃分析被认为是最高等级的证据，而科学期刊是科学信息的主要来源。
利用美国国立医学图书馆的Medline数据库，检索了1966年至1999年期间发表于1999年《科学引文索引》核心列表中主要专注于骨科领域的期刊上的所有随机对照试验和荟萃分析。文章摘要由每位作者独立审阅，并按年份、期刊名称和主题进行分类。
文章总数为36293篇，其中只有671篇是随机对照试验（1.85%），12篇是荟萃分析（0.03%）。尽管随机对照试验的数量呈逐渐增加的趋势，但其中一半以上（81.9%）发表于4种期刊。在随机对照试验中，66%是关于关节成形术的，髋和膝关节成形术占90.7%。
尽管随机对照试验和荟萃分析的数量趋于增加，但本研究的结论是，主要骨科期刊提供的高质量证据相当少，基于循证的骨科实践需要更多的随机对照试验和荟萃分析。
