Street John, Lenehan Brian, Fisher Charles
Combined Neurosurgical and Orthopaedic Spine Program, Vancouver Hospitals and Health Sciences Center, and Department of Orthopaedic Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
J Neurosurg Spine. 2009 Nov;11(5):512-7. doi: 10.3171/2009.4.SPINE08599.
Criteria for methodological quality have been widely accepted in many fields of surgical practice. These criteria include those of Velanovich and Gill and Feinstein. No such analysis of the spine surgery literature has ever been reported. This study is a systematic review of the quality of life (QOL) publications to determine if the recent interest in QOL measurements following spinal surgery has been accompanied by an improvement in the quality of the papers published.
The archives of the journals Journal of Neurosurgery: Spine, Spine, Journal of Spinal Disorders & Techniques, European Spine Journal, and The Spine Journal, for the years 2000-2004 inclusive, were examined, and all publications reporting QOL outcomes were analyzed. Each paper was scored according to the criteria of Velanovich and Gill and Feinstein, and the methodological quality of these manuscripts-and any time-dependent changes-were determined.
During the study period, the total number of articles published increased by 36%, while the number of QOL articles increased by 102%. According to the criteria of Velanovich, there was a statistically significant improvement in the quality of the publications over the study period (p = 0.0394). In 2000, only 27% of outcome measures were disease specific, 77% were valid, and 77% were appropriate for the study design. In 2004, 43% were disease specific, 88% were valid, and 89% were appropriate. In 2000, 53% of studies used appropriate statistical analysis compared with 100 and 96% for 2003 and 2004, respectively. There was no demonstrable improvement in the fulfillment of the more rigorous Gill and Feinstein criteria for any of the 5 journals over the period of the study.
The authors' study illustrates a moderate improvement in the quality of these publications over the study period but much methodological improvement is required.
方法学质量标准已在外科实践的许多领域被广泛接受。这些标准包括韦拉诺维奇、吉尔和费恩斯坦提出的标准。脊柱外科文献中从未有过此类分析报告。本研究是对生活质量（QOL）相关出版物质量的系统评价，以确定近期脊柱手术后对生活质量测量的关注是否伴随着所发表论文质量的提高。
查阅了《神经外科杂志：脊柱》《脊柱》《脊柱疾病与技术杂志》《欧洲脊柱杂志》和《脊柱杂志》2000年至2004年（含）的期刊存档，并对所有报告生活质量结果的出版物进行了分析。每篇论文根据韦拉诺维奇、吉尔和费恩斯坦的标准进行评分，并确定这些手稿的方法学质量以及任何随时间的变化。
在研究期间，发表的文章总数增加了36%，而生活质量相关文章的数量增加了102%。根据韦拉诺维奇的标准，在研究期间出版物的质量有统计学意义的提高（p = 0.0394）。2000年，只有27%的结局指标是疾病特异性的，77%有效，77%适合研究设计。2004年，43%是疾病特异性的，88%有效，89%适合。2000年，53%的研究使用了适当的统计分析，而2003年和2004年分别为100%和96%。在研究期间，这5种期刊中没有一种在更严格的吉尔和费恩斯坦标准的满足方面有明显改善。
作者的研究表明，在研究期间这些出版物的质量有适度提高，但仍需要很大的方法学改进。
