Kelley Simon P, Cashin Megan S, Douziech Jeffrey R, Varghese Renjit A, Mulpuri Kishore
British Columbia Children's Hospital, Vancouver, BC, Canada.
J Pediatr Orthop. 2010 Sep;30(6):612-6. doi: 10.1097/BPO.0b013e3181e0cb70.
Since 2003, levels of evidence have been used in the orthopaedic literature to inform the reader of the study quality and its relative significance. Our primary research question was to identify if, since their introduction, there has been an improvement in the levels of evidence of the scientific papers presented at Pediatric Orthopaedic Society of North America (POSNA) meetings.
The abstract of every paper presented orally at the POSNA annual meeting were identified for the years 2001, 2002 (pre-2003) and 2007, 2008 (post-2003). In all, 364 abstracts were identified by an independent reviewer who then excluded cadaver, animal, and basic science studies. The 307 included abstracts were then independently blinded and randomized. Two nonepidemiologically trained pediatric orthopaedic fellows independently assigned a study type and level of evidence to each abstract based on the primary research question. The first reviewer reanalyzed 50 randomly selected abstracts. Disagreement was resolved by consensus opinion with an epidemiologically trained pediatric orthopaedic surgeon. The interobserver and intraobserver reliability was calculated for the assignment of study type and levels of evidence. Changes in the study types and levels of evidence were analyzed to compare papers presented pre-2003 and post-2003.
For study type and levels of evidence the interobserver reliability between the authors showed substantial agreement (kappa 0.755 and 0.647, respectively). The intraobserver reliability also showed substantial agreement (kappa 0.806 and 0.789, respectively). Comparing pre-2003 and post-2003 studies there were no significant differences between the types of study presented. An increase in the number of level III studies was identified. A decrease in level I and level IV studies was identified.
There has been no significant improvement in the scientific quality of studies presented at POSNA Annual Meetings as measured by levels of evidence since their introduction. We have shown substantial agreement between nonepidemiologically trained orthopaedic surgeons when categorizing abstracts using this system. Study types and levels of evidence can be difficult to assign from the current abstract format due to their brevity and structure.
Not applicable.
自2003年以来，骨科文献中一直使用证据级别来让读者了解研究质量及其相对重要性。我们的主要研究问题是确定自引入证据级别以来，在北美小儿骨科学会（POSNA）会议上发表的科学论文的证据级别是否有所提高。
确定了2001年、2002年（2003年前）以及2007年、2008年（2003年后）在POSNA年会上口头发表的每篇论文的摘要。一名独立评审员共识别出364篇摘要，随后排除了尸体、动物和基础科学研究。然后将307篇纳入的摘要独立进行盲法和随机分组。两名未接受过流行病学培训的小儿骨科住院医师根据主要研究问题分别为每篇摘要确定研究类型和证据级别。第一位评审员重新分析了50篇随机选择的摘要。通过与一名接受过流行病学培训的小儿骨科外科医生达成共识来解决分歧。计算了研究类型和证据级别分配的观察者间和观察者内信度。分析研究类型和证据级别的变化以比较2003年前和200年后发表的论文。
对于研究类型和证据级别，作者之间的观察者间信度显示出高度一致性（kappa分别为0.755和0.647）。观察者内信度也显示出高度一致性（kappa分别为0.806和0.789）。比较2003年前和2003年后的研究，所呈现的研究类型之间没有显著差异。确定III级研究的数量有所增加。确定I级和IV级研究的数量有所减少。
自引入证据级别以来，以证据级别衡量，在POSNA年会上发表的研究的科学质量没有显著提高。我们已经表明，在使用该系统对摘要进行分类时，未接受过流行病学培训的骨科外科医生之间存在高度一致性。由于当前摘要格式简短且结构简单，研究类型和证据级别可能难以确定。
不适用。
