Moraes Vinícius Ynoe de, Belloti João Carlos, Moraes Fábio Ynoe de, Galbiatti José Antonio, Palácio Evandro Pereira, Santos João Baptista Gomes Dos, Faloppa Flávio
Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil.
Sao Paulo Med J. 2011 Mar;129(2):94-8. doi: 10.1590/s1516-31802011000200007.
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.
Secondary study conducted at Universidade Federal de São Paulo (Unifesp) and Faculdade Estadual de Medicina de Marília (Famema).
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).
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).
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.
在我们的研究环境中，对手外科专业的科研产出质量缺乏系统评估。本研究旨在系统评估手外科相关证据生成的现状，并基于证据金字塔评估分类方法的可重复性。
在圣保罗联邦大学（Unifesp）和马里利亚州立医学院（Famema）进行的二次研究。
两名研究人员独立在两个主要的巴西骨科期刊（《巴西骨科学报》和《巴西骨科杂志》）上对2000年至2009年间发表的手外科研究进行电子数据库检索。随后，根据方法学设计（文献系统综述、随机临床试验、队列研究、病例对照研究、病例系列及其他研究）和证据水平（I至V）对所确定的研究进行分类。
共评估了1150篇文章，最终分析纳入了83篇（7.2%）。证据水平为IV级（病例系列）的研究占已发表论文的41篇（49%）。证据水平为V级（其他研究）的研究占论文的12篇（14.5%）。只有两项研究（2.4%）被列为I级或II级。评分者间的可重复性极佳（k = 0.94）。
手外科文章占巴西骨科研究产出的比例不到十分之一。证据水平为IV级的研究是最常见的类型。按证据水平分层的分类可重复性几乎达到完美。
