Haughom Bryan D, Goldstein Zach, Hellman Michael D, Yi Paul H, Frank Rachel M, Levine Brett R
Department of Orthopaedic Surgery, Rush University, 1611 W. Harrison Blvd, Suite 200, Chicago, IL, 60612, USA,
Clin Orthop Relat Res. 2014 Dec;472(12):4024-32. doi: 10.1007/s11999-014-3895-0. Epub 2014 Aug 26.
Although the references recommended for the Orthopaedic In-Training Examination (OITE) have been evaluated in certain subspecialty domains, suggested reference level of evidence (LOE), impact factor, and citation age have not been evaluated comprehensively to our knowledge.
QUESTIONS/PURPOSES: We present an analysis of all references cited in the OITE recommended readings for each test question including the duration of time between their initial publication and their use in the OITE, which we defined as citation age, LOE, and the impact factor of the journals referenced.
We evaluated all references for the 2010 to 2012 OITE administrations (three examinations; 825 questions total). Publication characteristics, including citation age, were noted. The LOE for each journal article and the impact factor of each journal were determined; differences in LOE and impact factor were compared between test sections. A total of 1817 references were cited in the 825 questions we evaluated; this denominator was used in all calculations that follow.
The recommended reading references included 1337 journal article references (74%), 469 text references (26%), and 11 multimedia sources (0.6%; eg, websites, instructional DVDs). The three most commonly recommended journals were general orthopaedic journals, The Journal of Bone and Joint Surgery (American Volume), Journal of American Academy of Orthopaedic Surgeons, and Clinical Orthopaedics and Related Research. The majority (72.2%) of the cited journal references were published within 10 years of the test date, with a mean ± SD citation age of 8.3 ± 7.4 years. The majority of the cited journal articles were Levels IV and V evidence (mean, 4.16 ± 1.1). The Spine section had higher LOE (3.74; p < 0.001), although the practical relevance of such a difference is questionable, as all but two sections' LOE rounded to Level IV evidence. The Spine and Basic Science sections were published in journals with a larger mean impact factor (Basic Science, 7.16 ± 12.67; Spine, 5.73 ± 12.08; p < 0.001).
Our data show that the majority of the recommended readings for the OITE stem from higher impact general orthopaedic and major subspecialty journals. Furthermore the observed mean LOE of the recommended readings shows a preponderance of Levels IV and V research. These data may suggest that test-takers may find benefit in the review of high-level general orthopaedic journals, and review articles in particular while preparing for the OITE, although further study is necessary to determine optimal test preparation strategies. Finally, our study provides a baseline analysis of the study designs of OITE recommended references, and may provide insight for educators designing resident educational curricula.
尽管针对骨科住院医师培训考试（OITE）推荐的参考文献已在某些亚专业领域进行了评估，但据我们所知，推荐证据水平（LOE）、影响因子和引用年限尚未得到全面评估。
问题/目的：我们对OITE每个测试问题推荐读物中引用的所有参考文献进行了分析，包括其首次发表与在OITE中使用之间的时间间隔（我们将其定义为引用年限）、LOE以及被引用期刊的影响因子。
我们评估了2010年至2012年OITE考试（共三次考试；总计825个问题）的所有参考文献。记录了包括引用年限在内的出版特征。确定了每篇期刊文章的LOE和每种期刊的影响因子；比较了不同测试部分之间LOE和影响因子的差异。在我们评估的825个问题中共引用了1817篇参考文献；在后续所有计算中均使用此分母。
推荐读物参考文献包括1337篇期刊文章参考文献（74%）、469篇文本参考文献（26%）和11个多媒体资源（0.6%；如网站、教学DVD）。最常推荐的三种期刊是普通骨科期刊《骨与关节外科杂志》（美国版）、《美国骨科医师学会杂志》和《临床骨科与相关研究》。大多数（72.2%）被引用的期刊参考文献在考试日期前10年内发表，平均±标准差引用年限为8.3±7.4年。大多数被引用的期刊文章为IV级和V级证据（平均为4.16±1.1）。脊柱部分的LOE较高（3.74；p<0.001），尽管这种差异的实际相关性值得怀疑，因为除两个部分外，所有部分的LOE四舍五入后均为IV级证据。脊柱和基础科学部分发表的期刊平均影响因子较大（基础科学，7.16±12.67；脊柱，5.73±12.08；p<0.001）。
我们的数据表明，OITE的大多数推荐读物来自影响因子较高的普通骨科和主要亚专业期刊。此外，推荐读物的观察到的平均LOE显示IV级和V级研究占主导。这些数据可能表明，考生在准备OITE时，复习高水平的普通骨科期刊，尤其是综述文章可能会有所帮助，尽管需要进一步研究以确定最佳的考试准备策略。最后，我们的研究提供了OITE推荐参考文献研究设计的基线分析，并可能为设计住院医师教育课程的教育工作者提供参考。
