Murphy Robert F, Cibulas Andrew M, Sawyer Jeffrey R, Spence David D, Kelly Derek M
University of Tennessee-Campbell Clinic, Memphis, TN.
J Pediatr Orthop. 2015 Oct-Nov;35(7):779-81. doi: 10.1097/BPO.0000000000000362.
Periodic review of the published research in pediatric orthopaedics is helpful to evaluate the state of scientific methodology. The purpose of this paper was to review the levels of evidence (LOE) and types of evidence (TOE) published in the Journal of Pediatric Orthopaedics (JPO) from 2009 to 2013 and to compare the percentage of articles with each LOE to pediatric orthopaedic articles published in the Journal of Bone and Joint Surgery-American Volume (JBJS) during the same time.
All articles published in JPO from January 1, 2009, to December 31, 2013, were reviewed. Articles were classified as scientific studies, case reports, commentaries/letters to editor, reviews, expert opinion, and basic science articles. All scientific articles in the pediatrics section of the online version of JBJS were reviewed. If listed, the LOE was recorded from all clinical scientific studies. In addition, articles were abstracted for self-reported TOE (therapeutic, diagnostic, prognostic, or economic analysis).
We found 850 citations in JPO over the study period; 646 (76%) were identified as scientific articles and, of those, 552 (85%) had a LOE listed. There were 18 level I articles (3%), 101 level II (18%), 184 level III (34%), and 289 level IV (45%). The TOE was listed in 213 (39%) articles: 114 (54%) therapeutic, 37 (17%) prognostic, 55 diagnostic (26%), and 7 (3%) economic analysis. Comparing 2009 to 2013, the percentage of scientific studies with a self-reported LOE improved significantly (from 81% to 93%, P=0.001). Compared with JPO, JBJS had a significantly higher rate of level I (12% vs. 3%, P=0.006) and a significantly lower rate of level III (23% vs. 34%, P=0.01) articles.
From 2009 to 2013, 3% of articles in JPO were level I. Significantly more articles are now including a level of evidence designation. Approximately half of published studies are level IV, and most are therapeutic type. A higher percentage of level I studies were published in JBJS during the same time period.
定期回顾儿科骨科领域已发表的研究有助于评估科学方法的应用状况。本文旨在回顾2009年至2013年发表于《儿科骨科杂志》（JPO）的证据水平（LOE）和证据类型（TOE），并比较各证据水平文章所占百分比与同期发表于《骨与关节外科杂志-美国卷》（JBJS）的儿科骨科文章的情况。
回顾2009年1月1日至2013年12月31日发表于JPO的所有文章。文章分为科学研究、病例报告、述评/致编辑信、综述、专家意见和基础科学文章。对JBJS在线版儿科部分的所有科学文章进行回顾。若有列出，从所有临床科学研究中记录证据水平。此外，提取文章的自我报告证据类型（治疗、诊断、预后或经济分析）。
在研究期间，我们在JPO中发现850条引用；646条（76%）被确定为科学文章，其中552条（85%）列出了证据水平。有18篇I级文章（3%），101篇II级文章（18%），184篇III级文章（34%），289篇IV级文章（45%）。213篇（39%）文章列出了证据类型：114篇（54%）为治疗性，37篇（17%）为预后性，55篇（26%）为诊断性，7篇（3%）为经济分析。比较2009年至2013年，自我报告证据水平的科学研究百分比显著提高（从81%提高到93%，P = 0.001）。与JPO相比，JBJS的I级文章比例显著更高（12%对3%，P = 0.006），III级文章比例显著更低（23%对34%，P = 0.01）。
2009年至2013年，JPO中3%的文章为I级。现在有显著更多的文章包含证据水平标注。约一半已发表研究为IV级，且大多数为治疗类型。同期JBJS发表的I级研究比例更高。
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