Brophy Robert H, Kluck Dylan, Marx Robert G
Washington University, St Louis, Missouri, USA
Washington University, St Louis, Missouri, USA.
Am J Sports Med. 2016 May;44(5):1343-8. doi: 10.1177/0363546515591264. Epub 2015 Jul 22.
BACKGROUND: In recent years, the number of articles in The American Journal of Sports Medicine (AJSM) has risen dramatically, with an increasing emphasis on evidence-based medicine in orthopaedics and sports medicine. HYPOTHESIS: Despite the increase in the number of articles published in AJSM over the past decade, the methodological quality of articles in 2011-2013 has improved relative to those in 2001-2003 and 1991-1993. STUDY DESIGN: Meta-analysis. METHODS: All articles published in AJSM during 2011-2013 were reviewed and classified by study design. For each article, the use of pertinent methodologies, such as prospective data collection, randomization, control groups, and blinding, was recorded. The frequency of each article type and the use of evidence-based techniques were compared relative to 1991-1993 and 2001-2003 by use of Pearson χ(2) testing. RESULTS: The number of research articles published in AJSM more than doubled from 402 in 1991-1993 and 423 in 2001-2003 to 953 in 2011-2013. Case reports decreased from 15.2% to 10.6% to 2.1% of articles published over the study period (P < .001). Cadaveric/human studies and meta-analysis/literature review studies increased from 5.7% to 7.1% to 12.4% (P < .001) and from 0.2% to 0.9% to 2.3% (P = .01), respectively. Randomized, prospective clinical trials increased from 2.7% to 5.9% to 7.4% (P = .007). Fewer studies used retrospective compared with prospective data collection (P < .001). More studies tested an explicit hypothesis (P < .001) and used controls (P < .001), randomization (P < .001), and blinding of those assessing outcomes (P < .001). Multi-investigator trials increased (P < .001), as did the proportion of articles citing a funding source (P < .001). CONCLUSION: Despite a dramatic increase in the number of published articles, the research published in AJSM shifted toward more prospective, randomized, controlled, and blinded designs during 2011-2013 compared with 2001-2003 and 1991-1993, demonstrating a continued improvement in methodological quality.
背景：近年来，《美国运动医学杂志》（AJSM）上的文章数量急剧增加，骨科和运动医学领域对循证医学的重视也与日俱增。 假设：尽管在过去十年中AJSM发表的文章数量有所增加，但2011 - 2013年发表文章的方法学质量相较于2001 - 2003年和1991 - 1993年有所提高。 研究设计：荟萃分析。 方法：对2011 - 2013年在AJSM上发表的所有文章按研究设计进行回顾和分类。记录每篇文章相关方法的使用情况，如前瞻性数据收集、随机分组、对照组和盲法。通过Pearson卡方检验，比较相对于1991 - 1993年和2001 - 2003年各文章类型的频率以及循证技术的使用情况。 结果：AJSM发表的研究文章数量从1991 - 1993年的402篇和2001 - 2003年的423篇增加了一倍多，达到2011 - 2013年的953篇。病例报告在研究期间发表文章中的占比从15.2%降至10.6%再降至2.1%（P < 0.001）。尸体/人体研究和荟萃分析/文献综述研究分别从5.7%增至7.1%再增至12.4%（P < 0.001）以及从0.2%增至0.9%再增至2.3%（P = 0.01）。随机前瞻性临床试验从2.7%增至5.9%再增至7.4%（P = 0.007）。与前瞻性数据收集相比，使用回顾性数据收集的研究较少（P < 0.001）。更多研究检验了明确的假设（P < 0.001）并使用了对照组（P < 0.001）、随机分组（P < 0.001）以及对评估结果的人员进行盲法处理（P < 0.001）。多研究者试验有所增加（P < 0.001），引用资金来源的文章比例也有所增加（P < 0.001）。 结论：尽管发表文章数量大幅增加，但与2001 - 2003年和1991 - 1993年相比，2011 - 2013年在AJSM上发表的研究转向了更多的前瞻性、随机、对照和盲法设计，表明方法学质量持续提高。
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