Division of Vascular Surgery, Hamilton Health Sciences, Hamilton, Ontario, Canada.
Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
J Vasc Surg. 2018 Mar;67(3):951-959. doi: 10.1016/j.jvs.2017.10.053.
During the past decades, there has been an increasing emphasis on the use of high-quality evidence to inform clinical decision-making. The purpose of our study was to assess trends in the level of evidence (LOE) of abstracts presented at the Vascular Annual Meeting from 2012 to 2016.
All Vascular Annual Meeting abstracts for 2012 to 2016 were obtained through the Journal of Vascular Surgery. Two reviewers independently screened abstracts for eligibility. Research with a nonclinical focus was excluded from the study. Data extracted from eligible abstracts included study type (therapeutic, prognostic, diagnostic), study size, country of academic institution of primary author, presentation type, and whether the sample was recruited or from a database. Abstracts were assigned an LOE using the 2011 Oxford Centre for Evidence-Based Medicine classification scheme based on study design (eg, case series, randomized controlled trial). A χ test and analysis of variance test were conducted to assess nonrandom changes in LOE during the study period.
Of the 1403 abstracts screened, 1147 were included. Inter-rater agreement was high (κ value for abstract screening was 0.93; κ value for data extraction was 0.89). Therapeutic studies were the most common study type (58%), followed by prognostic studies (37%), then diagnostic studies (5%). The majority of abstracts (75.0%) were submitted from North American institutions. Overall, 0.35% of the presentations were level I evidence, 3.1% level II, 52.8% level III, 38.0% level IV, and 5.7% level V. The average LOE per year fluctuated between 3.54 and 3.32, with a mean LOE of 3.45. The proportion of high-quality evidence (level I and level II) increased in the years 2015 and 2016, representing 78% of all level I and level II abstracts presented in the 5-year period. A χ test between LOE and year yielded a P value of .0084, indicating significant nonrandom change in LOE between 2012 and 2016. The majority of high LOE research was presented in poster sessions (37.5%), plenary sessions (27.5%), and international forum sessions/talks (25%) at the meeting.
Overall, average LOE remained relatively consistent between 2012 and 2016, with most abstracts classified as level III or level IV. There was a gradual, albeit minor, increase in the proportion of level I and level II evidence in 2015 and 2016, potentially indicating the increasing commitment to producing and disseminating high-level research in vascular surgery. Furthermore, a lack of a classification tool specific to vascular surgery research occasionally presented a challenge in assigning LOE, perhaps indicating a need for such a tool in this specialty.
在过去几十年中,人们越来越强调使用高质量的证据来为临床决策提供信息。我们研究的目的是评估 2012 年至 2016 年血管年会摘要的证据水平(LOE)趋势。
通过《血管外科学杂志》获取 2012 年至 2016 年所有血管年会摘要。两位评审员独立筛选摘要以确定其是否符合入选标准。非临床重点研究的摘要被排除在研究之外。从合格摘要中提取的数据包括研究类型(治疗性、预后性、诊断性)、研究规模、主要作者所在学术机构的国家、报告类型以及样本是否是招募的或来自数据库。根据研究设计(例如病例系列、随机对照试验),使用 2011 年牛津循证医学中心证据分级方案对摘要进行 LOE 分级。采用卡方检验和方差分析检验研究期间 LOE 的非随机变化。
在筛选的 1403 篇摘要中,有 1147 篇被纳入。两位评审员对摘要筛选的一致性较高(κ 值为 0.93;数据提取的 κ 值为 0.89)。治疗性研究是最常见的研究类型(58%),其次是预后性研究(37%),然后是诊断性研究(5%)。大多数摘要(75.0%)来自北美机构。总体而言,0.35%的演讲为 I 级证据,3.1%为 II 级,52.8%为 III 级,38.0%为 IV 级,5.7%为 V 级。每年的平均 LOE 在 3.54 到 3.32 之间波动,平均 LOE 为 3.45。高质量证据(I 级和 II 级)的比例在 2015 年和 2016 年增加,占 5 年内所有 I 级和 II 级摘要的 78%。LOE 与年份之间的卡方检验 P 值为<.0084,表明 2012 年至 2016 年间 LOE 存在显著的非随机变化。大多数高 LOE 研究在会议的海报会议(37.5%)、全体会议(27.5%)和国际论坛会议/演讲(25%)中进行。
总体而言,2012 年至 2016 年间平均 LOE 相对稳定,大多数摘要被归类为 III 级或 IV 级。2015 年和 2016 年 I 级和 II 级证据的比例逐渐增加,尽管幅度较小,这可能表明血管外科学领域越来越致力于生成和传播高水平的研究。此外,血管外科研究特定的分类工具的缺乏偶尔会在分配 LOE 方面带来挑战,这可能表明该专业需要这样的工具。