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Which Subspecialty Has Highest Percentage of Level I and II Studies?

OrthoSpineNews reports on research recently published in the Journal of Clinical Orthopaedics and Trauma co-authored by HSS orthopedic trauma surgeon Sean T. Campbell, MD, which evaluated the level of evidence (LOE) based on subspecialty.

“We developed the idea for this study after observing that papers accepted for presentation at the AAOS [American Academy of Orthopaedic Surgeons] annual meeting were highly variable with regard to level of evidence. For example, some small retrospective series were included alongside large, randomized trials. We wanted to understand more about this, and in particular we wanted to determine if this level of evidence discrepancy was related to orthopaedic subspecialty,” explained Dr. Campbell. “One of the reasons we were interested in this topic is because we wanted to determine if those of us submitting papers in subspecialty fields that were in the middle, or on the lower end of the list could learn anything from our colleagues who were engaging in studies with more rigorous methodologic quality. This led us to think on the potential reasons for these discrepancies,” he continued.

Two independent raters assessed all abstracts for podium and poster presentations from the 2017 annual AAOS meeting (clinical research only). Level of evidence (I to V) was assessed using the latest Journal of Bone and Joint Surgery guidelines. The final analysis included 1,083 abstracts, 710 of which were podium presentations while 373 were poster presentations. Country of origin was as follows: United States (70.3%), Japan (4.7%), and South Korea (4.4%). 

Dr. Campbell noted, “The most important results of the study were that methodologic quality and level of evidence did have a relationship with subspecialty category. We found that papers accepted in the shoulder and elbow, adult knee reconstruction, hand and wrist, and sports categories had the highest mean level of evidence. Trauma, spine, and hip reconstruction were somewhere in the middle. The foot and ankle, pediatrics, and orthopaedic oncology categories had the lowest mean level of evidence.”

Read the full article at Orthospinenews.com.