Levels of evidence in otolaryngology journals

Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
Jared M WassermanRichard M Rosenfeld

Abstract

To identify trends in clinical research and levels of evidence in otolaryngology journals. We reviewed all original research articles from 1993, 1998, and 2003, in 4 major otolaryngology journals. Levels of evidence were graded 1 (strongest) through 5 (weakest). Of 2584 total articles, 1924 (75%) were clinical research. During the study period, there was increased median sample size (from 22 to 30, P=0.06), more planned research (from 30% to 37%, P=0.023), more internal control groups (from 36% to 43%, P=0.011), and more articles with P values (from 26% to 45%, P<0.001) or confidence intervals (from 1.2% to 7.6%, P<0.001). Most evidence was level 4 (57%), but median levels increased slightly over time (P=0.027). Therapy articles had the weakest evidence (80% levels 3 to 5) and diagnostic test assessments had the strongest (75% levels 1 and 2). Although clinical research increased in quantity and quality, sample sizes were modest, most articles lacked controls, and confidence intervals were rare. Therapy articles would benefit from higher evidence levels. By defining the current levels of evidence in otolaryngology journals, this overview should help guide future efforts.

References

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Citations

Dec 5, 2006·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Richard M Rosenfeld
Jan 11, 2007·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·J Gail NeelyRandal C Paniello
Oct 2, 2007·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Francisca YaoRichard M Rosenfeld
Feb 10, 2009·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Haidy BibawyRichard Rosenfeld
Feb 2, 2010·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Edward D McCoulRichard M Rosenfeld
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Jul 19, 2012·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Gordon H Sun
Jul 16, 2015·São Paulo Medical Journal = Revista Paulista De Medicina·Fabio Ynoe MoraesHeloísa Andrade Carvalho
Jan 1, 2015·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Sarfaraz M BanglawalaJohn Ioannidis
Apr 16, 2011·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Jennifer J ShinGregory W Randolph
Oct 11, 2013·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·David L WitsellKaren Chiswell
Aug 22, 2018·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Kevin WongGregory A Grillone
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Feb 1, 2008·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Neil Bhattacharyya, Nina L Shapiro
Feb 10, 2021·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Jennifer A SilverJoseph S Schwartz
Nov 3, 2020·Laryngoscope Investigative Otolaryngology·Aasif A KaziDaniel H Coelho
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