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      Design and level of evidence of studies published in two Brazilian medical journals recently indexed in the ISI Web of Science database Translated title: Desenho e nível de evidência dos estudos publicados em dois periódicos brasileiros recentemente indexados na Web of Science -ISI

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          CONTEXT AND OBJECTIVES: The level of evidence and methodological quality of articles published in medical journals are important aids for clinicians in decision-making and also affect journals' impact factor. Although systematic reviews (SR) are considered to represent the highest level of evidence, their methodological quality is not homogeneous and they need to be as carefully assessed as other types of study. This study aimed to assess the design and level of evidence of articles published in 2007, in two recently indexed Brazilian journals (Clinics and Revista da Associação Médica Brasileira), and to evaluate the methodological quality of the SRs. DESIGN AND SETTING: Descriptive study developed in the Brazilian Cochrane Center, Universidade Federal de São Paulo. METHODS: All 289 published articles were classified according to types of study design and level of evidence. The SRs were critically appraised by two evaluators using the AMSTAR tool. RESULTS: The most frequent design types were cross-sectional studies (39.9%), case reports (15.8%), experimental studies (10.8%) and narrative reviews (7.4%). According to the Oxford criteria, 25.6% of the articles were classified as level 4 or 5 evidence, while 2.8% were level 1. SRs represented only 2% of the published articles and their methodological quality scores were low. CONCLUSIONS: The main design types among the published papers were observational and experimental studies and narrative reviews. SRs accounted for a small proportion of the articles and had low methodological scores. Brazilian medical journals need to encourage publication of greater numbers of clinically relevant papers of high methodological quality.

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          CONTEXTO E OBJETIVOS: O nível de evidência e a qualidade metodológica dos artigos publicados em revistas médicas são importantes para auxiliar os clínicos a tomarem decisões e também afetam o fator de impacto dos periódicos. Apesar de as revisões sistemáticas (RS) serem consideradas o maior nível de evidência, sua qualidade metodológica não é homogênea e elas precisam ser avaliadas tão criteriosamente como outros tipos de estudos. O objetivo deste estudo foi avaliar os desenhos e nível de evidência dos artigos publicados em 2007 em duas revistas brasileiras recentemente indexadas (Clinics e Revista da Associação Médica Brasileira) e avaliar a qualidade metodológica das RS. TIPO DE ESTUDO E LOCAL: Estudo descritivo desenvolvido no Centro Cochrane do Brasil, Universidade Federal de São Paulo. MÉTODOS: Todos os 289 artigos publicados foram classificados quanto ao tipo de desenho e nível de evidência. As RS foram analisadas criticamente por dois revisores usando o instrumento AMSTAR. RESULTADOS: Os tipos de desenhos mais frequentes foram os transversais (39,9%), relatos de casos (15,8%), estudos experimentais (10,8%) e revisões narrativas (7,4%). Segundo os critérios de Oxford, 25,6% dos artigos eram de nível 4 ou 5 e 2,8% de nível 1. As RS representaram apenas 2% do total dos artigos publicados e tiveram notas de qualidade metodológica baixas. CONCLUSÕES: Os principais tipos de desenhos dos estudos publicados foram observacionais, experimentais e revisões narrativas. As RS representaram uma pequena parcela dos artigos e tiveram baixa pontuação metodológica. Revistas médicas brasileiras devem incentivar a publicação de mais artigos clinicamente relevantes com alta qualidade metodológica.

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          Most cited references 29

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          Epidemiologia Clínica: bases científicas da conduta médica

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            Experimental evaluation of 3-dimensional kinematic behavior of the cruciate ligaments

            PURPOSE: The purpose of this study was to evaluate a low-cost and easily reproducible technique for biomechanical studies in cadavers. In this kind of study, the natural effect of loading of the joint and shear forces are not taken into account. The objective is to describe the plastic deformation of the ligaments into 3-dimensional space. METHOD: For 18 intact human cadaver knees, the cruciate ligaments were divided into 3 fiber bundles, the tibial or femoral fixation points were marked, and 2 perpendicular different x-ray exposures were performed, thus obtaining radiographs of spatial projections of the bundle in 3 anatomic planes (frontal, sagittal, and transversal). From the measurements made on the x-ray films, we obtained the average distance between the 2 fixation points of the cruciate ligaments on the tibia and the femur at 4 different flexion angles. RESULTS: The distance between the fixation points of the medial and lateral fiber bundles of the cruciate ligaments did not change significantly during movement. There were, however, significant variations (P < .05) in the distance between the fixation points of the posterior fiber bundles of the anterior cruciate ligament and the anterior fiber bundles of the posterior cruciate ligament. CONCLUSIONS: This technique was efficient for demonstrating the plastic deformability of the cruciate ligaments. The results proceeding from this type of study can assist in the planning of physical rehabilitation programs.
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              Designs of studies published in two Brazilian journals of orthopedics and sports medicine, recently indexed in the ISI Web of Science

               Rachel Riera (2009)
              CONTEXT AND OBJECTIVE: The methodology and relevance of articles are among the keystones for promoting their citation and increasing journals' impact factors. Study designs appropriate for answering the questions and adequate sample sizes have the aim of reducing the risk of bias. This study evaluated the articles published in two Brazilian journals of orthopedics and sports medicine that were recently indexed in the ISI Web of Science, regarding study design, sample size calculation, randomization and blinding. DESIGN AND SETTING: Descriptive study at Brazilian Cochrane Center. METHODS: Through a manual search, all original manuscripts published in 2007 in Acta Ortopédica Brasileira and Revista Brasileira de Medicina do Esporte were selected and evaluated. RESULTS: All the 60 articles published in Acta Ortopédica Brasileira and the 87 articles in Revista Brasileira de Medicina do Esporte were included and evaluated. The commonest design in Acta Ortopédica Brasileira was experimental studies (n = 19) and in Revista Brasileira de Medicina do Esporte, update or review articles (n =14). Sample calculations were seen in a minority of the articles. None of the eight clinical trials published presented sample calculations or adequate randomization processes. Three were described as blinded, but none described the measures taken to prevent disclosure of the allocation concealment. CONCLUSIONS: Publication of studies of good methodological quality other than review and experimental studies should be strongly encouraged among Brazilian journals, with the aim of increasing their citation and therefore their impact factor.

                Author and article information

                Role: ND
                Role: ND
                Sao Paulo Medical Journal
                Sao Paulo Med. J.
                Associação Paulista de Medicina - APM (São Paulo )
                July 2010
                : 128
                : 4
                : 202-205
                [1 ] Universidade Federal de São Paulo Brazil
                [2 ] Universidade Federal de São Paulo Brazil
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