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Evidence-Based Plastic and Reconstructive Surgery: Developments over Two Decades

Becker, Axel M.D.; Blümle, Anette Ph.D.; Momeni, Arash M.D.

Plastic and Reconstructive Surgery: October 2013 - Volume 132 - Issue 4 - p 657e–663e
doi: 10.1097/PRS.0b013e31829fe0f7
Special Topics

Background: Increasing awareness of the importance of evidence-based medicine is demonstrated not only by an increasing number of articles addressing it but also by a specialty-wide evidence-based medicine initiative. The authors critically analyzed the quality of reporting of randomized controlled trials published in this Journal over a 21-year period (1990 to 2010).

Methods: A hand search was conducted, including all issues of Plastic and Reconstructive Surgery from January of 1990 to December of 2010. All randomized controlled trials published during this time period were identified with the Cochrane decision tree for identification of randomized controlled trials. To assess the quality of reporting, a modification of the checklist of the Consolidated Standard of Reporting Trials Statement was used.

Results: Of 7121 original articles published from 1990 to 2010 in the Journal, 159 (2.23 percent) met the Cochrane criteria. A significant increase in the absolute number of randomized controlled trials was seen over the study period (p < 0.0001). The median quality of these trials from 1990 to 2010 was “fair,” with a trend toward improved quality of reporting over time (p = 0.127).

Conclusions: A favorable trend is seen with respect to an increased number of published randomized controlled trials in Plastic and Reconstructive Surgery. Adherence to standard reporting guidelines is recommended, however, to further improve the quality of reporting. Consideration may be given to providing information regarding the quality of reporting in addition to the “level of evidence pyramid,” thus facilitating critical appraisal.

Offenburg and Freiburg, Germany; and Palo Alto, Calif.

From the Department of Traumatology and Hand Surgery, Klinikum Offenburg; Department of Medical Biometry and Statistics, German Cochrane Center, University Medical Center Freiburg; and Division of Plastic and Reconstructive Surgery, Stanford University Medical Center.

Received for publication December 11, 2012; accepted April 4, 2013.

Disclosure: The authors have no conflicts of interest to disclose.

Arash Momeni, M.D., Division of Plastic and Reconstructive Surgery, Stanford University Medical Center, 770 Welch Road, Suite 400, Palo Alto, Calif. 94304–5715,

©2013American Society of Plastic Surgeons