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Clinical Level of Evidence Presented at the Lumbar Spine Research Society (LSRS) Annual Meeting Over 10 Years (2008–2017)

A Systematic Review

Eyrich, Nicholas W. MS; Rodoni, Bridger M. BS; Patel, Rakesh MD†,‡; Aleem, Ilyas S. MD, MS, FRCSC†,‡

doi: 10.1097/BRS.0000000000003029

Study Design. A systematic review.

Objective. The Lumbar Spine Research Society (LSRS) is dedicated to advancing knowledge of the lumbar spine to promote evidence-based care. We sought to systematically review the level of clinical evidence presented at LSRS annual meetings from 2008 through 2017.

Summary of Background Data. Improvements in clinical evidence have been reported at similar bone and joint scientific meetings.

Methods. A total of 458 paper abstracts presented at LSRS annual meetings were independently assessed by two reviewers. Only clinical studies being included for analysis. Reviewers designated a clinical level of evidence (LOE) to each included abstract from level I to level IV based on criteria set forth by the Oxford Centre for Evidence-Based Medicine. Reviewer agreement was assessed using Cohens Kappa coefficient (k). Student t test was used to assess for differences in mean LOE grades. Chi-squared testing was used to assess nonrandom changes in LOE.

Results. A total of 299 abstracts met inclusion criteria. Over the last 10 LSRS meetings, 2.68% of the presentations were level I, 22.4% were level II, 37.1% were level III, and 37.8% were level IV. We found the average LOE from 2008 to 2017 to be 3.10 (median = 3). In addition, 63.9% presentations were Therapeutic Studies, 30.1% were Prognostic Studies, and 6.02% were Diagnostic studies. When comparing the first 5 years (2008–2012) to the last 5 years (2013–2017), we observed a significant increase in Level II (P < 0.05) and Level III (P < 0.05) evidence along with a corresponding decrease in level IV evidence (P < 0.01). The average LOE improved significantly from 3.28 (2008–2012) to 2.88 (2013–2017) (P < 0.001).

Conclusion. Emphasis on evidence-based medicine within spine surgery, specifically pertaining to the lumbar spine, has positively influenced the clinical LOE disseminated at LSRS annual meetings between 2008 and 2017.

Level of Evidence: 4

We systematically reviewed the clinical level of evidence presented at Lumbar Spine Research Society annual meetings from 2008 through 2017. A total of 299 clinical studies were included. The average level of evidence improved significantly from 3.28 (2008–2012) to 2.88 (2013–2017) (P < 0.001). Emphasis on EBM has positively influenced the quality of research at Lumbar Spine Research Society meetings.

University of Michigan Medical School, Ann Arbor, MI

Department of Orthopaedic Surgery Spine Service, Michigan Medicine, Ann Arbor, MI

Department of Neurological Surgery Spine Service, Michigan Medicine, Ann Arbor, MI.

Address correspondence and reprint requests to Nicholas W. Eyrich, MS, University of Michigan Medicine, 1500 E Medical Center Dr., Ann Arbor, MI 48109; E-mail:

Received 21 November, 2018

Revised 23 January, 2019

Accepted 18 February, 2019

This study's abstract was submitted to the 2019 North American Spine Society Annual Scientific Meeting, Chicago, IL, September 2019.

The manuscript submitted does not contain information about medical device(s)/drug (s).

No funds were received in support of this work.

Relevant financial activities outside the submitted work: board membership, consultancy.

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