Classification and appraisal of the level of clinical evidence of publications from the Canadian Association of Pediatric Surgeons for the past 10 years

J Pediatr Surg. 2009 May;44(5):1013-7. doi: 10.1016/j.jpedsurg.2009.01.048.


Introduction: Increasing evidence is placed on the evidence-based quality of publications. We classified the publication type and assessed the reporting quality of the highest evidence level publications from the Canadian Association of Pediatric Surgeons between 1998 and 2007.

Methods: All publications from Canadian Association of Pediatric Surgeons issues in the Journal of Pediatric Surgery from 1998 to 2007 were classified by study type and level of evidence (Oxford Center for Evidence-based Medicine Levels of Evidence). Cohort studies (level 2) were evaluated by 2 independent assessors using the Newcastle-Ottawa Quality Assessment Scale (NOQAS). Reliability and chi(2) analyses were performed.

Results: Three hundred two publications were classified by level of evidence as follows: level 2, 46; level 3, 13; level 4, 109; and level 5, 134. The median NOQAS score of the 46 level-2 cohort studies was 8 (range, 5-9), and the interrater reliability was 0.94 (95% confidence interval, 0.89-0.96). There was a significant increase in the number of level-2 evidence publications (P = .001) over the study period.

Conclusions: Level-2 evidence cohort studies met a high scientific standard as assessed by the NOQAS and significantly increased in number over the study period. However, there were no level-1 evidence (randomized controlled trial) publications, and most were in the lower evidence classification levels (3-5).

Publication types

  • Evaluation Study

MeSH terms

  • Bibliometrics*
  • Canada
  • Clinical Trials as Topic
  • Cohort Studies
  • Evidence-Based Medicine*
  • General Surgery*
  • Multicenter Studies as Topic
  • Pediatrics*
  • Periodicals as Topic / statistics & numerical data
  • Publications / classification*
  • Publications / statistics & numerical data
  • Publishing / standards
  • Publishing / statistics & numerical data*
  • Publishing / trends
  • Retrospective Studies
  • Societies, Medical / statistics & numerical data*