Ten-Year Trends in Level of Evidence in Hand Surgery.

Abstract

The purposes of this study were to analyze the trends in Oxford level of evidence (LOE), LOE of most-cited articles, and association between LOE and journal impact factor (IF) and SCImago Journal Rank (SJR) over a 10-year period (2009-2018) in 3 prominent hand surgery journals, specifically <i>HAND, Journal of Hand Surgery</i> (<i>American Volume</i>) (<i>JHS</i>), and <i>Journal of Hand Surgery</i> (<i>European Volume</i>) (<i>JHSE</i>). All articles published from 2009 to 2018 in <i>HAND, JHS</i>, and <i>JHSE</i> were reviewed for assigned or available LOE. Data were pooled and analyzed for trends in LOE; relationship among IF, SJR, and LOE; and citation density. A total of 3921 total publications were tabulated from 2009 to 2018, with the majority of studies being level V (1700, 43%) and fewer studies being level I (146, 4%). Over the 10-year study period, there was no significant change in frequency of level I studies for any journal. <i>HAND</i> trended significantly toward higher LOE, <i>JHS</i> trended toward higher LOE, and <i>JHSE</i> trended toward decreased LOE without significance. Among all journals, the annual number of articles and the average LOE were independent significant predictors of IF and SJR. Statistically significant correlations were found between citation density and LOE for <i>JHS</i> and <i>HAND</i>. Higher quality evidence is becoming more prevalent in the hand surgery literature over the past 10 years. Annual articles, average LOE, and level I and II and level IV articles were significant predictors of increasing IF and SJR.