student research day - Case Western Reserve University School of ...

Pritesh Mehta
PEER-REVIEW OF THE SURGICAL LITERATURE: A DOUBLE-BLINDED RANDOMIZED CONTROLLED TRIAL
Pritesh Mehta, S. A. Roman, D. C. Thomas, J. A. Sosa and Dr. Julie Ann Sosa M.D.
Department of Surgery, Department of Endocrine Surgery
Yale University School of Medicine, New Haven, CT
Introduction: Evidence-based surgery is predicated on the quality of published literature. We measured the quality
of surgical manuscripts selected by peer-review and identify predictors of excellence. Methods: A random sample
of 120 manuscripts about clinical therapeutics in surgery were taken from 1998 in five eminent peer-reviewed
surgical and medical journals. Manuscripts were blinded for author, institution, and journal of origin. Four surgeons
and four methodologists evaluated their quality using two novel, validated instruments based on subject selection,
study protocol (i.e. ―blinding‖, inclusion criteria, use of control groups), statistical analysis and inference,
intervention description, outcome assessments, presentation of results, and perceived impact a decade after
publication via citation index. They generated separate clinical and methodological quality scores for each
manuscript. Predictors of quality were identified based on univariate and multivariate regression analyses. Results:
Among our sample of manuscripts, oncology was the most common study subject (26%), followed by general
surgery/GI (24%), and vascular, transplant, and/or cardiothoracic surgery (23%). The average number of study
subjects was 417; the majority of manuscripts were from the U.S. (53%) and from a single institution (59%). Just
18% had a statistician-author. The mean number of citations was 128. Surgical manuscripts submitted to medical
journals, as compared to surgical journals, had on average significantly better clinical (1.7 vs. 2.5, p