Resumen
In modern day medical practice, “rules of evidence” have been established to grade clinical and research findings according to strength. The aim of this study is to describe the current pattern of publications in 5 major Nigerian medical journals in terms of levels of evidence. Five major peer-review medical journals (Nigerian Q J Hosp Med, Nigerian Post grad Med J, West African J Med, African J Med Med Sci, and Nigerian J Clin Pract) published in Nigeria were included in the study. All articles published in 2005 and 2006 were accessed, classified into four levels of evidence, and pattern of publications was described. All eligible 580 published articles were analysed. None (0%) achieved level I evidence, 15 (3%) were level II, 47 (8%) level III, and 258 (44%) level IV; and the majority (n=260, 45%) of the published were classified as non-evidence. There were more evidence articles in indexed journals than in non-indexed one (P=0.000). Among the 260 non-evidence articles there were 97 (37.3%) case reports, 28 (10.8%) non-systematic review articles, 30 (11.5%) animal studies, 6 (2.3%) laboratory studies, 3 (1.1%) technical notes and 94 (36.1%) were classified as others (KAP studies, reports, guidelines, questionnaire-based studies). The general level of evidence of articles published in the five major medical journals in the 2- year period 2005-2006 was low as only 11% of articles were levels II and III. There is a need to improve on the quality and funding of medical research in Nigeria in order to promote better patient care.
Keywords: Rule of evidence, published, journals appraisal, medical, Nigeria.
Résumé
Dans la pratique de la médicine moderne, “Force de l’évidence” ont été établi pour régler les résultats des recherches cliniques en fonction de leur force. Le but de cette étude est de décrire la fréquence des publications dans 5 journaux majeurs médicaux Nigérian en fonction de la force de l’évidence. Cinq journaux médicaux de répute (Nigerian Q J Hosp Med, Nigerian Postgrad Med J, West African J Med, African J Med Med Sci, et Nigerian J Clin Pract) publiés au Nigeria étaient inclus. Tous les journaux publiés entre 2005 et 2006 étaient évalués, classés en quatre selon leur niveau d’évidence et la fréquence de publication était décrit. Tous articles publiés éligibles étaient analysés. Aucun (0%) n’atteint le niveau d’évidence I, 15 (3%) étaient au niveau II, 47 (8%) niveau III, et 258 (44%) niveau IV; et la majorité (n=260, 45%) des articles publiés n avaient pas d’évidence. Ils avaient plus articles évident dans les journaux indexés que les non indexés (P=0.000). Parmi les 260 d’articles non-evident, ils avaient 97 (37.3%) cas rapportés, 28 (10.8%) de revue non-systematique, 30 (11.5%) étude animales, 6 (2.3%) étude au laboratoire, 3 (1.1%) notes techniques et 94 (36.1%) étaient classés comme autres (guides, questionnaire). Le niveau général des évidences des articles publiés dans les cinq journaux médicaux majeurs dans les 2 dernières années 2005-2006 était faible vu que seulement 11% des articles étaient aux niveaux II et III. Il est nécessaire d’améliorer sur la qualité et le financement des recherches médicales au Nigeria afin de promouvoir des meilleurs soins de santé
Correspondence: Dr. W.L. Adeyemo, Department of Oral and Maxillofacil Surgery, College of Medicine, University of Lagos, PMB 12003, Nigeria. Email: lanreadeyemo@yahoo.com
Referencias
Sackett DL, Rosenberg WM, Gray JA, Haynes RB and Richardson WS. Evidence based medicine: what it is and what isn’t. BMJ 1996; 312: 71-72.
Sutherland SE. Evidence-based dentistry: Part IV. Research design and levels of evidence. J Can Dent Assoc 2001; 67: 375-378.
Richards D and Lawrence A. Evidence based dentistry. Br Dent J 1995; 179: 270-273.
Lau SL and Samman N. Levels of evidence and journal impact factor in oral and maxillo- facial surgery. Int J Oral Maxillofac Surg 2007; 36: 1-5.
Van Weel C. Translating research into practice-a three paper series (commentary).Lancet
; 362: 1170.
Leung GM. Evidence-based practice revisited. Asia Pac J Public Health 2001; 13: 116-121.
Fletcher S and Sackett DL. The periodic health examination. Canadian Task Force on the Periodic Health Examination. Can Med Assoc J 1979; 121: 1193-1254.
NHMRC.Guidelines to the Development,Implementation and Evaluation of Clinical Practice Guidelines. http://www.nhmrc.gov.au/ publications/_files/cp30.pdf; 1999. (cited on 01/ 04/2007).
Oxford Centre for Evidence-based Medicine Levels of Evidence (2001). http://www.cebm. net/levels_of_evidence.asp.(cited on 01/05/2007).
Bauer J, Spackman S, Chiapelli F and Prolo P. Model for evidence-based dental decision making. J Evid Base Dent Pract 2005; 5: 189- 197.
Lau S L and Samman N. Evidence-based practice in oral and maxillofacial surgery: audit of 1 training center. J Oral Maxillofac Surg 2007; 65: 651-657.
Smith R. Where is the wisdom…? BMJ 1991; 303: 798-799.
Chalmers TC, Celano P, Sacks HS and Smith H Jr. Bias in treatment assignment in controlled clinical trials. N Eng J Med 1983;309:1358-1361.
Antczak A A, Tang J and Chalmers T C.Quality assessment of randomized control trials in dental research. II. Results: periodontal research. J Periodontal Res 1986; 21: 315-321.
Kingston R, Barry M, Tierney S, Drumm J and Grace P. Treatment of surgical patients is evidence-based. Eur J Surg 2001; 167: 324-330.
Haines SJ. Randomized clinical trials in the evaluation of surgical innovation. J Neurosurg 1979; 51: 5-11.
Solomon MJ and McLeod RS. Clinical studies in surgical journals- have we improved? Dis Colon Rectum 1993; 36: 43-48.
Solomon MJ and McLeod RS. Surgery and the randomized controlled trial: past, present and future. Med J Aust 1998; 169: 380-383.
Mant D. Can randomized trials inform clinical decisions about individual patients? Lancet 1999; 353: 743-746.