The Journal of Bone and Joint Surgery (American). 2009;91:867-873.
doi:10.2106/JBJS.G.01233
© 2009 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow CME: Take the activity for this article:
 CME 2: April, May, June 2009 (publication date July 6, 2009; expiration dat...
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow Rights and Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Schmidt, A. H.
Right arrow Articles by Turkelson, C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Schmidt, A. H.
Right arrow Articles by Turkelson, C.
Related Collections
Right arrow Adult Trauma
Right arrow Basic Science
Right arrow Spine
Right arrow Adult Hip
Right arrow Adult Knee
Right arrow Foot/Ankle
Right arrow Shoulder
Right arrow Elbow
Right arrow Hand/Wrist
Right arrow Sports
Right arrow Pediatrics
Right arrow Oncology
Right arrow Rehabilitation
Right arrow Education and Training
Right arrow Pain Management
Right arrow Ethics
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Facebook   Add to Technorati   Add to Twitter  
What's this?

Levels of Evidence at the AAOS Meeting: Can Authors Rate Their Own Submissions, and Do Other Raters Agree?

Andrew H. Schmidt, MD1, Guofen Zhao, MS2 and Charles Turkelson, PhD2

1 Department of Orthopedic Surgery, Mailcode G2, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN 55415. E-mail address: schmi115{at}umn.edu
2 American Academy of Orthopaedic Surgeons, 6300 North River Road, Rosemont, IL 60018

Investigation performed at the Department of Orthopedic Surgery, Hennepin County Medical Center, Minneapolis, Minnesota, and American Academy of Orthopaedic Surgeons, Rosemont, Illinois

Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits or a commitment or agreement to provide such benefits from commercial entities (Thieme, Synthes USA, Twin Star Medical, FH Orthopedics, and AGA [less than $10,000] and Smith and Nephew [in excess of $10,000]). Also, commercial entities paid or directed in any one year, or agreed to pay or direct, benefits in excess of $10,000 (Synthes USA, Smith and Nephew, and Medtronic) or less than $10,000 (Twin Star Medical) to a research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which one or more of the authors, or a member of his or her immediate family, is affiliated or associated.

Background: A hierarchy of levels of evidence is commonly used to categorize the methodology of scientific studies in order to assist in their critical analysis. Organizers of large scientific meetings are faced with the problem of whether and how to assign levels of evidence to studies that are presented. The present study was performed to investigate two hypotheses: (1) that session moderators and others can consistently assign a level of evidence to papers presented at national meetings, and (2) that there is no difference between the level of evidence provided by the author of a paper and the level of evidence assigned by independent third parties (e.g., members of the Program Committee).

Methods: A subset of papers accepted for presentation at the 2007 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting was used to evaluate differences in the levels of evidence assigned by the authors, volunteer graders who had access to only the abstract, and session moderators who had access to the full paper. The approved AAOS levels of evidence were used. Statistical tests of interrater correlation were done to compare the various raters to each other, with significance appropriately adjusted for multiple comparisons.

Results: Interrater agreement was better than chance for most comparisons between different graders; however, the level of agreement ranged from slight to moderate (kappa = 0.16 to 0.46), a finding confirmed by agreement coefficient statistics. In general, raters had difficulty in agreeing whether a study comprised Level-I or Level-II evidence and authors graded the level of evidence of their own work more favorably than did others who graded the abstract.

Conclusions: When abstracts submitted to the AAOS Annual Meeting were rated, there was substantial inconsistency in the assignments of the level of evidence to a given study by different observers and there was some evidence that authors may not rate their own work the same as independent reviewers. This has important implications for the use of levels of evidence in scientific meetings.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Facebook Facebook   Add to Technorati Technorati   Add to Twitter Twitter    What's this?