[Scientific evidence in the endoscopic treatment of the vesico-ureteral reflux].
The way used by physicians to obtain information from scientific research may have low-quality, with effects on assistance. Evidence-based medicine became necessary due to the exponential growing produced in the published research.


OBJECTIVE
1. To establish the scientific goodness of published papers on endoscopic treatment of vesicoureteral reflux. 2. To quantify the quality level of the papers by means of a series of explicit criteria.


METHODS
Work type: Bibliometric revision. Databases: Revision of the electronic bases: Medline, ACP Journal Bandolier, Cochrane Collaboration and Pediatric Evidence Based Medicine.


METHODS
Papers on endoscopic treatment of primary reflux in children. Evaluation criteria: 1. Scientific level: Evidence classification proposed by Goodman, describing 10 levels from 1 (high) to 10 (low) and the Agency of Evaluation of Technology (AET) describing 9 levels. 2. Quality level: Dichotomic characters referred to the presence or absence of: experimental design, objectives, result measurement and concordance of methods and conclusion with the objectives.


RESULTS
114 papers were found and analyzed 1. Evidence level: 86.9% of papers showed a low level of evidence by Goodman score (level 9) whereas 90.4% presented level 8 of AET. 79.5% of papers were consecutive series of clinical cases, 9% were non-critical bibliographic revisions, 1.7% were cohorts works, 5.3% non-randomized clinical trials and only 1 paper was a randomized clinical trial. 2. Quality level: 61.4% did not explicit the objectives and 57% did not expose the design. The population was not defined in 68.4% of papers and the way to appreciate the results in 73.7%. The experimental design, in 57.9% of works, and the conclusions, in 64.9%, did not concordate with the objectives.


CONCLUSIONS
Endoscopic treatment of vesicoureteral reflux is becoming more popular. However, its effectiveness has to be proved by means of solid scientific bases, for works referring to it have low methodological level and low quality.
Jiménez Alvarez
C
C
Servicio de Cirugía Pediátrica, Hospital Materno-Infantil, Hospital Universitario Virgen de las Nieves, Granada.
Alaminos Mingorance
M
M
Martínez Martínez
L
L
D002986:Clinical Trials as Topic; D006801:Humans; D018666:Ureteroscopy / Q000379:methods*; D014718:Vesico-Ureteral Reflux / Q000601:surgery*