Quality of clinical studies in aesthetic surgery journals: a 10-year review.
BACKGROUND
Evidence-based medicine (EBM) has earned increasing attention in all fields of medicine. However, the implementation of EBM is not yet universal, especially in surgery and its subspecialties. A critical assessment of the quality of scientific evidence in the aesthetic surgery literature is needed to promote the practice of EBM.


OBJECTIVE
This study seeks to evaluate the research designs of aesthetic surgery studies published in 3 leading plastic surgery journals during the past 10 years.


METHODS
All studies published in Plastic and Reconstructive Surgery, Annals of Plastic Surgery, and Aesthetic Surgery Journal between January 1, 1998 and December 31, 2007 were reviewed. Articles pertaining to aesthetic surgery were tabulated according to their study design into the following groups: randomized, controlled trials; prospective cohort studies; retrospective cohort studies; and "others" (case series, case reports, expert opinions, and noncritical reviews).


RESULTS
Of the 1419 manuscripts included in the study, 45 papers (3.2%) were classified as randomized controlled trials. Sixty studies (4.2%) were prospective cohort studies. Ninety papers (6.3%) were retrospective cohort studies. The remaining 1224 articles (86.3%) were case series, case reports, reviews, or expert opinions. The percentage of research representing levels 1 and 2 evidence increased from the first to the second half of the decade (from 10.1% to 16.8%).


CONCLUSIONS
Aesthetic surgery literature is inundated with uncontrolled case series, case reports, and expert opinions. Continued efforts are needed to provide scientifically rigorous data on which to base clinical practice in aesthetic surgery.
Department of Surgery, University of Michigan Health System, Ann Arbor, MI 48109-0340, USA.
Edwin Y
EY
Chang
Christopher J
CJ
Pannucci
Edwin G
EG
Wilkins
D019317:Evidence-Based Medicine; D006801:Humans; D010506:Periodicals as Topic / Q000706:statistics & numerical data; D011643:Publishing / Q000592:standards*; D011786:Quality Control; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D013518:Surgery, Plastic