title: Reduction in surgical innovation, 1988 to 2006.
abstract: OBJECTIVE
  We hypothesize that increasing regulation of human subject research has reduced the number of published reports of surgical innovation in otolaryngology.
  
  
  METHODS
  A systematic review of a predetermined subset of otolaryngology literature.
  
  
  METHODS
  We randomly selected half of the articles published in 1988 and 2006 in three prominent journals. After identifying information was concealed, abstracts were classified independently by two authors into three groups: innovation, modification, or neither. Disagreements were resolved by a third author who read the entire article. Proportions were compared with chi(2) analysis.
  
  
  RESULTS
  The proportion of articles classified as innovation or modification decreased significantly from 67 of 367 (18.3%) in 1988 to 59 of 548 (10.8%) in 2006 (P = 0.001). The elimination of radiology and pathology quiz cases yielded similar results: 11.1 percent vs 18.9 percent, P = 0.001. Innovation or modification in animal model research also decreased (0.9% vs 3.8%, P = 0.003). Overall, only 4 articles were actually classified as true innovation.
  
  
  CONCLUSIONS
  The frequency of true innovation was low in both years, but articles that described surgical modifications decreased significantly over this 18-year period. One reason may be increased administrative barriers for clinical research approval. Although our analysis cannot determine cause and effect, it is an important finding that deserves further study.
authors.affiliation: Department of Otorhinolaryngology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Rosow
authors.forename: Ilya
authors.initials: I
authors.lastname: Likhterov
authors.forename: Michael G
authors.initials: MG
authors.lastname: Stewart
authors.forename: Max M
authors.initials: MM
authors.lastname: April
mesh_terms: D016009:Chi-Square Distribution; D004059:Diffusion of Innovation; D006805:Human Experimentation / Q000331:legislation & jurisprudence*; D006801:Humans; D010038:Otorhinolaryngologic Diseases / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000639:trends*; D010506:Periodicals as Topic