title: Evidence-based surgery--evidence from survey and citation analysis in orthopaedic surgery.
abstract: BACKGROUND
  The results of a survey on evidence-based surgery (EBS) among members of the American Academy of Orthopedic Surgeons (AAOS) and the British Orthopaedic Association (BOA) are presented. The study also analyzes the citations earned by articles with different levels of evidence  (LOE) to see if LOE have any bearing on the importance attached to the articles by authors and contributors to the journals.
  
  
  METHODS
  The questionnaire was e-mailed to 1000 randomly chosen consultant orthopaedic surgeons who were members of either the AAOS or the BOA. Participants  were provided with the option of responding through web-based entry. For citation analysis, citation data were gathered from the Journal of Bone and Joint Surgery (American volume) between the years 2003 and 2007 (5-year period).
  
  
  RESULTS
  The survey showed that awareness and access  to EBS have improved greatly over the years. At the present time, these factors are not important barriers to the implementation of EBS in clinical practice in developed countries. There was a statistically significant difference in those with and without additional qualifications with regard  to the approach to EBS. However, an equal percentage of surgeons with and without additional qualifications felt that it was difficult to adhere to EBS guidelines in daily clinical practice. Citation analysis showed that readers of professional journals attach importance to LOE category of  the article and tend to cite level-I evidence articles more than other articles.
authors.affiliation: Hosmat Hospital, Bangalore, India. docmnkumar@gmail.com
authors.forename: Malhar
authors.initials: M
authors.lastname: Kumar
authors.forename: Chethan
authors.initials: C
authors.lastname: Gopalakrishna
authors.forename: Pazhayannur V
authors.initials: PV
authors.lastname: Swaminath
authors.forename: Sanjay S
authors.initials: SS
authors.lastname: Mysore
mesh_terms: D000328:Adult; D000368:Aged; D015706:Bibliometrics; D003430:Cross-Sectional Studies; D019317:Evidence-Based Medicine; D006801:Humans; D008875:Middle Aged; D009985:Orthopedics / Q000639:trends*; D011364:Professional Practice / Q000639:trends*; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014481:United States