title: Level of evidence of clinical orthopedic surgery research in Saudi Arabia.
abstract: OBJECTIVE
  To evaluate the level of evidence (LOE) of Saudi clinical orthopedic research.
  
  
  METHODS
  In July 2012, a list of Saudi orthopedic surgeons (N=93) affiliated with all major universities and hospitals in Saudi Arabia were obtained. PubMed and Embase searches were performed for all eligible studies over the last 2 decades (August 1991 to May 2012). The Oxford LOE scale was utilized to determine the LOE of these studies (Level V studies were excluded). The LOE trends were compared between the last 2 decades. In addition, the LOE of Saudi orthopedic studies was compared with North American studies.
  
  
  RESULTS
  Of 251 articles, 159 met the inclusion criteria for the LOE evaluation. Most of the published studies are Level IV (86%). The average level of evidence was 3.75. There was no statistically significant difference when we compared the LOE trend between the last 2 decades. North American studies contained higher proportions of high-level studies when compared to Saudi studies (p<0.05).
  
  
  CONCLUSIONS
  Most of the published studies are low LOE. Academic staff, institutions, and training programs are required to develop research strategies to improve orthopedic research quality in Saudi Arabia.
authors.affiliation: Division of Orthopedic Surgery, McGill University, Montreal, Quebec, Canada. makhdomas@hotmail.com
authors.forename: Asim M
authors.initials: AM
authors.lastname: Makhdom
authors.forename: Saad M
authors.initials: SM
authors.lastname: Alqahtani
authors.forename: Khalid A
authors.initials: KA
authors.lastname: Alsheikh
authors.forename: Osama A
authors.initials: OA
authors.lastname: Samargandi
authors.forename: Neil
authors.initials: N
authors.lastname: Saran
mesh_terms: D035843:Biomedical Research; D006801:Humans; D019637:Orthopedic Procedures; D012529:Saudi Arabia