title: Levels of evidence: a comparison between top medical journals and general pediatric journals.
abstract: BACKGROUND
  Given the large number of publications in all fields of practice, it is essential that clinicians focus on the resources that provide the highest level of evidence (LOE). We sought to determine the LOE that exists in the field of pediatrics, present in the general pediatric as well as high impact clinical literature.
  
  
  METHODS
  Clinical pediatric literature, published between April 2011 and March 2012 inclusive in high-impact clinical journals (HICJ) (New England Journal of Medicine, Journal of the American Medical Association, & The Lancet) and the highest-impact general pediatric journals (GPJ) (Pediatrics, Journal of Pediatrics, & Archives of Pediatrics & Adolescent Medicine), was assessed. In addition to the LOE, articles were evaluated on criteria including subspecialty within pediatrics, number of authors, number of centers, and other parameters. Eligible level I randomized control trials were appraised using the Consolidated Standards of Reporting Trials (CONSORT) guidelines.
  
  
  RESULTS
  Of 6511 articles screened, 804 met inclusion criteria (68 in HICJ and 736 in GPJ). On average, LOE in pediatrics-focused articles within The Lancet were significantly higher than all GPJ (p < 0.05). Average CONSORT scores were significantly higher in HICJ vs. GPJ (15.2 vs. 13.6, respectively, p < 0.001).
  
  
  CONCLUSIONS
  LOE and quality of randomized control trials within the pediatric field is highest within HICJ, however, only represent a small proportion of data published. Following CONSORT criteria, and promoting studies of high LOE may allow authors and readers to turn to journals and articles of greater clinical impact.
authors: Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada. jacobson.dustin@gmail.com.
authors: Dustin A
authors: DA
authors: Jacobson
authors: Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada. kunal.bhanot@medportal.ca.
authors: Kunal
authors: K
authors: Bhanot
authors: Department of Neurosurgery, McMaster University, Hamilton, ON, Canada. blake@yarascavitch.com.
authors: Blake
authors: B
authors: Yarascavitch
authors: Department of Plastic Surgery, McMaster University, Hamilton, ON, Canada. jennifer@chuback.ca.
authors: Jennifer
authors: J
authors: Chuback
authors: Depatment of Pediatrics, McMaster University, Hamilton, ON, Canada. erosenb@mcmaster.ca.
authors: Ehud
authors: E
authors: Rosenbloom
authors: Departments of Epidemiology and Biostatistics and Orthopedic Surgery, McMaster University, Hamilton, ON, Canada. bhandam@mcmaster.ca.
authors: Mohit
authors: M
authors: Bhandari
mesh_terms: D019317:Evidence-Based Medicine / Q000592:standards*; D055811:Journal Impact Factor; D010372:Pediatrics / Q000592:standards*; D010506:Periodicals as Topic / Q000592:standards*; D016032:Randomized Controlled Trials as Topic / Q000592:standards; D014481:United States