Levels of Evidence in Plastic Surgery Research over 20 Years
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
BACKGROUND: Evidence-based medicine, particularly randomized controlled trials, influences many daily decisions within the medical specialties. The structure of questions asked during the history and selection of physical examination maneuvers, diagnostic tests, and treatment regimens are all guided by evidence-based medicine. Implementation of evidence-based medicine has been slower in surgical practice. The purpose of this study was to survey published plastic surgery literature to evaluate changes in the level of evidence from pre-evidence-based medicine popularization to the present time. METHODS: Articles from Plastic and Reconstructive Surgery for the years 1983, 1993, and 2003 were ranked by a five-point level of evidence scale. The highest level of evidence value (1) was given to randomized clinical trials and the lowest value (5) was given to individual case reports; 989 articles were ranked. RESULTS: The average level of evidence of an article published in 1983 was lower than that of one published in 2003 (4.42 versus 4.16, respectively), and the majority of research (86.9 percent in 2003) remained largely uncontrolled and descriptive in nature. However, there was a trend toward higher-quality research. The percentage of studies with control or placebo groups nearly doubled from 1983 to 2003 (from 7.21 percent to 13.7 percent), and the number of randomized clinical trials increased (zero versus seven). CONCLUSION: The plastic surgery literature has responded to the demand for more evidence-based medicine, but the rate of change has been slow and the field will likely never enjoy the high level of evidence of medical fields.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | Metaresearch Domain: Methods · Genre: Review About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | MetaresearchBibliometrics Domain: Evaluation · Genre: Review About the Canadian research system: no · About a Canadian topic: no | Observational | medium |
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.148 | 0.637 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.025 | 0.009 |
| Bibliometrics | 0.009 | 0.010 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.014 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it