An Assessment of the Methodological Quality of Research Published in The American Journal of Sports Medicine

Background: Evidence-based medicine has become a popular topic in academic medicine during the past several decades and more recently in orthopaedics and sports medicine.

Hypothesis: Articles published in The American Journal of Sports Medicine have shown an improvement in methodological quality in 2001-2003, compared with 1991-1993.

Study Design: Systematic review.

Methods: All articles published in The American Journal of Sports Medicine during the periods 1991-1993 and 2001-2003 were reviewed and classified by type of study. The use of pertinent methodologies such as prospective data collection, randomization, blinding, and controlled studies was noted for each article. The frequency of each article type and the use of evidence-based techniques were compared across study periods.

Results: Case series and descriptive studies decreased during the study period, from 27.4% to 15.3% (P= .00003) and from 11.9% to 5.6% (P= .001), respectively, of articles published. Prospective cohort studies increased from 4.7% to 14.1% (P= .000005), and randomized, prospective clinical trials increased from 2.7% to 5.9% of articles (P= .04). More studies tested an explicit hypothesis (P= .0000002), used prospective data collection (P= .000003), and used blinding (P= .02), and more studies identified a funding source (P= .004).

Conclusions: Overall, there was a shift toward more prospective and randomized research designs published in The American Journal of Sports Medicine during 2001-2003 compared to 1991-1993, demonstrating an improvement in the methodological quality of published research.