Level of evidence of clinical orthopedic surgery research in Saudi Arabia

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).

CONCLUSION: 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.