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[Evidence-based medicine methods and critical reading of the paper devoted to degenerative lumbar and sacral spinal stenosis (comment to the article)].

Authors :
Shevelev IN
Kornienko VN
Konovalov NA
Cherkashov AM
Iashina LP
Asiutin DS
Timonin SIu
Source :
Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko [Zh Vopr Neirokhir Im N N Burdenko] 2012; Vol. 76 (4), pp. 64-8; discussion 68.
Publication Year :
2012

Abstract

The paper provides critical analysis of the article "Correlated analysis of radiologic criteria's referred to central degenerative spinal canal stenosis and intensity of clinical implications". Critical analysis was carried out by the 5-step evidence cycle. First step is supposed to formulate primary goal of the research and identify its type. This investigation belongs to prognostic studying of certain patient's characteristics and their impact on the state of disease and the treatment outcome. According to Oxford evidence based center of medicine gradation, this study is attributed to level IV (clinical series). Analysis performed allowed to state that investigation sampling might be considered as representative, but nonhomogeneous. Absence of blind evaluation of the treatment results could alter treatment outcomes when compared by two different scales. Multifactor analysis was not held in the present study. Analyzed investigation has low methodological level, however, it has no major disadvantages. Statistical significance between various factors and clinical effect can be achieved when study is based upon database analysis of many patients, which however cannot be managed by efforts of a single medical institution. Organizing investigations by registration treatment outcomes with follow up evaluation nationwide could be a problem solution. In particular, vertebrological register might be a very useful tool for development prognostic risk scales and predictive models in degenerative spine disease surgery.

Details

Language :
Russian
ISSN :
0042-8817
Volume :
76
Issue :
4
Database :
MEDLINE
Journal :
Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko
Publication Type :
Academic Journal
Accession number :
23033596