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Editorial |

Evidence and Quality Initiative Moving Beyond Levels of Evidence

John S. Rhee, MD, MPH1,2
[+] Author Affiliations
1Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin Clinic at Froedtert West, Milwaukee
2Editor, JAMA Facial Plastic Surgery
JAMA Facial Plast Surg. 2015;17(2):80-81. doi:10.1001/jamafacial.2014.1544.
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In May 2013, JAMA Facial Plastic Surgery launched the Levels of Evidence (LOE) initiative for original investigation manuscripts.1 From that time through December 2014, we published 45 ratable original investigations with an LOE designation (Table)—recall that the only category of articles that were rated were clinical, therapeutic (disease treatment) investigations. One should be careful not to draw strong conclusions or get overly excited over 2 data points (would not be evidence based), but it is interesting to note the directionality of the trend—what appears to be improving most is the transition of LOE 4 studies (retrospective case series) to LOE 3 studies (retrospective cohort studies). Our investigators are creating and analyzing comparison groups with statistical analyses beyond basic descriptive techniques, thus elevating the rigor of the study design and therefore decreasing bias as it relates to the results and its interpreted meaning.

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