Evidence-based burn care--An assessment of the methodological quality of research published in burn care journals from 1982 to 2008

Introduction: The quantity and quality of research evidence in peer-reviewed burn care journals have never been evaluated. The aim of this study was to empirically assess the evidence available in this literature.

Methods: All studies published in Burns and Journal of Burn Care and Research between 1st January 1982 and 31st December 2008 were reviewed. Articles were tabulated according to their study design into the following groups: meta-analyses; randomised controlled trials; controlled trials; comparative studies and case series/reports.

Results: A total of 2215 original articles were evaluated, of which 67.0% were from Burns and 33.0% were from Journal of Burn Care and Research. There were 3 meta-analyses (0.1%), 179 (8.1%) randomised controlled trials, 56 (2.5%) controlled clinical trials, 715 (32.3%) comparative studies and 1262 (57.1%) case series/reports. Journal of Burn Care and Research published a higher proportion of randomised controlled trials than Burns (11.9% vs. 6.2%; p<0.001). There was no significant difference in the proportion of published controlled trials between the two journals (3.0% vs. 2.3%; p=0.333). Journal of Burn Care and Research published a higher proportion of comparative studies than Burns (27.9% vs. 41.4%; p<0.001). Case series/reports made up the highest proportion of articles in both Burns (63.6%) and Journal of Burn Care and Research (43.7%), with Burns publishing a higher proportion of these than Journal of Burn Care and Research (p<0.001). From 1982 to 2008, when articles from both journals were considered together there were significant increases in the proportion of randomised controlled trials (0 (0%) to 10 (9%); p<0.001) and controlled clinical trials (0 (0%) to 1 (1%); p<0.001). There were no significant changes in the proportion of comparative studies (11 (44%) to 28 (16%); p=0.846) or case series/reports (14 (56%) to 71 (65%); p=0.448).

Discussion: The burn care literature suffers from a relative shortage of high-quality evidence. More randomised controlled trials are warranted.