2006/2007

Introdução à Medicina

Estevão, Vânia;Estevão, Vânia; Fernandes, Daniela;Fernandes, Daniela; Leite, Luís;Leite, Luís; Monteiro, Tiago; Monteiro, Tiago; Pimenta, André;Pimenta, André; Rodrigues, João; Silva, Sandra; Teixeira, Hugo; Rodrigues, João; Silva, Sandra; Teixeira, Hugo;

Class 22Class 22

Supervisor: Santos, CristinaSupervisor: Santos, Cristina

• it is necessary that the results given it is necessary that the results given by a diagnostic test are as much trustful by a diagnostic test are as much trustful as possible as possible [1][1]

• iin oncology, diagnostic tests are n oncology, diagnostic tests are essential to determinate if someone has a essential to determinate if someone has a cancer and how to treat it, if presentcancer and how to treat it, if present

• [1] [1] Smidt N, Rutjes A, van der Windt D, Ostelo R, Reitsma J, Bossuyt P, Bouter L, Vet Smidt N, Rutjes A, van der Windt D, Ostelo R, Reitsma J, Bossuyt P, Bouter L, Vet H. Quality of Reporting of Diagnostic Accuracy Studies. H. Quality of Reporting of Diagnostic Accuracy Studies. RadiologyRadiology 2005; 235:347-353 2005; 235:347-353

• when a diagnostic test is used, it is when a diagnostic test is used, it is necessary that who uses it knows its risks necessary that who uses it knows its risks and benefits and the level of credibility and benefits and the level of credibility [2][2]

• information obtained from it must be information obtained from it must be integrated with clinical history and other integrated with clinical history and other physical examinationsphysical examinations

• [2] [2] Griner PF, Mayewski RJ, Mushlin AI, Greenland P. Selection and interpretation of Griner PF, Mayewski RJ, Mushlin AI, Greenland P. Selection and interpretation of diagnostic tests and procedures. Principles and applications. Ann Intern Med 1981; 94: diagnostic tests and procedures. Principles and applications. Ann Intern Med 1981; 94: 557-592557-592

• the combinations between the result the combinations between the result given by the diagnostic test and the given by the diagnostic test and the patient’s real health condition are:patient’s real health condition are:

NegativeNegative

PositivePositive

True negativeTrue negativeDisease absentDisease absent

Disease presentDisease present

Disease absentDisease absent

Disease presentDisease present

TestTest

True positiveTrue positive

False negativeFalse negative

False positiveFalse positive

STARD c h e c k l i s tSTARD c h e c k l i s t

• published by a group of scientists and published by a group of scientists and editors in 2003editors in 2003

• consists of 25 items and encourages the consists of 25 items and encourages the improvement of quality of reporting of improvement of quality of reporting of studies of diagnostic accuracy studies of diagnostic accuracy [3][3]

• [3] [3] Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Lijmer Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Lijmer JG, Moher D, Rennie D, de Vet HCW, for the STARD group. Towards complete and JG, Moher D, Rennie D, de Vet HCW, for the STARD group. Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. accurate reporting of studies of diagnostic accuracy: the STARD initiative. Family PracticeFamily Practice 2004; 21: 4–102004; 21: 4–10

• evaluate how the quality of reporting in evaluate how the quality of reporting in oncology diagnostic test accuracy from oncology diagnostic test accuracy from 2001 to 2005 is developing2001 to 2005 is developing

• evaluate if the journals with lower and evaluate if the journals with lower and higher impact factor publish diagnostic higher impact factor publish diagnostic test accuracy articles with different test accuracy articles with different qualityquality

• compare the evolution in quality of the compare the evolution in quality of the journals of higher and lower impact journals of higher and lower impact factorsfactors

Study design :Study design : Sistematic review

Bibliographic search : Bibliographic search :

• we performed a systematic search in all we performed a systematic search in all issues of Reporting of Studies of Diagnostic issues of Reporting of Studies of Diagnostic Accuracy in Oncology LiteratureAccuracy in Oncology Literature

• we created a query using specific terms we created a query using specific terms (MeSH terms) and words that might be present (MeSH terms) and words that might be present in articles with interest to our work*in articles with interest to our work*

• we used ISI Web of Knowledge to obtain the we used ISI Web of Knowledge to obtain the names of the journals which had the impact names of the journals which had the impact factor we wanted in each situationfactor we wanted in each situation

* based on a search strategy in PubMed (MEDLINE) for publications about the * based on a search strategy in PubMed (MEDLINE) for publications about the evaluation of diagnostic accuracy, suggested by a research article:evaluation of diagnostic accuracy, suggested by a research article:

Devillé, W. L. et. al., Conducting systematic reviews of diagnostic Devillé, W. L. et. al., Conducting systematic reviews of diagnostic studies: didactic guidelinesstudies: didactic guidelines

• we repeated 10 times the query, two for we repeated 10 times the query, two for each year, and from these one to each group each year, and from these one to each group of impact factorsof impact factors

• the queries used to each year are the the queries used to each year are the follow:follow:

2001 – 2001 – impact factor 1 or lessimpact factor 1 or less

(((((((("(((((((("sensitivity and specificitysensitivity and specificity"[All Fields] OR ""[All Fields] OR "sensitivity and specificity/standardssensitivity and specificity/standards"[All "[All Fields]) OR "Fields]) OR "specificityspecificity"[All Fields]) OR ""[All Fields]) OR "screeningscreening"[All Fields]) OR ""[All Fields]) OR "false positivefalse positive"[All "[All Fields]) OR "Fields]) OR "false negativefalse negative"[All Fields]) OR ""[All Fields]) OR "accuracyaccuracy"[All Fields]) OR ((((""[All Fields]) OR (((("predictive predictive valuevalue"[All Fields] OR ""[All Fields] OR "predictive value of testspredictive value of tests"[All Fields]) OR ""[All Fields]) OR "predictive value of predictive value of tests/standardstests/standards"[All Fields]) OR ""[All Fields]) OR "predictive valuespredictive values"[All Fields]) OR ""[All Fields]) OR "predictive values of predictive values of teststests"[All Fields])) OR ((""[All Fields])) OR (("reference valuereference value"[All Fields] OR ""[All Fields] OR "reference valuesreference values"[All Fields]) "[All Fields]) OR "OR "reference values/standardsreference values/standards"[All Fields]) OR (((((((((((""[All Fields]) OR ((((((((((("rocroc"[All Fields] OR ""[All Fields] OR "roc roc analysesanalyses"[All Fields]) OR ""[All Fields]) OR "roc analysisroc analysis"[All Fields]) OR ""[All Fields]) OR "roc androc and"[All Fields]) OR ""[All Fields]) OR "roc roc areaarea"[All Fields]) OR ""[All Fields]) OR "roc aucroc auc"[All Fields]) OR ""[All Fields]) OR "roc characteristicsroc characteristics"[All Fields]) OR ""[All Fields]) OR "roc roc curvecurve"[All Fields]) OR ""[All Fields]) OR "roc curve methodroc curve method"[All Fields]) OR ""[All Fields]) OR "roc curvesroc curves"[All Fields]) OR "[All Fields]) OR ""roc estimatedroc estimated"[All Fields]) OR ""[All Fields]) OR "roc evaluationroc evaluation"[All Fields]) OR (""[All Fields]) OR ("likelihood ratiolikelihood ratio"[All "[All Fields])) ANDFields])) AND (INT J HYPERTHER[Journal] OR AM J CLIN ONCOL-CANC[Journal] OR SURG ONCOL[Journal] OR TERATOGEN CANCIN MUT[Journal] OR CLIN ONCOL-UK[Journal] OR J EXP CLIN CANC RES[Journal] OR INT J GYNECOL CANCER[Journal] OR NEOPLASMSA[Journal] OR JPN J CLIN ONCOL[Journal] OR ONKOLOGIE[Journal] OR EUR J GYNAECOL ONCOL[Journal] OR BREAST[Journal] OR CURR PROB CANCER[Journal] OR B CANCER[Journal] OR BIODRUGS[Journal] OR PROSTATE CANCER P D[Journal] OR TUMORI[Journal] OR EUR J CANCER CARE[Journal] OR PEDIATR HEMAT ONCOL[Journal] OR ENVIRON CARCIN ECO R[Journal] OR ONCOLOGY-NY[Journal] OR EXP ONCOL[Journal] OR J TUMOR MARKER ONCOL[Journal])

2001 – 2001 – impact factor 4 or higherimpact factor 4 or higher

(((((((("(((((((("sensitivity and specificitysensitivity and specificity"[All Fields] OR ""[All Fields] OR "sensitivity and sensitivity and specificity/standardsspecificity/standards"[All Fields]) OR ""[All Fields]) OR "specificityspecificity"[All Fields]) OR ""[All Fields]) OR "screeningscreening"[All "[All Fields]) OR "Fields]) OR "false positivefalse positive"[All Fields]) OR ""[All Fields]) OR "false negativefalse negative"[All Fields]) OR "[All Fields]) OR ""accuracyaccuracy"[All Fields]) OR ((((""[All Fields]) OR (((("predictive valuepredictive value"[All Fields] OR ""[All Fields] OR "predictive value predictive value of testsof tests"[All Fields]) OR ""[All Fields]) OR "predictive value of tests/standardspredictive value of tests/standards"[All Fields]) OR "[All Fields]) OR ""predictive valuespredictive values"[All Fields]) OR ""[All Fields]) OR "predictive values of testspredictive values of tests"[All Fields])) OR "[All Fields])) OR (("(("reference valuereference value"[All Fields] OR ""[All Fields] OR "reference valuesreference values"[All Fields]) OR ""[All Fields]) OR "reference reference values/standardsvalues/standards"[All Fields]) OR (((((((((((""[All Fields]) OR ((((((((((("rocroc"[All Fields] OR ""[All Fields] OR "roc roc analysesanalyses"[All Fields]) OR ""[All Fields]) OR "roc analysisroc analysis"[All Fields]) OR ""[All Fields]) OR "roc androc and"[All Fields]) "[All Fields]) OR OR "roc area"roc area"[All Fields]) OR ""[All Fields]) OR "roc aucroc auc"[All Fields]) OR ""[All Fields]) OR "roc characteristicsroc characteristics"[All "[All Fields]) OR "Fields]) OR "roc curveroc curve"[All Fields]) OR ""[All Fields]) OR "roc curve methodroc curve method"[All Fields]) OR ""[All Fields]) OR "roc roc curvescurves"[All Fields]) OR ""[All Fields]) OR "roc estimatedroc estimated"[All Fields]) OR ""[All Fields]) OR "roc evaluationroc evaluation"[All "[All Fields]) OR ("Fields]) OR ("likelihood ratiolikelihood ratio"[All Fields])) "[All Fields])) AND (CA-CANCER J CLIN[Journal] OR J NATL CANCER I[Journal] OR ADV CANCER RES[Journal] OR BBA-REV CANCER[Journal] OR J CLIN ONCOL[Journal] OR CANCER RES[Journal] OR ONCOGENE[Journal] OR EXP CELL RES[Journal] OR CLIN CANCER RES[Journal] OR SEMIN CANCER BIOL[Journal] OR CARCINOGENESIS[Journal] OR GENE CHROMOSOME CANC[Journal] OR LEUKEMIA[Journal] OR INT J CANCER[Journal])

2002 2002 – – impact factor 1 or lessimpact factor 1 or less

(((((((("(((((((("sensitivity and specificitysensitivity and specificity"[All Fields] OR ""[All Fields] OR "sensitivity and sensitivity and specificity/standardsspecificity/standards"[All Fields]) OR ""[All Fields]) OR "specificityspecificity"[All Fields]) OR ""[All Fields]) OR "screeningscreening"[All "[All Fields]) OR "Fields]) OR "false positivefalse positive"[All Fields]) OR ""[All Fields]) OR "false negativefalse negative"[All Fields]) OR "[All Fields]) OR ""accuracyaccuracy"[All Fields]) OR ((((""[All Fields]) OR (((("predictive valuepredictive value"[All Fields] OR ""[All Fields] OR "predictive value of predictive value of teststests"[All Fields]) OR ""[All Fields]) OR "predictive value of tests/standardspredictive value of tests/standards"[All Fields]) OR "[All Fields]) OR ""predictive valuespredictive values"[All Fields]) OR ""[All Fields]) OR "predictive values of testspredictive values of tests"[All Fields])) OR "[All Fields])) OR (("(("reference valuereference value"[All Fields] OR ""[All Fields] OR "reference valuesreference values"[All Fields]) OR ""[All Fields]) OR "reference reference values/standardsvalues/standards"[All Fields]) OR (((((((((((""[All Fields]) OR ((((((((((("rocroc"[All Fields] OR ""[All Fields] OR "roc analysesroc analyses"[All "[All Fields]) OR "Fields]) OR "roc analysisroc analysis"[All Fields]) OR ""[All Fields]) OR "roc androc and"[All Fields]) OR ""[All Fields]) OR "roc arearoc area"[All "[All Fields]) OR "Fields]) OR "roc aucroc auc"[All Fields]) OR ""[All Fields]) OR "roc characteristicsroc characteristics"[All Fields]) OR ""[All Fields]) OR "roc roc curvecurve"[All Fields]) OR ""[All Fields]) OR "roc curve methodroc curve method"[All Fields]) OR ""[All Fields]) OR "roc curvesroc curves"[All Fields]) "[All Fields]) OR "OR "roc estimatedroc estimated"[All Fields]) OR ""[All Fields]) OR "roc evaluationroc evaluation"[All Fields]) OR (""[All Fields]) OR ("likelihood likelihood ratioratio"[All Fields])) AND"[All Fields])) AND (CHEMOTHERAPY[Journal] OR CURR PROB CANCER[Journal] OR ONKOLOGIE[Journal] OR CANCER PRACT[Journal] OR J CHEMOTHERAPY[Journal] OR UROL ONCOL[Journal] OR CLIN ONCOL-UK[Journal] OR J CANCER EDUC[Journal] OR J EXP CLIN CANC RES[Journal] OR JPN J CLIN ONCOL[Journal] OR NEOPLASMA[Journal] OR PEDIATR HEMAT ONCOL[Journal] OR BREAST[Journal] OR PROSTATE CANCER P D[Journal] OR B CANCER[Journal] OR EUR J CANCER CARE[Journal] OR EUR J GYNAECOL ONCOL[Journal] OR TUMORI[Journal] OR EXP ONCOL[Journal] OR J ENVIRON SCI HEAL C[Journal])

2002 2002 – – impact factor 4 or higherimpact factor 4 or higher

(((((((("(((((((("sensitivity and specificitysensitivity and specificity"[All Fields] OR ""[All Fields] OR "sensitivity and sensitivity and specificity/standardsspecificity/standards"[All Fields]) OR ""[All Fields]) OR "specificityspecificity"[All Fields]) OR ""[All Fields]) OR "screeningscreening"[All "[All Fields]) OR "Fields]) OR "false positivefalse positive"[All Fields]) OR ""[All Fields]) OR "false negativefalse negative"[All Fields]) OR "[All Fields]) OR ""accuracyaccuracy"[All Fields]) OR ((((""[All Fields]) OR (((("predictive valuepredictive value"[All Fields] OR ""[All Fields] OR "predictive value predictive value of testsof tests"[All Fields]) OR ""[All Fields]) OR "predictive value of tests/standardspredictive value of tests/standards"[All Fields]) OR "[All Fields]) OR ""predictive valuespredictive values"[All Fields]) OR ""[All Fields]) OR "predictive values of testspredictive values of tests"[All Fields])) OR "[All Fields])) OR (("(("reference valuereference value"[All Fields] OR ""[All Fields] OR "reference valuesreference values"[All Fields]) OR ""[All Fields]) OR "reference reference values/standardsvalues/standards"[All Fields]) OR (((((((((((""[All Fields]) OR ((((((((((("rocroc"[All Fields] OR ""[All Fields] OR "roc roc analysesanalyses"[All Fields]) OR ""[All Fields]) OR "roc analysisroc analysis"[All Fields]) OR ""[All Fields]) OR "roc androc and"[All Fields]) "[All Fields]) OR "OR "roc arearoc area"[All Fields]) OR ""[All Fields]) OR "roc aucroc auc"[All Fields]) OR ""[All Fields]) OR "roc characteristicsroc characteristics"[All "[All Fields]) OR "Fields]) OR "roc curveroc curve"[All Fields]) OR ""[All Fields]) OR "roc curve methodroc curve method"[All Fields]) OR "[All Fields]) OR "roc "roc curvescurves"[All Fields]) OR ""[All Fields]) OR "roc estimatedroc estimated"[All Fields]) OR ""[All Fields]) OR "roc evaluationroc evaluation"[All "[All Fields]) OR ("Fields]) OR ("likelihood ratiolikelihood ratio"[All Fields])) AND "[All Fields])) AND (CA-CANCER J CLIN[Journal] OR J NATL CANCER I[Journal] OR NAT REV CANCER[Journal] OR J CLIN ONCOL[Journal] OR ADV CANCER RES[Journal] OR BBA-REV CANCER[Journal] OR CANCER RES[Journal] OR ENDOCR-RELAT CANCER[Journal] OR CLIN CANCER RES[Journal] OR ONCOGENE[Journal] OR NEOPLASIA[Journal] OR SEMIN CANCER BIOL[Journal] OR CARCINOGENESIS[Journal] OR CANCER EPIDEM BIOMAR[Journal] OR EXP CELL RES[Journal] OR LEUKEMIA[Journal] OR CURR OPIN ONCOL[Journal] OR GENE CHROMOSOME CANC[Journal] OR INT J CANCER[Journal] OR STEM CELLS[Journal])

2003 2003 – – impact factor 1 or lessimpact factor 1 or less(((((((("(((((((("sensitivity and specificitysensitivity and specificity"[All Fields] OR ""[All Fields] OR "sensitivity and sensitivity and specificity/standardsspecificity/standards"[All Fields]) OR ""[All Fields]) OR "specificityspecificity"[All Fields]) OR ""[All Fields]) OR "screeningscreening"[All "[All Fields]) OR "Fields]) OR "false positivefalse positive"[All Fields]) OR ""[All Fields]) OR "false negativefalse negative"[All Fields]) OR "[All Fields]) OR ""accuracyaccuracy"[All Fields]) OR ((((""[All Fields]) OR (((("predictive valuepredictive value"[All Fields] OR ""[All Fields] OR "predictive value predictive value of testsof tests"[All Fields]) OR ""[All Fields]) OR "predictive value of tests/standardspredictive value of tests/standards"[All Fields]) OR "[All Fields]) OR ""predictive valuespredictive values"[All Fields]) OR ""[All Fields]) OR "predictive values of testspredictive values of tests"[All Fields])) OR "[All Fields])) OR (("(("reference valuereference value"[All Fields] OR ""[All Fields] OR "reference valuesreference values"[All Fields]) OR ""[All Fields]) OR "reference reference values/standardsvalues/standards"[All Fields]) OR (((((((((((""[All Fields]) OR ((((((((((("rocroc"[All Fields] OR ""[All Fields] OR "roc roc analysesanalyses"[All Fields]) OR ""[All Fields]) OR "roc analysisroc analysis"[All Fields]) OR ""[All Fields]) OR "roc androc and"[All Fields]) "[All Fields]) OR "OR "roc arearoc area"[All Fields]) OR ""[All Fields]) OR "roc aucroc auc"[All Fields]) OR ""[All Fields]) OR "roc characteristicsroc characteristics"[All "[All Fields]) OR "Fields]) OR "roc curveroc curve"[All Fields]) OR ""[All Fields]) OR "roc curve methodroc curve method"[All Fields]) OR ""[All Fields]) OR "roc roc curvescurves"[All Fields]) OR ""[All Fields]) OR "roc estimatedroc estimated"[All Fields]) OR ""[All Fields]) OR "roc evaluationroc evaluation"[All "[All Fields]) OR ("Fields]) OR ("likelihood ratiolikelihood ratio"[All Fields])) AND"[All Fields])) AND (CLIN ONCOL-UK[Journal] OR CANCER PRACT[Journal] OR JPN J CLIN ONCOL[Journal] OR TERATOGEN CARCIN MUT[Journal] OR NEOPLASMA[Journal] OR PROSTATE CANCER P D[Journal] OR PEDIATR HEMAT ONCOL[Journal] OR B CANCER[Journal] OR EUR J CANCER CARE[Journal] OR J EXP CLIN CANC RES[Journal] OR J ENVIRON SCI HEAL C[Journal] OR EUR J GYNAECOL ONCOL[Journal] OR BREAST[Journal] OR J CANCER EDUC[Journal] OR TUMORI[Journal] OR EXP ONCOL[Journal])

2003 2003 – – impact factor 4 or higherimpact factor 4 or higher

(((((((("(((((((("sensitivity and specificitysensitivity and specificity"[All Fields] OR ""[All Fields] OR "sensitivity and specificity/standardssensitivity and specificity/standards"[All "[All Fields]) OR Fields]) OR "specificity"specificity"[All Fields]) OR ""[All Fields]) OR "screeningscreening"[All Fields]) OR ""[All Fields]) OR "false positivefalse positive"[All "[All Fields]) OR "Fields]) OR "false negativefalse negative"[All Fields]) OR ""[All Fields]) OR "accuracyaccuracy"[All Fields]) OR ((((""[All Fields]) OR (((("predictive predictive valuevalue"[All Fields] OR ""[All Fields] OR "predictive value of testspredictive value of tests"[All Fields]) OR ""[All Fields]) OR "predictive value of predictive value of tests/standardstests/standards"[All Fields]) OR ""[All Fields]) OR "predictive valuespredictive values"[All Fields]) OR ""[All Fields]) OR "predictive values of predictive values of teststests"[All Fields])) OR ((""[All Fields])) OR (("reference valuereference value"[All Fields] OR ""[All Fields] OR "reference valuesreference values"[All Fields]) "[All Fields]) OR "OR "reference values/standardsreference values/standards"[All Fields]) OR (((((((((((""[All Fields]) OR ((((((((((("rocroc"[All Fields] OR ""[All Fields] OR "roc roc analysesanalyses"[All Fields]) OR ""[All Fields]) OR "roc analysisroc analysis"[All Fields]) OR ""[All Fields]) OR "roc androc and"[All Fields]) OR ""[All Fields]) OR "roc roc areaarea"[All Fields]) OR ""[All Fields]) OR "roc aucroc auc"[All Fields]) OR ""[All Fields]) OR "roc characteristicsroc characteristics"[All Fields]) OR ""[All Fields]) OR "roc roc curvecurve"[All Fields]) OR ""[All Fields]) OR "roc curve methodroc curve method"[All Fields]) OR ""[All Fields]) OR "roc curvesroc curves"[All Fields]) OR "[All Fields]) OR ""roc estimatedroc estimated"[All Fields]) OR ""[All Fields]) OR "roc evaluationroc evaluation"[All Fields]) OR (""[All Fields]) OR ("likelihood ratiolikelihood ratio"[All "[All Fields]))Fields])) AND (NAT REV CANCER[Journal] OR CA-CANCER J CLIN[Journal] OR CANCER CELL[Journal] OR J NATL CANCER I[Journal] OR J CLIN ONCOL[Journal] OR ENDOCR-RELAT CANCER[Journal] OR CANCER RES[Journal] OR BBA REV CANCER[Journal] OR ADV CANCER RES[Journal] OR LANCET ONCOL[Journal] OR CLIN CANCER RES[Journal] OR ONCOGENE[Journal] OR STEM CELLS[Journal] OR SEMIN CANCER BIOL[Journal] OR LEUKEMIA[Journal] OR SEMIN ONCOL[Journal] OR CANCER EPIDEM BIOMAR[Journal] OR CARCINOGENESIS[Journal] OR CURR OPIN ONCOL[Journal] OR INT J CANCER[Journal] OR NEOPLASIA[Journal] OR INT J RADIAT ONCOL[Journal] OR GENE CHROMOSOME CANC[Journal] OR CANCER[Journal])

2004 2004 – impact factor 1 or less– impact factor 1 or less

(((((((("(((((((("sensitivity and specificitysensitivity and specificity"[All Fields] OR ""[All Fields] OR "sensitivity and sensitivity and specificity/standardsspecificity/standards"[All Fields]) OR ""[All Fields]) OR "specificityspecificity"[All Fields]) OR ""[All Fields]) OR "screeningscreening"[All "[All Fields]) OR "Fields]) OR "false positivefalse positive"[All Fields]) OR ""[All Fields]) OR "false negativefalse negative"[All Fields]) OR "[All Fields]) OR ""accuracyaccuracy"[All Fields]) OR ((((""[All Fields]) OR (((("predictive valuepredictive value"[All Fields] OR ""[All Fields] OR "predictive value predictive value of testsof tests"[All Fields]) OR ""[All Fields]) OR "predictive value of tests/standardspredictive value of tests/standards"[All Fields]) OR "[All Fields]) OR ""predictive valuespredictive values"[All Fields]) OR ""[All Fields]) OR "predictive values of testspredictive values of tests"[All Fields])) OR "[All Fields])) OR (("(("reference valuereference value"[All Fields] OR ""[All Fields] OR "reference valuesreference values"[All Fields]) OR ""[All Fields]) OR "reference reference values/standardsvalues/standards"[All Fields]) OR (((((((((((""[All Fields]) OR ((((((((((("rocroc"[All Fields] OR ""[All Fields] OR "roc roc analysesanalyses"[All Fields]) OR ""[All Fields]) OR "roc analysisroc analysis"[All Fields]) OR ""[All Fields]) OR "roc androc and"[All Fields]) "[All Fields]) OR "OR "roc arearoc area"[All Fields]) OR ""[All Fields]) OR "roc aucroc auc"[All Fields]) OR ""[All Fields]) OR "roc characteristicsroc characteristics"[All "[All Fields]) OR "Fields]) OR "roc curveroc curve"[All Fields]) OR ""[All Fields]) OR "roc curve methodroc curve method"[All Fields]) OR ""[All Fields]) OR "roc roc curvescurves"[All Fields]) OR ""[All Fields]) OR "roc estimatedroc estimated"[All Fields]) OR ""[All Fields]) OR "roc evaluationroc evaluation"[All "[All Fields]) OR ("Fields]) OR ("likelihood ratiolikelihood ratio"[All Fields])) AND"[All Fields])) AND (BIRTH DEFECTS RES B[Journal] OR JPN J CLIN ONCOL[Journal] OR INT J BIOL MARKER[Journal] OR CLIN ONCOL-UK[Journal] OR NEOPLASMA[Journal] OR BREAST[Journal] OR B CANCER[Journal] OR TERATOGEN CARCIN MUT[Journal] OR EUR J CANCER CARE[Journal] OR TUMORI[Journal] OR J EXP CLIN CANC RES[Journal] OR EUR J GYNAECOL ONCOL[Journal] OR J CANCER EDUC[Journal] OR PEDIATR HEMAT ONCOL[Journal] OR EXP ONCOL[Journal])

2004 2004 – impact factor 4 or higher– impact factor 4 or higher

(((((((("(((((((("sensitivity and specificitysensitivity and specificity"[All Fields] OR ""[All Fields] OR "sensitivity and specificity/standardssensitivity and specificity/standards"[All "[All Fields]) OR "Fields]) OR "specificityspecificity"[All Fields]) OR ""[All Fields]) OR "screeningscreening"[All Fields]) OR ""[All Fields]) OR "false positivefalse positive"[All "[All Fields]) OR "Fields]) OR "false negativefalse negative"[All Fields]) OR ""[All Fields]) OR "accuracyaccuracy"[All Fields]) OR ((((""[All Fields]) OR (((("predictive predictive valuevalue"[All Fields] OR ""[All Fields] OR "predictive value of testspredictive value of tests"[All Fields]) OR ""[All Fields]) OR "predictive value of predictive value of tests/standardstests/standards"[All Fields]) OR ""[All Fields]) OR "predictive valuespredictive values"[All Fields]) OR ""[All Fields]) OR "predictive values of predictive values of teststests"[All Fields])) OR ((""[All Fields])) OR (("reference valuereference value"[All Fields] OR ""[All Fields] OR "reference valuesreference values"[All Fields]) OR "[All Fields]) OR ""reference values/standardsreference values/standards"[All Fields]) OR (((((((((((""[All Fields]) OR ((((((((((("rocroc"[All Fields] OR ""[All Fields] OR "roc analysesroc analyses"[All "[All Fields]) OR "Fields]) OR "roc analysisroc analysis"[All Fields]) OR ""[All Fields]) OR "roc androc and"[All Fields]) OR ""[All Fields]) OR "roc arearoc area"[All Fields]) "[All Fields]) OR OR "roc auc"roc auc"[All Fields]) OR ""[All Fields]) OR "roc characteristicsroc characteristics"[All Fields]) OR ""[All Fields]) OR "roc curveroc curve"[All Fields]) OR "[All Fields]) OR ""roc curve methodroc curve method"[All Fields]) OR ""[All Fields]) OR "roc curvesroc curves"[All Fields]) OR ""[All Fields]) OR "roc estimatedroc estimated"[All Fields]) "[All Fields]) OR "OR "roc evaluationroc evaluation"[All Fields]) OR (""[All Fields]) OR ("likelihood ratiolikelihood ratio"[All Fields]))"[All Fields])) AND (CA-CANCER J CLIN[Journal] OR NAT REV CANCER[Journal] OR CANCER CELL[Journal] OR BBA-REV CANCER[Journal] OR J NATL CANCER I[Journal] OR J CLIN ONCOL[Journal] OR EJC SUPPL[Journal] OR LANCET ONCOL[Journal] OR CANCER RES[Journal] OR SEMIN CANCER BIOL[Journal] OR ONCOGENE[Journal] OR ADV CANCER RES[Journal] OR LEUKEMIA[Journal] OR CLIN CANCER RES[Journal] OR STEM CELLS[Journal] OR CARCINOGENESIS[Journal] OR MOL CANCER THER[Journal] OR MOL CANCER RES[Journal] OR ONCOLOGIST[Journal] OR EBDOCR RELAT CANCER[Journal] OR CANCER EPIDEM BIOMAR[Journal] OR CANCER[Journal] OR INT J CANCER[Journal] OR NEOPLASIA[Journal] OR ANN ONCOL[Journal] OR INT J RADIAT ONCOL[Journal] OR GENE CHROMOSOME CANC[Journal] OR ANN SURG ONCOL[Journal] OR EXP CELL RES[Journal])

2005 2005 – impact factor 1 or less– impact factor 1 or less

(((((((("(((((((("sensitivity and specificitysensitivity and specificity"[All Fields] OR ""[All Fields] OR "sensitivity and sensitivity and specificity/standardsspecificity/standards"[All Fields]) OR ""[All Fields]) OR "specificityspecificity"[All Fields]) OR ""[All Fields]) OR "screeningscreening"[All "[All Fields]) OR "Fields]) OR "false positivefalse positive"[All Fields]) OR ""[All Fields]) OR "false negativefalse negative"[All Fields]) OR "[All Fields]) OR ""accuracyaccuracy"[All Fields]) OR ((((""[All Fields]) OR (((("predictive valuepredictive value"[All Fields] OR ""[All Fields] OR "predictive value predictive value of testsof tests"[All Fields]) OR ""[All Fields]) OR "predictive value of tests/standardspredictive value of tests/standards"[All Fields]) OR "[All Fields]) OR ""predictive valuespredictive values"[All Fields]) OR ""[All Fields]) OR "predictive values of testspredictive values of tests"[All Fields])) OR "[All Fields])) OR (("(("reference valuereference value"[All Fields] OR ""[All Fields] OR "reference valuesreference values"[All Fields]) OR ""[All Fields]) OR "reference reference values/standardsvalues/standards"[All Fields]) OR (((((((((((""[All Fields]) OR ((((((((((("rocroc"[All Fields] OR ""[All Fields] OR "roc roc analysesanalyses"[All Fields]) OR ""[All Fields]) OR "roc analysisroc analysis"[All Fields]) OR ""[All Fields]) OR "roc androc and"[All Fields]) "[All Fields]) OR "OR "roc arearoc area"[All Fields]) OR ""[All Fields]) OR "roc aucroc auc"[All Fields]) OR ""[All Fields]) OR "roc characteristicsroc characteristics"[All "[All Fields]) OR "Fields]) OR "roc curveroc curve"[All Fields]) OR ""[All Fields]) OR "roc curve methodroc curve method"[All Fields]) OR ""[All Fields]) OR "roc roc curvescurves"[All Fields]) OR ""[All Fields]) OR "roc estimatedroc estimated"[All Fields]) OR ""[All Fields]) OR "roc evaluationroc evaluation"[All "[All Fields]) OR ("Fields]) OR ("likelihood ratiolikelihood ratio"[All Fields])) AND"[All Fields])) AND (EJSO[Journal] OR MED ONCOL[Journal] OR EUR J CANCER CARE[Journal] OR CANCER NURS[Journal] OR B CANCER[Journal] OR EXP ONCOL[Journal] OR TUMORI[Journal] OR NEOPLASMA[Journal] OR J CANCER EDUC[Journal] OR J EXP CLIN CANC RES[Journal] OR CURR PROB CANCER[Journal] OR EUR J GYNAECOL ONCOL[Journal] OR PEDIATR HEMAT ONCOL[Journal] OR TERATOGEN CARCIN MUT[Journal])

2005 2005 – impact factor 4 or higher– impact factor 4 or higher

(((((((("(((((((("sensitivity and specificitysensitivity and specificity"[All Fields] OR ""[All Fields] OR "sensitivity and specificity/standardssensitivity and specificity/standards"[All Fields]) "[All Fields]) OR "OR "specificityspecificity"[All Fields]) OR ""[All Fields]) OR "screeningscreening"[All Fields]) OR ""[All Fields]) OR "false positivefalse positive"[All Fields]) OR ""[All Fields]) OR "false false negativenegative"[All Fields]) OR ""[All Fields]) OR "accuracyaccuracy"[All Fields]) OR ((((""[All Fields]) OR (((("predictive valuepredictive value"[All Fields] OR "[All Fields] OR ""predictive value of testspredictive value of tests"[All Fields]) OR ""[All Fields]) OR "predictive value of tests/standardspredictive value of tests/standards"[All Fields]) OR "[All Fields]) OR ""predictive valuespredictive values"[All Fields]) OR ""[All Fields]) OR "predictive values of testspredictive values of tests"[All Fields])) OR ((""[All Fields])) OR (("reference reference valuevalue"[All Fields] OR ""[All Fields] OR "reference valuesreference values"[All Fields]) OR ""[All Fields]) OR "reference values/standardsreference values/standards"[All Fields]) "[All Fields]) OR ((((((((((("OR ((((((((((("rocroc"[All Fields] OR ""[All Fields] OR "roc analysesroc analyses"[All Fields]) OR ""[All Fields]) OR "roc analysisroc analysis"[All Fields]) OR ""[All Fields]) OR "roc roc andand"[All Fields]) OR ""[All Fields]) OR "roc arearoc area"[All Fields]) OR ""[All Fields]) OR "roc aucroc auc"[All Fields]) OR ""[All Fields]) OR "roc characteristicsroc characteristics"[All "[All Fields]) OR "Fields]) OR "roc curveroc curve"[All Fields]) OR ""[All Fields]) OR "roc curve methodroc curve method"[All Fields]) OR ""[All Fields]) OR "roc curvesroc curves"[All Fields]) "[All Fields]) OR "OR "roc estimatedroc estimated"[All Fields]) OR ""[All Fields]) OR "roc evaluationroc evaluation"[All Fields]) OR (""[All Fields]) OR ("likelihood ratiolikelihood ratio"[All Fields]))"[All Fields])) AND (CA-CANCER J CLIN[Journal] OR NAT REV CANCER[Journal] OR CANCER CELL[Journal] OR J NATL CANCER I[Journal] OR BBA-REV CANCER[Journal] OR J CLIN ONCOL[Journal] OR LANCET ONCOL[Journal] OR CANCER METAST REV[Journal] OR SEMIN CANCER BIOL[Journal] OR ADV CANCER RES[Journal] OR CANCER RES[Journal] OR ONCOGENE[Journal] OR LEUKEMIA[Journal] OR STEM CELLS[Journal] OR CLIN CANCER RES[Journal] OR MOL CANCER RES[Journal] OR MOL CANCER THER[Journal] OR ONCOLOGIST[Journal] OR CARCINOGENESIS[Journal] OR ENDOCR-RELAT CANCER[Journal] OR CANCER[Journal] OR INT J CANCER[Journal] OR BREAST CANCER RES TR[Journal] OR INT J RADIAT ONCOL[Journal] OR CANCER TREAT REV[Journal] OR CANCER EPIDEM BIOMAR[Journal] OR ANN ONCOL[Journal] OR PROG EXP TUMOR RES[Journal] OR CELL ONCOL[Journal] OR NEURO-ONCOLOGY[Journal] OR EXP CELL RES[Journal] OR BRIT J CANCER[Journal] OR CANCER IMMUNOL IMMUN[Journal] OR BREAST CANCER RES[Journal])

With these queries , With these queries , 695695 articles were obtained articles were obtained with impact factor 1 or less and with impact factor 1 or less and 39843984 articles were articles were

obtained with impact factor 4 or higher obtained with impact factor 4 or higher

yearyear

impact factorimpact factor 20012001 20022002 20032003 20042004 20052005

1 or less1 or less 9898 180180 137137 137137 143143

4 or higher4 or higher 469469 527527 758758 10191019 12111211

Inclusion criteriaInclusion criteria

― deal with studies that deal with studies that evaluate the accuracy of oncology evaluate the accuracy of oncology diagnostic tests diagnostic tests

• the articles should:the articles should:

- be written in english, french, spanish - be written in english, french, spanish or portugueseor portuguese

• they must have been published in a they must have been published in a journal with impact factor 1 or less or at journal with impact factor 1 or less or at least 4 and published in the years studiedleast 4 and published in the years studied

― have an abstracthave an abstract

― deal with human researchdeal with human research

Exclusion criteriaExclusion criteria

• full article is not availablefull article is not available

• review articles and case reports will be review articles and case reports will be excludedexcluded

• using SPSS we required 10 random samples using SPSS we required 10 random samples of 50 articles, 2 for each of the five of 50 articles, 2 for each of the five years (one random sample for each of the years (one random sample for each of the impact factors)impact factors)

• the articles were then analysed by title the articles were then analysed by title and abstract (when necessary and and abstract (when necessary and available) and included or not accordingly available) and included or not accordingly the inclusion criteriathe inclusion criteria

Selecting articlesSelecting articles

• when the number of articles selected was when the number of articles selected was not the desired we performed new not the desired we performed new one-on-one random samples until we one-on-one random samples until we obtained themobtained them

• when analysing the articles by abstract, when analysing the articles by abstract, as soon as we got 10 articles for the yearas soon as we got 10 articles for the year and impact factor wanted we stopped our and impact factor wanted we stopped our analysisanalysis

Article’s qualityArticle’s quality

• the article’s quality was determined by the article’s quality was determined by the number of points from the STARD the number of points from the STARD checklist present*checklist present*

• * * ((Bossuyt, P. M. et. al., Towards Complete and Accurate Reporting of Bossuyt, P. M. et. al., Towards Complete and Accurate Reporting of Studies of Diagnostic Accuracy: The STARD Initiative, Annals of Internal Studies of Diagnostic Accuracy: The STARD Initiative, Annals of Internal Medicine Vol 138 – nº1, 7 January 2003)Medicine Vol 138 – nº1, 7 January 2003)

• each article was submitted to evaluation each article was submitted to evaluation by two reviewers that independently graded by two reviewers that independently graded them as far as quality was concernedthem as far as quality was concerned

• disagreements were solved by a third disagreements were solved by a third reviewer reviewer

• the results obtained were stored in a the results obtained were stored in a database on SPSS for posterior analysisdatabase on SPSS for posterior analysis

Data extractionData extraction

• For each article, the information extracted For each article, the information extracted was: was:

- the year of publication- the year of publication

- the journal of publication (and its - the journal of publication (and its impact factor)impact factor)

- The number of STARD points present- The number of STARD points present

- Statistical methods- Statistical methods

• the total number of STARD items follows the total number of STARD items follows a normal distribution, so we used mean and a normal distribution, so we used mean and standard deviationstandard deviation

• however, the ANOVA method for however, the ANOVA method for homogeneity of variances is not homogeneity of variances is not accomplished accomplished

• this way we used a non-parametric test this way we used a non-parametric test (Kruskal Wallis)(Kruskal Wallis) in our analysis to check in our analysis to check if the results have statistic significanceif the results have statistic significance

ResultsResults

- Article selection - titles- Article selection - titles

• from the random samples required to from the random samples required to SPSS, we obtained 522 articlesSPSS, we obtained 522 articles

• after analysing the titles, we selected after analysing the titles, we selected 202 articles to read the abstracts202 articles to read the abstracts

• the first and second reviewers agreed the first and second reviewers agreed 492 times – 94% - by accepting 199 492 times – 94% - by accepting 199 articles and rejecting 293. articles and rejecting 293.

• the level of agreement is shown by the the level of agreement is shown by the value value KappaKappa = 0 = 0,881,881

• the difference between the 199 included the difference between the 199 included by agreement and the 202by agreement and the 202 abstractsabstracts analysed are the articles included by the analysed are the articles included by the third reviewerthird reviewer

- Article selection - abstracts- Article selection - abstracts

• the 202 articles included by the title the 202 articles included by the title were then analysed by abstractwere then analysed by abstract

• after analysing the abstracts, we after analysing the abstracts, we selected 103 articles to include in our selected 103 articles to include in our work: 88 were not accepted and 11 were work: 88 were not accepted and 11 were unavailableunavailable

• the first and second reviewers agreed the first and second reviewers agreed 189 times – 94% - by accepting 102 189 times – 94% - by accepting 102 articles and rejecting 87 articles and rejecting 87

• the level of agreement is shown by the the level of agreement is shown by the value value KappaKappa = 0 = 0,979,979

• the difference between the 102 included the difference between the 102 included by agreement and the 103by agreement and the 103 full textsfull texts selected is the article included by the selected is the article included by the third reviewerthird reviewer

- Article analysis – STARD checklist- Article analysis – STARD checklist

• we splited the analysis by the two we splited the analysis by the two groups of impact factors and the five groups of impact factors and the five years analysedyears analysed

• we then analysed both variables togheter we then analysed both variables togheter to reach some conclusionsto reach some conclusions

• we had no access to 3 full papers, so we we had no access to 3 full papers, so we needed 103 articles to collect the 100 we needed 103 articles to collect the 100 we included in the workincluded in the work

- First and second reviewer agreement- First and second reviewer agreement

1 – Identify the article as a study of diagnostic accuracy 1 – Identify the article as a study of diagnostic accuracy (recommended MeSH heading “sensitivity and specificity”)(recommended MeSH heading “sensitivity and specificity”)

25 – Discuss the clinical applicability of the study findings25 – Discuss the clinical applicability of the study findings

STARD STARD itemitem

agreementagreementpercentage of percentage of agreementagreement KappaKappa

presentpresent absentabsent

11 6161 3939 100100 1,0001,000

2525 8686 1414 100100 1,0001,000

22 6262 3737 9999 0,9790,979

2020 1616 8383 9999 0,9640,964

44 5656 4242 9898 0,9590,959

2121 7272 2626 9898 0,9490,949

55 3939 5858 9797 0,9380,938

1212 5353 4444 9797 0,9400,940

STARD STARD itemitem

agreementagreementpercentage of percentage of agreementagreement KappaKappa

presentpresent absentabsent

1818 6161 3636 9797 0,9360,936

1919 5555 4242 9797 0,9390,939

2222 2020 7777 9797 0,9110,911

2424 1313 8484 9797 0,8790,879

33 5151 4545 9696 0,9200,920

77 3939 5757 9696 0,9170,917

1010 2323 7373 9696 0,8930,893

1616 3232 6464 9696 0,9110,911

STARD STARD itemitem

agreementagreementpercentage of percentage of agreementagreement KappaKappa

presentpresent absentabsent

2323 3333 6363 9696 0,9120,912

88 6363 3232 9595 0,8890,889

99 3434 6161 9595 0,8920,892

1111 3131 6464 9595 0,8880,888

1313 2121 7474 9595 0,8610,861

1515 5050 4444 9494 0,8800,880

1717 1919 7575 9494 0,8250,825

66 3636 5757 9393 0,8540,854

1414 4646 4646 9292 0,8410,841

6 – Data collection: was data collection planned before the index 6 – Data collection: was data collection planned before the index test and reference standard were performed (prospective study) or test and reference standard were performed (prospective study) or after (retrospective study)after (retrospective study)

14 – When study was done, including beginning and ending dates of 14 – When study was done, including beginning and ending dates of recruitmentrecruitment

fstard25

fstard21

fstard8

fstard18

fstard2

fstard1

fstard19

fstard4

fstard3

fstard12

fstard15

fstard14

fstard7

fstard5

fstard6

fstard9

fstard23

fstard16

fstard11

fstard10

fstard22

fstard13

fstard17

fstard20

fstard24

100806040200

% > 0

- Global analysis- Global analysis

25 – Discuss the clinical applicability of the study findings21 – Estimates of diagnostic accuracy and measures of statistical uncertainty (e.g. 95% confidence intervals)

20 – Any adverse events from performing the index tests or the reference standard24 – Estimates of test reproducibility, typically imprecision (as CV) at 2 or 3 concentrations

fstard25

fstard8

fstard21

fstard2

fstard18

fstard1

fstard4

fstard12

fstard14

fstard19

fstard3

fstard15

fstard7

fstard16

fstard6

fstard9

fstard23

fstard11

fstard10

fstard5

fstard13

fstard20

fstard22

fstard17

fstard24

100806040200

% > 0

- Impact factor 1 or less- Impact factor 1 or less

25 – Discuss the clinical applicability of the study findings 8 – Technical specifications of material and methods involved including how and when measurements were taken, and/or cite references for index tests and reference standard

17 – Time interval from the index tests to the reference standard, and any treatment administered between24 – Estimates of test reproducibility, typically imprecision (as CV) at 2 or 3 concentrations

fstard25

fstard21

fstard19

fstard18

fstard15

fstard3

fstard1

fstard4

fstard2

fstard12

fstard5

fstard8

fstard7

fstard14

fstard6

fstard9

fstard23

fstard16

fstard11

fstard22

fstard13

fstard10

fstard17

fstard24

fstard20

100806040200

% > 0

- Impact factor 4 or higher- Impact factor 4 or higher

25 – Discuss the clinical applicability of the study findings21 – Estimates of diagnostic accuracy and measures of statistical uncertainty (e.g. 95% confidence intervals)

24 – Estimates of test reproducibility, typically imprecision (as CV) at 2 or 3 concentrations20 – Any adverse events from performing the index tests or the reference standard

yearyear

impact factorimpact factor 20012001 20022002 20032003 20042004 20052005 pp

1 or less1 or less 9 (2)9 (2) 6 (2)6 (2) 8 (2)8 (2) 11 (2)11 (2) 15 (2)15 (2) <0,01<0,01

4 or higher4 or higher 11 (2)11 (2) 10 (2)10 (2) 11 (4)11 (4) 14 (3)14 (3) 16 (3)16 (3) <0,01<0,01

- Confronting years and impact factors- Confronting years and impact factors

Mean (standard deviation) of the STARD score of the Mean (standard deviation) of the STARD score of the journals with impact factor ≤ 1 e ≥4 splited by year journals with impact factor ≤ 1 e ≥4 splited by year

Group StatisticsGroup Statistics

- T-Test- T-Test

* * these results have statistic significance because these results have statistic significance because p<0,01p<0,01

impact factorimpact factor MeanMean Std. DeviationStd. Deviation

total total STARDSTARD

4 or higher4 or higher 12 *12 * 4 *4 *

1 or less1 or less 10 *10 * 3 *3 *

20052004200320022001

year of publication

25

20

15

10

5

0

star

d s

core

of

the

arti

cle

imp. fact. at least 4imp. fact. 1 or less

division between impact factor 1 or less and at

least 4.

20052004200320022001

year

25

20

15

10

5

0

tota

l_s

tard

division between impact factor 1 or less and at least 4.: imp. fact. 1 or less

20052004200320022001

year

25

20

15

10

5

0

tota

l_s

tard

division between impact factor 1 or less and at least 4.: imp. fact. at least 4

DiscussionDiscussion

• it is possible to see that in both it is possible to see that in both impact factors the article quality is impact factors the article quality is improving from 2001 to 2005improving from 2001 to 2005

• the improvement of quality might be as a the improvement of quality might be as a consequence of the increasing demanding of consequence of the increasing demanding of magazines reviewers that only publish magazines reviewers that only publish articles with qualityarticles with quality

• we believe that these improvement is we believe that these improvement is just the beginning of a great improvement just the beginning of a great improvement in all articles quality in this areain all articles quality in this area

• the evolution was higher in the articles the evolution was higher in the articles with impact factor 1 or less – will they, with impact factor 1 or less – will they, within some years, have the same quality within some years, have the same quality that the ones with impact factor 4 or that the ones with impact factor 4 or higher?higher?

• in order to get some definitive in order to get some definitive conclusion about this, this study should conclusion about this, this study should be repeated, for example, within 2 yearsbe repeated, for example, within 2 years

• it is not possible to conclude if the it is not possible to conclude if the STARD checklist had influence or not, STARD checklist had influence or not, because:because:

- we only analysed two years after its - we only analysed two years after its publicationpublication

- the differences might have happened as - the differences might have happened as a consequence of a increasing attention a consequence of a increasing attention with the readers’ demands on quality with the readers’ demands on quality

• from our analysis, we can conclude that:from our analysis, we can conclude that:

- in both impact factors the quality of - in both impact factors the quality of the articles is increasing (except 2002, the articles is increasing (except 2002, that in both cases it decreased)that in both cases it decreased)

ConclusionsConclusions

- even though both impact factors have - even though both impact factors have increased their article's quality, the increased their article's quality, the better articles are published in the better articles are published in the journals with higher impact factorjournals with higher impact factor

- from 2003, the improvement in quality is - from 2003, the improvement in quality is higher than it was beforehigher than it was before

Website Website

Planning our workPlanning our work

• wwe created a Gantt chart where we inserted e created a Gantt chart where we inserted all the tasks to be done, the finishing time all the tasks to be done, the finishing time of each task and who was responsible to do of each task and who was responsible to do itit

Gantt chartGantt chart

• the Gantt chart was updated during the the Gantt chart was updated during the time the work was being carried on, each time the work was being carried on, each time some change was necessarytime some change was necessary

Start

Read titles and abstracts (2 reviewers)

Apply inclusion/exclusion criteria

Article excluded by at least 2 reviewers?

Article included by at least 2 reviewers?

Consult a third reviewerObtain full paper

Create a database

Statistic analysis

End

No

Yes

No

Yes

STARD analysis (2 reviewers)

STARD analysis agreedance?

Consult a third reviewer

Yes

No

Random sample

Articles obtained

Exclude article

Were obtained 10 full papers for each year in

each impact factor?

No

Impact factor < 1?

Impact factor > 4?

No

Define Queries

Yes

No

Define Queries

Yes

Yes

Was the article included?

Exclude article

No

Yes

Methods flowchartMethods flowchart

Participants flowchartParticipants flowchart

Start

Random sample

Article excluded by at least 2 reviewers?

Article included by at least 2 reviewers?

Consult a third reviewer

Obtain full paper

End

No

500 articles obtained

Yes

Apply inclusion/exclusion criteria

100 full papers obtained

??? excluded articles

Yes

No

Was the article included?

Yes

??? excluded articles

No

Were obtained 10 full papers for each year in

each impact factor?

Yes

Impact factor < 1?

Impact factor > 4?

???? articles founded after

queries defining

Yes

No

???? articles founded after

queries defining

No

Yes

New random sample

No

AcknowledgementsAcknowledgements

Professor Altamiro da Costa PereiraProfessor Altamiro da Costa Pereira

Professora Cristina SantosProfessora Cristina Santos