Evidence-Based Medicine in Plastic Surgery Are We There Yet?

Background: The practice of evidence-based medicine in plastic surgery is no longer a trend but a reality, with a growing number of studies published in recent years using evidence-based medicine as an assessment tool. Objective: The aim of this study was to verify whether the number of citations to articles with a high level of evidence is greater than articles with low level of evidence. Methods: A search was conducted in the 4 main international journals of plastic surgery. All original articles published in 2011 were analyzed, selected, and classified based on the study design. The articles were then divided into 2 groups: group 1, high level of evidence; and group 2, low level of evidence. Next, Scopus was searched for the number of citations of each article in the 2 subsequent years. The proportion of the number of citations received by articles in groups 1 and 2 was statistically compared. Results: The articles with the highest level of evidence were the most cited among original articles, with 48.6% of them being cited more than 10 times over 2 years, whereas only 18.4% of articles in group 2 were cited with the same frequency. The mean number of citations was 12.6 citations per article in group 1 and 6.56 citations in group 2, with a significant difference between groups (P < 0.0001). Conclusions: The articles with a higher level of evidence are, on average, cited more often than those with low levels of evidence in the leading journals of plastic surgery.