The quality and utility of research in ectopic pregnancy in the last three decades: An analysis of the published literature.

OBJECTIVE: Ectopic pregnancy is a potentially life-threatening health problem that affects fertility and generates a significant economic burden. Optimal management, including when to choose methotrexate, and whether to do salpingectomy or salpingostomy, is still unclear. This study aimed to assess the quality and utility of research on ectopic pregnancy in the last three decades. STUDY DESIGN: We analyzed the quantity, quality and utility of the published literature, including 6,309 articles published over a 30-year period. We searched PubMed for studies on ectopic pregnancy, with subsequent analysis utilizing bibliometric network maps. Consolidated Standards of Reporting Trials (CONSORT) guidelines and a newly adapted checklist for usefulness of research were applied to assess randomized controlled trial (RCT) quality. RESULTS: The initial search returned 14,727 articles, of which, after filters of publication date (1987/01/01 to 2017/12/31), species (Human) and language (English) were applied, 6,309 articles remained. The number of publications each year remained relatively stable, with a mean number of 280 articles published three decades ago versus 248 articles published on average in the last decade. The 7,733 human species articles published between 1987-2017 were written in 27 different languages, with 82 % in English. Publications in 14 selected high-impact journals accounted for 26.5 % (1,673/6,309) of all articles, with on average 54 publications per year across three decades. An increase in systematic reviews and meta-analyses (+1000 %), and case reports (+53 %) was seen between 1987-2017, while the percentage of RCTs (-25 %) decreased. The analyzed RCTs were of moderate quality, and few addressed the most important clinical questions. CONCLUSION: In the last three decades, both the number of articles on ectopic pregnancy and the number of articles in high-impact journals have remained stable. Despite these constant numbers, the quality of RCTs was suboptimal and there was a decrease in the annual number of published RCTs, while the use of meta-analysis significantly amplified. This study suggests continued review of research practices and provides suggestions on how the quality of the published literature can be improved.

Quality of evidence on pre-eclampsia in the last three decades: An analysis of published literature.

OBJECTIVES: In recent years, there has been an increasing amount of information published on pre-eclampsia. We analyzed trends in pre-eclampsia literature between 1997 and 2016 and reported on the quality and utility of randomized controlled trials (RCTs) between 1987 and 2016. METHODS: We searched PubMed for all articles containing "pre-eclampsia" or "hypertensive disorders of pregnancy" in the title between 1997 and 2016 for the general literature and between 1987 and 2016 for RCTs. An analysis was performed based on study type, languages and publications from high-impact journals. Specific to RCTs, a quality and utility analysis based on the CONSORT guidelines and a usefulness checklist was adapted. An analysis by continents and proportion of RCTs published was also performed. Bibliometric network maps were created to determine trends in pre-eclampsia literature. RESULTS: In total, 9654 articles were identified, with a doubling in the number of annual average publications from 310 to 655 between 1997 and 2016. This increase occurred in both English and non-English publications. There was a decline in the proportion of publications from selected high-impact journals from 22% in 1997-2001 to 8% in 2012-2016. Out of the available 130 RCTs that we analyzed, the number of RCTs published in 5-yearly periods remained relatively stable between 1987 and 2016, with quality and utility scores increasing from 24.6 and 11.6 to 31.9 and 13.3, respectively. A geographical search by continents showed that North America produced the majority of RCTs, followed by Asia and Europe. For completed pre-eclampsia trials that were registered between 2005 and 2014, only 68% resulted in peer-reviewed publications. CONCLUSION: The yearly number of publications on pre-eclampsia has substantially increased, with a stable number of high-level study types and publications from high-impact journals. The reporting quality and usefulness of RCTs relating to pre-eclampsia have improved over time.