The addition of level of evidence ratings to the journal has several benefits: improve studies by an explicit delineation of the primary research question; allow monitoring and reporting of trends in the quality of the orthopedic clinical research; and, most importantly, place a clinical research study into context for the reader. It is important to remember that levels of evidence are only a cursory guide to study quality and comprehensive assessment requires a critical appraisal of the specific study. Furthermore, level-I evidence may not be available for all clinical situations as randomized controlled trials (RCTs) may not be possible, and level-III or IV evidence can still be of value. Lastly, a composite assessment of all evidence types is necessary to thoroughly answer a clinical question.
Wright et al. (Fri,) studied this question.