To The Editor:In his Presidential Address to the American Academy of Orthopaedic Surgeons
(AAOS), "Knowledge Is Our Business"
(2004;86:1575-8), Dr. Bucholz,
as they say, hit the nail on the head. Knowledge is the business of the
American Academy of Orthopaedic Surgeons. As he so eloquently stated, the
Academy is "the authority for up-to-date, accurate knowledge on
musculoskeletal diseases and patient care." With that thought in mind, I
would propose that the Academy begin to integrate level-of-evidence ratings
into their activities. Levels of evidence are a way of grading the quality of
the studies on the basis of their methodology, where Level I, a randomized
clinical trial, is the highest level and Level V, expert opinion, is the
lowest level of evidence.