The search for level I evidence in solid-tumor oncology

Background: We have developed a method to identify, filter, review, and dis tribute the published level I evidence for solid tumor oncology. Methods: A standardized MEDLINE search identified prospective randomized co ntrolled trials (PRCTs) in solid tumor oncology. Only PRCTs with therapeuti c end points were included. All references were reviewed by a surgical onco logy fellow in consultation with experts in the field. The full citations w ere imported into a comprehensive database. Data on statistical methods acc ording to the Consolidated Standard of Reporting Trials statement were tabu lated along with reviewer's comments. A designation of Ia was given to arti cles that were well designed and significant contributions to their field. The database powers a dynamic, easily searchable Web site on our intranet a nd is available in personal digital assistant (PDA) format. Results: By using standard search criteria, only .03% of the 11 million art icles listed in MEDLINE are PRCTs concerning therapy for solid organ malign ancies. Approximately 14% of reviewed articles were given a designation of Ia. Having comprehensive data readily available with intranet access or PDA s during conferences enhances their educational value and specificity. Conclusions: We have developed an exciting tool that uses a highly trained filter to screen and record the, medical data available to the clinician. T his information has been made available and portable by using the Internet and PDAs.