Nonoperative Management of Tibial Stress Fractures Result in Higher Return to Sport Rates Despite Increased Failure Versus Operative Management: A Systematic Review

Editorial Commentary: Medical Research Study Quality Could Improve if Authors Consider General and Condition-Specific Study Quality Scoring Systems When Designing Their Investigations

Medical researchers constantly try to improve, but multiple studies have suggested that the quality of scientific publications is getting worse. The key to improving may be routine incorporation of metrics of study quality. Examples include the Modified Coleman Methodology Score and the Newcastle-Ottawa Scale. Although these metrics do include points for prospective versus retrospective design, they also include more general markers of robust quality such as "follow-up time," "number of patients," and "description of participant selection process." This scoring permits a delineation between comprehensive versus more limited retrospective studies. Although the Modified Coleman Methodology Score and Newcastle-Ottawa Scale are primarily tools used in systematic reviews to assess the quality of the studies included in their analysis, perhaps journals should encourage authors of original research to measure and report the quality of their manuscript, similar to the Strengthening the Reporting of Observational Studies in Epidemiology checklist requirement for prospective studies. Then, authors could self-regulate and consider these rubrics when designing studies. By providing a target, authors would know for what to strive. For our community to advance to the next phase of data analysis, we will need to improve the quality of our work, both from a design standpoint and a greater collective emphasis on comprehensive data input. The only way to get better is to keep score.