The search for level I evidence in solid-tumor oncology

Background: We have developed a method to identify, filter, review, and distribute the published level I evidence for solid tumor oncology. Methods: A standardized MEDLINE search identified prospective randomized controlled trials (PRCTs) in solid tumor oncology. Only PRCTs with therapeutic end points were included. All references were reviewed by a surgical oncology fellow in consultation with experts in the field. The full citations were imported into a comprehensive database. Data on statistical methods according to the Consolidated Standard of Reporting Trials statement were tabulated along with reviewer's comments. A designation of Ia was given to articles that were well designed and significant contributions to their field. The database powers a dynamic, easily searchable Web site on our intranet and is available in personal digital assistant (PDA) format. Results: By using standard search criteria, only .03% of the 11 million articles listed in MEDLINE are PRCTs concerning therapy for solid organ malignancies. Approximately 14% of reviewed articles were given a designation of Ia. Having comprehensive data readily available with intranet access or PDAs 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. This information has been made available and portable by using the Internet and PDAs.