Introduction & Objectives:
Evidence in medicine was largely anecdotal before the mid-19th Century, until doctors such as Pierre Louis (1787-1872) statistically interrogated established practice. It was not until 1946 that the first Randomised Controlled Trial (RCT) was published. We present how approaches to research in Urology have evolved over the last 50 years.
Material & Methods:
Writing on the advances of research in medicine was evaluated, before looking specifically at Urology. Three reviews of 'key papers' in Urology (1967, 1999 and 2010) were analysed for changes in approaches to research. We also considered what are currently the most cited papers.
Results:
In 1967 experts referenced papers from eight decades; in 1999 there were selections from each of the previous three decades; but in 2010 the vast majority were from the preceding ten years. In the first two reviews most studies were case series, with no RCTs in the first and less than 10% in the second. However, in the 2010 publication, RCT was the most frequently used study technique (38%).
In slight contrast the most commonly cited papers come from a greater period than in the 2010 review, with proportionally less RCTs. This may represent the fact that earlier work reports the initial evidence, which the authors subsequently go on to explore in their own research.
Conclusions:
Urology has developed and expanded over the last half century. Research that is now considered the most significant is increasingly contemporary, with RCT (despite flaws) being seen as the most important approach.