Mislabeling of Case-Control Studies in Ophthalmologic Literature: A Bibliometric Analysis

Purpose: To characterize the prevalence and determinants of case-control study mislabeling in recent ophthalmologic journals. Methods: A bibliometric analysis was conducted on 386 articles self-declared as case-control or case-controlled studies, published from 2022 to 2023 across 95 PubMed-indexed ophthalmologic journals. Two blinded reviewers independently classified study designs using established epidemiological criteria and standardized the Level of Evidence per the Joanna Briggs Institute (2014) guidelines. Associations between mislabeling and bibliometric factors (Journal Citation Reports quartile, place of publication) were evaluated using logistic regression. Results: A total of 273 articles (70.7%) were mislabeled. Reclassification revealed alterations in evidence hierarchies, with 49% exhibiting inflated level of evidence and 18% demonstrating under-reported level of evidence. Logistic regression revealed that articles published in Q1 journals had significantly lower odds of being mislabeled (odds ratio, 0.511; 95% confidence interval, 0.277-0.943) compared with Q4 journals. No significant association was found between mislabeling and the place of publication. Conclusions: There is pervasive mislabeling of study designs in ophthalmologic journals that distorts levels of evidence, necessitating standardized guidelines and validation tools. Translational Relevance: This study enhances the reliability of ophthalmologic evidence by providing a framework to identify and correct mislabeled study designs.