Evidence-based surgery

Abstract

Evidence-based surgery (EBS) involves the integration of the best clinical and scientific evidence to treat patients. Best evidence is derived from the research literature and can be categorised into a hierarchy of levels. Application of the knowledge derived from best evidence results in enhanced care for patients and also improved standards for surgeons and health care institutions. The sources of surgical evidence are discussed, and we review surgical training in evidence-based practice. Techniques for answering a surgical question using an evidence-based method and for practising surgery in an evidence-based environment are described. Furthermore, we examine the role of treatment networks, cost-effectiveness, evidence synthesis, surgical decision making and the ethics of EBS. For the current and future surgeon, evidence-based practice is now an inevitable and fundamental component of the surgical profession. Its universal adoption will play an important role in the advancement of patient care and surgery worldwide. © Springer-Verlag Berlin Heidelberg 2010.