Skip to main content

Advertisement

SpringerLink
Log in

Evidence-based medicine—from best research evidence to a better surgical practice and health care

  • Current Concepts in Clinical Surgery
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background

The use of the terms evidence-based medicine (EBM) and healthcare (EBHC) has become commonplace in the medical as well as in the surgical literature. Using the best available evidence, however, is not yet a working routine among surgeons because of the large amount and complexity of published research and the lack of user-friendly tools and necessary skills for the use of research results.

Discussion

This article encourages to formulate surgically relevant questions and to answer them on the basis of high-quality research, preferably by using systematic reviews which are based on the quality criteria of the Cochrane Collaboration.

Conclusions

As currently only 77 Cochrane reviews address surgical procedures; much work remains to be done to enlarge the number of high-quality and relevant reviews. Similarly, the number and quality of randomized controlled trials need to be increased in all surgical specialties.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Antes G, Galandi D, Bouillon B (1999) What is evidence-based medicine? Langenbeck’s Arch Surg 384:409–416

    Article  PubMed  CAS  Google Scholar 

  2. Antman EM, Lau J, Kupelnick B, Mosteller F, Chalmers TC (1992) A comparison of results of meta-analyses of randomized control trials and recommendations of clinical experts. Treatments for myocardial infarction. JAMA 268:240–248

    Article  PubMed  CAS  Google Scholar 

  3. Bauer H (2005) Evidenzbasierte Medizin: Wunsch und Wirklichkeit im chirurgischen Alltag. Chirurg 76:795–796

    Article  PubMed  CAS  Google Scholar 

  4. Black N (1999) Evidence-based surgery: a passing fad? World J Surg 23:789–793

    Article  PubMed  CAS  Google Scholar 

  5. Chalmers IG, Collins RE, Dickersin K (1992) Controlled trials and meta-analyses can help resolve disagreements among orthopaedic surgeons. J Bone Joint Surg Br 74:641–643

    PubMed  CAS  Google Scholar 

  6. Clancy CM, Kamerow DB (1996) Evidence-based medicine meets cost-effectiveness analysis [editorial]. JAMA 276:329–330

    Article  PubMed  CAS  Google Scholar 

  7. Claridge JA, Fabian TC (2005) History and development of evidence-based medicine. World J Surg 29:547–553

    Article  PubMed  Google Scholar 

  8. Devereaux PJ, Bhandari M, Clarke M, Montori VM, Cook DJ, Yusuf S, Sackett DL, Cinà CS, Walter SD, Haynes B, Schünemann HJ, Norman GR, Guyatt GH (2005) Need for expertise based randomised controlled trials. BMJ 330:88–91

    Article  PubMed  CAS  Google Scholar 

  9. Dixon E, Hameed M, Sutherland F, Cook DJ, Doig C (2005) Evaluating meta-analyses in the general surgical literature: a critical appraisal. Ann Surg 241:450–459

    Article  PubMed  Google Scholar 

  10. Evidence-Based Medicine Working Group (1992) Evidence-based medicine: a new approach to teaching the practice of medicine. JAMA 268:2420–2425

    Article  Google Scholar 

  11. Goldhahn S, Audige L, Helfet DL, Hanson B (2005) Pathways to evidence-based knowledge in orthopaedic surgery: an international survey of AO course participants. Int Orthop 29:59–64

    Article  PubMed  Google Scholar 

  12. GRADE Working Group (2004) Grading quality of evidence and strength of recommendations. BMJ 328:1490

    Article  PubMed  Google Scholar 

  13. Hall JC, Platell C (1997) Half-life of truth in surgical literature [letter]. Lancet 350:1752

    Article  PubMed  CAS  Google Scholar 

  14. Horton R (1996) Surgical research or comic opera: questions, but few answers [editorial]. Lancet 347:984–985

    Article  PubMed  CAS  Google Scholar 

  15. Howes N, Chagla L, Thorpe M, McCulloch P (1997) Surgical practice is evidence based. Br J Surg 84:1220–1223

    Article  PubMed  CAS  Google Scholar 

  16. Hurwitz SR, Slawson D, Shaughnessy A (2000) Orthopaedic information mastery: applying evidence-based information tools to improve patient outcomes while saving orthopaedists’ time. J Bone Jt Surg 82-A:888–894

    Google Scholar 

  17. Institute of Medicine—Committee on Quality of Health Care in America (2001) Crossing the quality chasm: a new health system for the 21st century. National Academy Press, Washington

    Google Scholar 

  18. Kingston R, Barry M, Tierney S, Drumm J, Grace P (2001) Treatment of surgical patients is evidence-based. Eur J Surg 167:324–330

    Article  PubMed  CAS  Google Scholar 

  19. McDonald S, Lefebvre C, Antes G, Galandi D, Gøtzsche P, Hammarquist C, Haugh M, Jensen KL, Kleijnen J, Loep M, Pistotti V, Rüther A (2002) The contribution of handsearching European general health care journals to the Cochrane Controlled Trials Register. Eval Health Prof 25:65–75

    Article  PubMed  Google Scholar 

  20. Medical Research Council (2003) Clinical trials for tomorrow. An MRC review of randomized controlled trials. MRC, London

    Google Scholar 

  21. Mirow L, Schwandner O, Bruch HP (2005) Was ist evidenzbasiert in der Viszeralchirurgie? Viszeralchirurgie 40:1–8

    Article  Google Scholar 

  22. Muir Gray JA (2001) Evidence-based healthcare: how to make health-policy and management decisions, 2nd edn. Churchill Livingstone, Edinburgh

    Google Scholar 

  23. Sackett DL, Rosenberg WM, Muir Gray JA, Haynes RB, Richardson WS (1996) Evidence based medicine: what it is and what it isn’t. BMJ 312:71–72

    PubMed  CAS  Google Scholar 

  24. Sauerland S, Bouillon B, Neugebauer E (2003) Praktische Anwendung der EBM in der Chirurgie: Evidenz und Erfahrung. Z Ärztl Fortbild Qualitätssich 97:271–276

    PubMed  Google Scholar 

  25. Sauerland S, Lefering R, Neugebauer EAM (1999) The pros and cons of evidence-based surgery. Langenbeck’s Arch Surg 384:423–431

    Article  PubMed  CAS  Google Scholar 

  26. Sauerland S, Maegele M (2004) A CRASH landing in severe head injury [editorial]. Lancet 364:1291–1292

    Article  PubMed  Google Scholar 

  27. Sauerland S, Seiler CM (2005) The role of systematic reviews and meta-analysis in evidence-based medicine. World J Surg 29:582–587

    Article  PubMed  Google Scholar 

  28. Seiler CM, Knaebel H-P, Wente MN, Rothmund M, Büchler MW (2004) Plädoyer für mehr evidenzbasierte Chirurgie. Dtsch Ärztebl 101:A338–A344

    Google Scholar 

  29. Slim K (2005) Limits of evidence-based surgery. World J Surg 29:606–609

    Article  PubMed  Google Scholar 

  30. Slim K, Panis Y, Chipponi J (2004) Half of the current practice of gastrointestinal surgery is against the evidence: a survey of the French Society of Digestive Surgery. J Gastrointest Surg 8:1079–1082

    Article  PubMed  Google Scholar 

  31. Straus SE, Richardson WS, Glasziou P, Haynes RB (2005) Evidence-based medicine: how to practice and teach EBM. Churchill Livingstone, Edinburgh

    Google Scholar 

  32. Toedter LJ, Thompson LL, Rohatgi C (2004) Training surgeons to do evidence-based surgery: a collaborative approach. J Am Coll Surg 199:293–299

    Article  PubMed  Google Scholar 

  33. Ubbink DT, Legemate DA (2004) Evidence-based surgery. Br J Surg 91:1091–1092

    Article  PubMed  CAS  Google Scholar 

  34. University of Sheffield School of Health and Related Research (2005) What proportion of healthcare is evidence based? http://www.shef.ac.uk/scharr/ir/percent.html. Accessed 31 August 2005

  35. Wente MN, Seiler CM, Uhl W, Büchler MW (2003) Perspectives of evidence-based surgery. Dig Surg 20:263–269

    Article  PubMed  Google Scholar 

  36. Young C, Horton R (2005) Putting clinical trials into context. Lancet 366:107–108

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. German Cochrane Centre, Department of Medical Biometrics and Informatics, Division of Medical Biometrics and Statistics, University of Freiburg, Stefan-Meier-Street 26, 79104, Freiburg, Germany

    G. Antes

  2. Institute for Research in Operative Medicine, University of Witten/Herdecke, Cologne, Germany

    S. Sauerland

  3. Study Centre of the German Surgical Society, Department of Surgery, University of Heidelberg, Heidelberg, Germany

    C. M. Seiler

Authors
  1. G. Antes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Sauerland
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. M. Seiler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. Antes.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Antes, G., Sauerland, S. & Seiler, C.M. Evidence-based medicine—from best research evidence to a better surgical practice and health care. Langenbecks Arch Surg 391, 61–67 (2006). https://doi.org/10.1007/s00423-005-0006-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-005-0006-4

Keywords

Search

Navigation