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Evidence-Based Science
A Worthwhile Mode of Surgical Inquiry
Jyoti Arya, MD;
Heather Wolford, MD;
Alden H. Harken, MD
Arch Surg. 2002;137:1301-1303.
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INTRODUCTION
The randomized clinical trial (RCT) is a laudable and invaluable mode of surgical inquiry. It has been presented as the Holy Grail—responsible surgeons must base all patient-related therapies on level I evidence. In this article, we propose (1) to plumb the origins of evidence-based thought, (2) to explore the validity of programs that predigest the morass of surgical information provided to data-deluged surgeons, and (3) to examine the value of all 5 (I-V) levels of scientific inquiry in directing therapeutic surgical strategies.
ARE THERE REALLY "LEVELS" OF SCIENTIFIC INQUIRY?
The traditional levels of scientific investigation are presented in Table 1, from the exalted RCT to the lowly case report and expert opinion. Perhaps predictably, if we review the reviews of RCTs and the RCT reviewers, patterns of reviewer confusion and conflict emerge.1 Equally predictable is the observation that we only publish our results if we are . . . [Full Text of this Article]
WHAT IS THE PROBLEM?
IS EVIDENCE-BASED DECISION MAKING NEW?
WHO WAS ARCHIBALD L. COCHRANE?
SO, HOW SHOULD WE SURGEONS DECIDE?
SO, LET US PRACTICE EVIDENCE-BASED MEDICINE
From the Department of Surgery, University of Colorado, Denver.
RELATED ARTICLE
This Month in Archives of Surgery
Arch Surg. 2002;137(11):1216.
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