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Evidence-based surgery

Evidence-based surgery
Evidence-based surgery

Every year an estimated 234 million major surgical procedures are undertaken worldwide. In 2009–10, 4.8 million hospital admissions involved surgical input in England alone, and around 4 in 5 adults are likely to have an operation in their lifetime. Despite these enormous numbers, lack of objective evidence for the indications and benefits (or otherwise) of surgical procedures is often lacking. Lack of robust research into surgical disease and treatments has been criticized. Less than 5% of national funding for health research involves surgery. This seems surprising as inappropriate surgical treatments can be hazardous for the patient and costly to the health care system. The demand for evidence-based clinical practice is increasing, driven by public and professional expectations. The scarcity of high-quality studies across many different fields of surgery has led to ambiguity in the management of many common surgical conditions with widely varying clinical outcomes in different geographical areas. Surgical treatments are costly and need to be justified not only on clinical benefit, but on their cost effectiveness compared to other treatments. Several approaches have been adopted to evaluate evidence of benefit for surgical treatments. This article outlines these and their application in a clinical setting. The components of evidence-based medicine and the GRADE method of evaluating quality of evidence are explored. The importance of taking into consideration cost effectiveness and patient attitudes to treatment are also discussed.

Evidence-based medicine, meta-analyses, randomized controlled trials, surgical research, systematic review
0263-9319
1-6
Shearman, Alexander D.
3326cf13-db74-4385-9329-e4646f1aef6e
Shearman, Clifford P.
cf4d6317-f54d-4ab3-ba49-c6797897bbcf
Shearman, Alexander D.
3326cf13-db74-4385-9329-e4646f1aef6e
Shearman, Clifford P.
cf4d6317-f54d-4ab3-ba49-c6797897bbcf

Shearman, Alexander D. and Shearman, Clifford P. (2018) Evidence-based surgery. Surgery, 1-6. (doi:10.1016/j.mpsur.2018.07.010).

Record type: Article

Abstract

Every year an estimated 234 million major surgical procedures are undertaken worldwide. In 2009–10, 4.8 million hospital admissions involved surgical input in England alone, and around 4 in 5 adults are likely to have an operation in their lifetime. Despite these enormous numbers, lack of objective evidence for the indications and benefits (or otherwise) of surgical procedures is often lacking. Lack of robust research into surgical disease and treatments has been criticized. Less than 5% of national funding for health research involves surgery. This seems surprising as inappropriate surgical treatments can be hazardous for the patient and costly to the health care system. The demand for evidence-based clinical practice is increasing, driven by public and professional expectations. The scarcity of high-quality studies across many different fields of surgery has led to ambiguity in the management of many common surgical conditions with widely varying clinical outcomes in different geographical areas. Surgical treatments are costly and need to be justified not only on clinical benefit, but on their cost effectiveness compared to other treatments. Several approaches have been adopted to evaluate evidence of benefit for surgical treatments. This article outlines these and their application in a clinical setting. The components of evidence-based medicine and the GRADE method of evaluating quality of evidence are explored. The importance of taking into consideration cost effectiveness and patient attitudes to treatment are also discussed.

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More information

e-pub ahead of print date: 1 September 2018
Keywords: Evidence-based medicine, meta-analyses, randomized controlled trials, surgical research, systematic review

Identifiers

Local EPrints ID: 426582
URI: http://eprints.soton.ac.uk/id/eprint/426582
ISSN: 0263-9319
PURE UUID: 5aa86676-4aa8-499b-99c0-afc0dac9580d

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Date deposited: 30 Nov 2018 17:30
Last modified: 30 Nov 2018 17:30

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Contributors

Author: Alexander D. Shearman

University divisions

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