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Evidence-based surgery

Bibliographic Details
Title: Evidence-based surgery
Authors: Miran Rems
Source: Zdravniški Vestnik, Vol 76, Iss 4 (2007)
Publisher Information: Slovenian Medical Association, 2007.
Publication Year: 2007
Collection: LCC:Medicine
Subject Terms: evidence-based surgery, surgeon, critical assessment, ethics, Medicine
More Details: Background: Surgery is setting a new ground by the reign of evidence that was brought up by the Evidence Based Medicine (EBM). While experiences and opinion of an expert count the least by the principles of EBM, randomized controlled trials (RCT) and other comparative studies have gained their importance. Recommendations that were included in guidelines represent a demanding shift in surgeon’s professional thinking. Their thinking and classical education have not yet been completely based on the results of such studies and are still very very much master-pupil centred. Assessment of someone’s own experiences is threatened by objectivity as negative experiences get recorded in deeper memory. Randomized studies and meta-analyses do appear also in surgery. However, they demand an extra knowledge about critical assessment.Conclusions: Setting a patient to the foreground brings a surgeon’s decision to the field of EBM. The process has already begun and cannot be avoided. Decision hierarchy moves from the experience field to the evidence territory but to a lesser extent when compared to the rest of medicine. There exist objective restrictions with approving a new paradigm. However, these should not stop the process of EBM implementation. Finally, there is an ethic issue to be considered. Too slow activities in research, education and critical assessment can bring the surgeon to the position when a well-informed patient loses his/her trust.
Document Type: article
File Description: electronic resource
Language: English
Slovenian
ISSN: 1318-0347
1581-0224
Relation: http://vestnik.szd.si/index.php/ZdravVest/article/view/1706; https://doaj.org/toc/1318-0347; https://doaj.org/toc/1581-0224
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Accession Number: edsdoj.835a7ffd93a4a278ac6a96c4c803cbf
Database: Directory of Open Access Journals
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  Data: Background: Surgery is setting a new ground by the reign of evidence that was brought up by the Evidence Based Medicine (EBM). While experiences and opinion of an expert count the least by the principles of EBM, randomized controlled trials (RCT) and other comparative studies have gained their importance. Recommendations that were included in guidelines represent a demanding shift in surgeon’s professional thinking. Their thinking and classical education have not yet been completely based on the results of such studies and are still very very much master-pupil centred. Assessment of someone’s own experiences is threatened by objectivity as negative experiences get recorded in deeper memory. Randomized studies and meta-analyses do appear also in surgery. However, they demand an extra knowledge about critical assessment.Conclusions: Setting a patient to the foreground brings a surgeon’s decision to the field of EBM. The process has already begun and cannot be avoided. Decision hierarchy moves from the experience field to the evidence territory but to a lesser extent when compared to the rest of medicine. There exist objective restrictions with approving a new paradigm. However, these should not stop the process of EBM implementation. Finally, there is an ethic issue to be considered. Too slow activities in research, education and critical assessment can bring the surgeon to the position when a well-informed patient loses his/her trust.
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