Evidence-Based Surgery: A Guide to Understanding and Interpreting the Surgical Literature

ISBN-13: 9783030051198 / Angielski / Miękka / 2019 / 360 str.

Thoma, Achilles

Opis

Surgeons are frequently inundated with new academic publications relevant to their clinical practice. There is an ever-increasing number of surgical journals and publications available to surgeons from which they can intake these advances in patient care. While most publications go through a rigorous peer-reviewed process, this process does not include the steps of evidence-based surgery; consequently "the truth" maybe different from what we read. As most surgeons do not have health research methodology skills necessary to help them understand how the research was done, what the findings of the research were, and how to interpret the findings they may have difficulty applying what they read to their surgical practice. This text, will help academic and community surgeons as well as trainees in surgery, learn the skills to appraise and apply the surgical literature to their daily practice. With these skills, they will be better informed on the best available evidence before applying it to patient care. Although a similar purpose textbook exists for medical subspecialties the content is often not applicable to surgical care due to differences in surgical research methodology and a lack of surgical examples within the medical themed books. In the proposed book, each chapter will start with a clinical surgical scenario with uncertain course of action which will make it relevant for the surgical community. The reader will be taught how to search the literature for the best evidence that will answer the surgical problem under discussion. An identified article that seems relevant to the problem will then be appraised and will address the following questions in a simple and easy to follow manner: 1. Is the study Valid? 2. What are the results? 3. Can I apply them to my practice? Depending on the study design, additional subsidiary questions will be asked and these will also be appraised. Although the primary goal of this text is to teach surgeons how to appraise the surgical literature, an added benefit is to inform surgeons how to produce higher quality surgical research.

Spis treści

History of Evidence-Based Surgery (EBS).- The Steps of Practicing Evidence-Based Surgery (EBS).- Developing a Surgical Clinical Research Question: To Find the Answer in Literature Search or in Pursuing Clinical Research.- Finding the Evidence Through Searching the Literature.- Hierarchy of Evidence in Surgical Research.- Evaluating Surgical Interventions.- A Primer on Outcome Measures for Surgical Interventions.- Patient Important Outcome Measures in Surgical Care.- Surrogate Endpoints.- How to asses an Article that Deals with health-Related Quality of Life.- Randomized Controlled Trial Comparing Surgical Interventions.- How to Assess a Pilot Trial in Surgery.- Non-Inferiority Randomized Controlled Trials.- Expertise-Based Randomized Controlled Trials.- The Surgeon’s Guide to Systematic Review and Meta-Analysis.- Prospective and Retrospective Cohort Studies.- Case-Control Studies.- Evaluating Case Series in Surgery.- Quality Improvement and Patient Safety in Surgery.- Diagnostic Studies in Surgery.- How to Assess a Prognostic Study.- Decision Analysis and Surgery.- Economic Evaluations in Surgery.- Studies Reporting Harm in Surgery.- Evaluating Surveys and Questionnaires in Surgical Research.- Opinion Pieces in Surgery.- Simple Statistical Tests and P Values.- Confidence Intervals.- Power and Sample Size.- Subgroup Analyses in Surgery.- Introduction to Clinical Practice Guidelines.

O autorze

Achilles Thoma

Department of Surgery, Division of Plastic Surgery

Department of Health Research Methods, Evidence and Impact (HEI)

McMaster University 

Hamilton, Ontario, Canada

 

Sheila Sprague,

Department of Surgery, Division of Orthopaedic Surgery

Department of Health Research Methods, Evidence and Impact (HEI)

McMaster University

Hamilton, Ontario, Canada

 

Sophocles H. Voineskos

Department of Surgery, Division of Plastic Surgery

McMaster University

Hamilton, Ontario, Canada

Charlie H. Goldsmith

Department of Health Research Methods, Evidence and Impact (HEI)

McMaster University

Hamilton, Ontario, Canada

Faculty of Health Sciences, Simon Fraser University

Burnaby, British Columbia, Canada

Department of Occupational Science and Occupational Therapy, Faculty of Medicine,

The University of British Columbia,

Vancouver, BC, Canada

Blurb

The purpose of this book specifically is to teach surgeons (academic or community), surgical fellows and surgical residents regardless of the surgical specialty, the skills to appraise what they read in the surgical literature.  Surgeons need to be able to understand what they read before applying the conclusions of a surgical article to their practice.  As most surgeons do not have the extra training in health research methodology, understanding how the research was done, how to interpret the results and finally deciding to apply them to the patient level is indeed a difficult task.

 

Chapters explain the methodological issues pertaining to the various study designs reported in the surgical literature.  Most chapters begin with a clinical scenario with uncertain course of action with which most surgeons are struggling.  Readers are taught how to search the literature for the best evidence that will answer the surgical problem under discussion. An identified article that seems relevant to the problem you are investigating can be appraised by addressing 3 key questions: 1). Is the study I am reading valid? 2). What are the results of this study? 3). Can I apply these results to my patients?

 

While the primary goal of Evidence-Based Surgery is to teach surgeons how to appraise the surgical literature, an added benefit is that the concepts explained here may help research-minded surgeons produce higher quality research.