TY - CHAP M1 - Book, Section TI - Understanding, Evaluating, and Using Evidence for Surgical Practice A1 - Benjamin, Andrew J. A1 - Schneider, Andrew B. A1 - Matthews, Jeffrey B. A1 - An, Gary A2 - Brunicardi, F. Charles A2 - Andersen, Dana K. A2 - Billiar, Timothy R. A2 - Dunn, David L. A2 - Kao, Lillian S. A2 - Hunter, John G. A2 - Matthews, Jeffrey B. A2 - Pollock, Raphael E. PY - 2019 T2 - Schwartz's Principles of Surgery, 11e AB - Key Points Cognitive bias is inescapable, and limits the ability of both individual practitioners and the surgical field in general, to advance and improve in a scientific fashion. Evidence Based Medicine is an attempt to codify the process of interpreting experience, assessing the literature and translating it into practice. Dealing with and interpreting the vast amount of surgical literature available on the Internet can be daunting, and this task can be aided by the application of identified formats for executing online search. The PICO (Patient/Population, Intervention, Comparison and Outcome) format is a commonly used method for codifying online search. Not all literature or evidence is created equal. There exist various approaches, such as the Oxford Center for Evidence Based Medicine (CEBM) Levels of Evidence or the GRADE (Grading and Recommendations, Assessment, Development and Evaluation) system, that have been developed to provide guidance in assessing and reifying scientific literature. The conversion of evidence into clinical practice often manifests in the creation of clinical guidelines. As with all things related to evidence based medicine, not all guidelines are created equal, and therefore there are certain characteristics that can be used to evaluate the quality of a particular clinical guideline. There are specific challenges in the application of evidence based medicine to surgery, not least of which is the difficulty in performing a truly randomized clinical trial. The CONSORT (Consolidated Standard of Reporting Clinical Trials) guidelines were developed to serve as minimal recommendations for reporting randomized clinical trials. The well-known saying “There are lies, damn lies and then statistics” points to the recognition that statistical tools can be prone to misuse, and emphasizes the need to understand the appropriate application, limits of and interpretation of reported statistics. Evidence based medicine has not thus far been held to its own standards of evidence. Recognizing that available “evidence” is a constantly shifting landscape should warn one against the dangers of epistemic certainty, and further emphasizes the fact that surgical education is an ongoing and perpetual process. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1175961353 ER -