Wente Moritz N, Seiler Christoph M, Uhl Waldemar, Büchler Markus W
Center for Clinical Studies in Surgery, Department of General, Visceral and Trauma Surgery, University of Heidelberg, Heidelberg, Germany.
Dig Surg. 2003;20(4):263-9. doi: 10.1159/000071183. Epub 2003 May 15.
The assessment of the optimal treatment option based on best current knowledge is called evidence-based medicine (EBM). Considering the cost explosion in public health systems, EBM should also incorporate proper utilization of the restricted economical resources and should enforce quality assurance in medicine. It is imperative that surgeons realize that randomized controlled trials are applicable to the operative specialties in a large scale, and are necessary to provide evidence-based surgery. So far, only 3.4% of all publications in the leading surgical journals are randomized controlled trials. Furthermore, only 44.1% of the published surgical randomized controlled studies compared different surgical procedures, whereas 55.9% of the articles compared medical therapies in surgical patients. Evidence-based surgical therapy is essential for further development of a high- quality surgical standard, which will also provide quality assurance in future surgical care. This article presents the definition of EBM and discusses specific problems involved in the introduction of its principles into the surgical discipline.
基于当前最佳知识评估最佳治疗方案被称为循证医学（EBM）。考虑到公共卫生系统中的成本激增，循证医学还应包括对有限经济资源的合理利用，并应加强医学质量保证。外科医生必须认识到随机对照试验在很大程度上适用于手术专科，并且对于提供循证手术是必要的。到目前为止，在领先的外科期刊上发表的所有文章中，只有3.4%是随机对照试验。此外，已发表的外科随机对照研究中，只有44.1%比较了不同的手术程序，而55.9%的文章比较了外科患者的药物治疗。循证外科治疗对于高质量外科标准的进一步发展至关重要，这也将为未来的外科护理提供质量保证。本文介绍了循证医学的定义，并讨论了将其原则引入外科学科所涉及的具体问题。
