Schnitzbauer Andreas A, Proneth Andrea, Pengel Liset, Ansorg Jörg, Anthuber Matthias, Bechstein Wolf O, Schlitt Hans J, Geissler Edward K
Department of General and Visceral Surgery, Frankfurt University Hospitals, Goethe University Frankfurt am Main, Frankfurt am Main, Germany.
Eur Surg Res. 2015;54(1-2):14-23. doi: 10.1159/000367940. Epub 2014 Oct 9.
Evidence-based medicine (EbM) is a vital part of reasonable and conclusive decision making for clinicians in daily clinical work. To analyze the knowledge and the attitude of surgeons towards EbM, a survey was performed in the UK and Germany.
A web-based questionnaire was distributed via mailing lists from the Royal College of Surgeons of England (RCSE) and the Berufsverband Deutscher Chirurgen (BDC). Our primary aim was to get information about knowledge of EbM amongst German and British surgeons.
A total of 549 individuals opened the questionnaire, but only 198 questionnaires were complete and valid for analysis. In total, 40,000 recipients were approached via the mailing lists of the BDC and RCSE. The response rate was equally low in both countries. On a scale from 1 (unimportant) to 10 (very important), all participants rated EbM as very important for daily clinical decision making (7.3 ± 1.9) as well as for patients (7.8 ± 1.9) and the national health system (7.8 ± 1.9). On a scale from 1 (unimportant) to 5 (very important), systematic reviews (4.6 ± 0.6) and randomized controlled trials (4.6 ± 0.6) were identified as the highest levels of study designs to enhance evidence in medicine. British surgeons considered EbM to be more important in daily clinical work when compared to data from German surgeons (7.9 ± 1.6 vs. 6.7 ± 2.1, p < 0.001). Subgroup analysis showed different results in some categories; however, a pattern to explain the differences was not evident. Personal requirements expressed in a free text field emphasized the results and reflected concerns such as broad unwillingness and lack of interdisciplinary approaches for patients (n = 59: 25 in the UK and 34 in Germany).
The overall results show that EbM is believed to be important by surgeons in the UK and Germany. However, perception of EbM in the respective health system (UK vs. Germany) may be different. Nonetheless, EbM is an important tool to navigate through daily clinical problems although a discrepancy between the knowledge of theoretical abstract terms and difficulties in implementing EbM in daily clinical work has been detected. The provision of infrastructure, courses and structured education as a permanent instrument will advance the knowledge, application and improvement of EbM in the future.
循证医学（EbM）是临床医生在日常临床工作中进行合理且有结论性决策的重要组成部分。为分析外科医生对循证医学的认知和态度，在英国和德国开展了一项调查。
通过英国皇家外科医学院（RCSE）和德国外科医生职业协会（BDC）的邮件列表分发基于网络的问卷。我们的主要目的是获取德国和英国外科医生关于循证医学知识的信息。
共有549人打开了问卷，但只有198份问卷完整且有效可供分析。通过BDC和RCSE的邮件列表总共联系了40000名收件人。两国的回复率都同样很低。在从1（不重要）到10（非常重要）的量表上，所有参与者都认为循证医学对日常临床决策（7.3±1.9）、对患者（7.8±1.9）以及对国家卫生系统（7.8±1.9）都非常重要。在从1（不重要）到5（非常重要）的量表上，系统评价（4.6±0.6）和随机对照试验（4.6±0.6）被确定为提高医学证据的最高级别研究设计。与德国外科医生的数据相比，英国外科医生认为循证医学在日常临床工作中更重要（7.9±1.6对6.7±2.1，p<0.001）。亚组分析在某些类别中显示出不同结果；然而，解释这些差异的模式并不明显。在自由文本字段中表达的个人要求强调了这些结果，并反映了一些担忧，如普遍的不情愿以及缺乏针对患者的跨学科方法（n = 59：英国25人，德国34人）。
总体结果表明，英国和德国的外科医生都认为循证医学很重要。然而，在各自国家（英国与德国）对循证医学的认知可能有所不同。尽管如此，循证医学是应对日常临床问题的重要工具，尽管已发现理论抽象术语的知识与在日常临床工作中实施循证医学的困难之间存在差异。提供基础设施、课程和结构化教育作为一种长期手段，将在未来促进循证医学的知识、应用和改进。
