Clinical Research and Evidence-Based Pediatric Surgery
- 295 Downloads
Evidence-based medicine (EBM) is the process of acquiring the best available research evidence and applying this evidence to inform the best practice in a defined problem in clinical practice. The widespread popularization of the concept of EBM since its first introduction more than three decades ago has resulted in a paradigm shift in biomedicine from a largely experience- and opinion-based practice toward one based increasingly on objective scientific evidence.
Properly designed and implemented clinical research represents the best way to provide high-quality scientific evidence for informing the practice of EBM. Among different study designs, prospective randomized controlled trial (RCT) is regarded as the gold standard of clinical research and gives the highest level of evidence (Class I evidence). For specialties that are progressing faster in the practice of EBM, the rapid accumulation of research finding also highlights the importance of critical appraisal skill for assessing the quality of available evidence. In many surgical settings including pediatric surgery, however, important barriers that may hinder the proper design and implementation of RCTs are still common. A better understanding of the concept of clinical research and EBM would thus serve to equip researchers in these settings to produce better scientific evidence and for practitioners to incorporate the best available evidence into their clinical practice.
KeywordsClinical research Evidence-based medicine Randomized controlled trial (RCT) Study design Critical appraisal Hierarchy of evidence
- Bossuyt PM, Reitsma JB, Bruns DE Gatsonis PP, Glasziou PP, Irwig LM, Moher D, Rennie D, De Vet HC, Lijmer JG. Standards for reporting of diagnostic accuracy. The STARD statement for reporting of diagnostic accuracy: explanation and elaboration. Clin Chem. 2003;49(1):7–18.CrossRefPubMedGoogle Scholar
- Cochrane AL. Effectiveness and efficiency: random reflections on health services. London: Nuffield Provincial Hospitals Trust; 1972. Reprinted in 1989 in association with the BMJ. Reprinted in 1999 for Nuffield Trust by the Royal Society of Medicine Press, London, ISBN 1-85315-394-XGoogle Scholar
- New format for BMJ research articles in print. BMJ. 2008;337:a2946.Google Scholar