Der EbM-Kommentar auf dem DKOU: Hintergründe, Ziele und Vision

Abstract

The critical appraisal of clinical and scientific work to assure the effectiveness and to balance the risks of treatment are mandatory today. Recent innovations in medicine often lead only to minor improvement in patient benefit. For the better understanding of the presented study results, the EbM commentary was introduced in 2007 at the Annual Meeting of the German Society of Orthopaedics and Traumatology. The EbM commentary was developed within the Swiss Orthopaedic Society and is a vital part of the Annual Meetings. The EbM commentary is a carefully prepared critical appraisal of an orally presented study by a specially trained colleague. The commentary consists of three components and begins with a systematic analysis following the SPION principle. What kind of study was carried out? Which patients were enrolled in the investigation? What kind of interventions were compared? How was the outcome measured? What is the benefit of the study for my own practice and what is the benefit for the patient? The reporting and the evaluation of the patient benefit is of great interest. In the second step the strengths and weaknesses of the study were discussed and the study will be rated for their evidence. For the best case the presented study implies direct changes in the usual treatment of patients. In the worst case no changes are necessary and the study is rated "so what" because of methodological weaknesses making the drawn conclusions invalid. For the audience the EbM commentary may support their rating of the quality of the presented study. The congress team selects interesting presentations for the EbM commentary. The EbM commentators receive the oral presentation and in most cases additional information from the selected studies four weeks in advance of the meeting. The EbM commentary is focused on a precise analysis of the presented data in an open and pleasant discussion. The aim of the EbM commentary is to clearly point out the patient benefit and to disclose the biases and weaknesses. The best studies of the DKOU were awarded following the suggestion of the EbM jury. The experiences have shown some methodological improvement of the presentations. The pragmatic style of the EbM commentary has led to good acceptance at the Annual Meeting of the German Society of Orthopaedics and Traumatology.