Abstract
Evidence-based medicine is defined as delivery of care supported by clinical studies reflecting the highest level of evidence available. Surgeon experience and preference of the patient also must enter into clinical decision making. 1 Sackett D.L. Rosenberg W.M. Gray J.A. et al. Evidence based medicine: What it is and what it isn’t. BMJ. 1996; 312: 71 Crossref PubMed Google Scholar , 2 Montori V.M. Guyatt G.H. Progress in evidence-based medicine. JAMA. 2008; 300: 1814 Crossref PubMed Scopus (203) Google Scholar , 3 Urschel J.D. Goldsmith G.H. Tandan V.R. et al. Users’ guide to evidence-based surgery: How to use an article evaluating surgical interventions. Evidence-Based Surgery Working Group. Can J Surg. 2001; 44: 95 PubMed Google Scholar , 4 Evidence-Based Medicine Working Group Evidence-based medicine. A new approach to teaching the practice of medicine. JAMA. 1992; 268: 2420 Crossref PubMed Scopus (3479) Google Scholar The principal goal is to use all available source data to provide the best possible patient care. Levels of evidence are ranked with the randomized controlled trial (RCT) and meta-analyses of high-quality RCT studies at the pinnacle. Cohort or case-control studies, case series, case reports, expert opinion, and animal (preclinical) studies, in descending order, constitute the remainder of the hierarchy (Centre for Evidence-based Medicine; http://www.cebm.net; Fig 1).
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