BackgroundThe publication rate of neurosurgical guidelines has increased tremendously over the past decade; however, only a small proportion of clinical decisions appear to be based on high-quality evidence.ObjectiveThe aim was to evaluate the evidence available within neurosurgery and its value within clinical practice according to neurosurgeons.MethodsA Web-based survey was sent to 2552 neurosurgeons, who were members of the European Association of Neurosurgical Societies.ResultsThe response rate to the survey was 6.78% (173/2552). According to 48.6% (84/173) of the respondents, neurosurgery clinical practices are based on less evidence than other medical specialties and not enough high-quality evidence is available; however, 84.4% (146/173) of the respondents believed neurosurgery is amenable to evidence. Of the respondents, 59.0% (102/173) considered the neurosurgical guidelines in their hospital to be based on high-quality evidence, most of whom considered their own treatments to be based on high-quality (level I and/or level II) data (84.3%, 86/102; significantly more than for the neurosurgeons who did not consider the hospital guidelines to be based on high-quality evidence: 55%, 12/22; P<.001). Also, more neurosurgeons with formal training believed they could understand, criticize, and interpret statistical outcomes presented in journals than those without formal training (93%, 56/60 and 68%, 57/84 respectively; P<.001).ConclusionsAccording to the respondents, neurosurgery is based on high-quality evidence less often than other medical specialties. The results of the survey indicate that formal training in evidence-based medicine would enable neurosurgeons to better understand, criticize, and interpret statistical outcomes presented in journals.

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BACKGROUND:The publication rate of neurosurgical guidelines has increased tremendously over the past decade. However, only a small proportion of clinical decisions appears to be based on highquality evidence. OBJECTIVE: To evaluate the available evidence within neurosurgery and its value within clinical practice according to neurosurgeons. METHODS: A web-based survey was sent to 2552 neurosurgeons, who were members of the European Association of Neurosurgical Societies. RESULTS:The response rate to the survey was 7% (173 respondents). According to 49% of the respondents, neurosurgery is based on less evidence compared with other medical specialties, and not enough high-quality evidence is available on which to base clinical practice. However, 84% of the respondents believed neurosurgery is amenable to evidence. Of the respondents, 59% considered the neurosurgical guidelines in their hospital to be based on high-quality evidence. Responders that did consider the neurosurgical guidelines in their hospital to be based on high-quality evidence did consider their own treatments more often as based on Level I and/or Level II (84% resp. 55%) (P < . 001). Also, neurosurgeons with formal training believed they could understand, criticize and interpret statistical outcomes presented in journals better than those without formal training (93% resp. 68%) (P < .001). CONCLUSION: According to the respondents, neurosurgery is based less often on high-quality evidence than other medical specialties. When looking at the results of the survey, formal training in EBM is desirable, so neurosurgeons can better understand, criticize and interpret statistical outcomes presented in journals.

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