How to Practice Evidence-Based Medicine

Abstract

Evidence-based medicine (EBM) is defined as the conscientious, explicit and judicious use of current best evidence, combined with individual clinical expertise and patient preferences and values, in making decisions about the care of individual patients. In an effort to emphasize the importance of EBM in plastic surgery, ASPS and PRS have launched an initiative to improve the understanding of EBM concepts and provide tools for implementing EBM in practice. Through a series of special articles aimed at educating plastic surgeons, our hope is that readers will be compelled to learn more about EBM and incorporate its principles into their own practices. As the first of the series, this article provides a brief overview of the evolution, current application, and practice of EBM.

So You Want to Be an Evidence-Based Plastic Surgeon? A Lifelong Journey

“…The American Society of Plastic Surgeons' Level of Evidence Scale for Therapeutic Studies is shown in Table 1. 1 Currently, most articles in the plastic surgery literature are level 4 or 5. Articles with these levels of evidence are indeed valuable, but our intent is to raise the overall level of evidence in the plastic surgery literature over the next several years, to provide plastic surgeons with higher-quality data and truly change how we practice plastic surgery ( Table 2).…”

“…Five of the articles were "tutorial" articles, teaching what EBM is and how to practice it. 1,[3][4][5][6] The other five articles were directed toward a clinical question, showing how EBM can be applied to practical questions we all face as plastic surgeons. [7][8][9][10][11] Afternoon meetings involved break-out sessions on eight topics:…”

Taking Evidence-Based Plastic Surgery to the Next Level

“…can only be definitively obtained through large, prospective clinical trials. 21,23,28 By having organizations prioritize key research goals, academicians can be directed toward these kinds of important questions, and funding sources can be targeted. After extensive discussion, the Evidence-Based Plastic Surgery Summit II participants developed a list of such research priorities (Table 2).…”

Cirugía basada en la evidencia. Una herramienta necesaria

“…Otro ejemplo es el riesgo de tratar de imponer ciegamente una guía de práctica clínica sin el juicio del cirujano, que es como imponer una receta de cocina independientemente de la disponibilidad de los ingredientes y del gusto del comensal, lo que merma la autonomía del cirujano y la individualidad del paciente. La evidencia sola no puede contestar preguntas clínicas acerca de pacientes en específico: se requiere del juicio y la experiencia del cirujano 22,23 . Pero un cirujano sin la actualización y el armazón que brinda la cirugía basada en la evidencia es también como un ciego guiando a otro ciego.…”