Treatment of Surgical Patients is Evidence-based

Kingston, Ross; Barry, Mary; Tierney, Sean; Drumm, John; Grace, Pierce A.

doi:10.1080/110241501750215168

Cited by 23 publications

(3 citation statements)

References 56 publications

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“…As a result, hand surgeons must support surgical decision-making with the best available evidence. Although much has been written about the established difficulty of influencing surgical practice with best-practice guidelines (42, 43), our analysis reveals the widespread adoption of in-situ release for treatment of cubital tunnel syndrome in Florida and these numbers are increasing. As with most procedures, however, patient demographics and surgeon-level factors influence procedure selection.…”

Section: Discussionmentioning

confidence: 98%

Surgical Treatment of Cubital Tunnel Syndrome: Trends and the Influence of Patient and Surgeon Characteristics

Adkinson

Zhong

Aliu

et al. 2015

The Journal of Hand Surgery

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Purpose Cubital tunnel syndrome is the second most common compression neuropathy in the upper extremity. A variety of procedures are used for treatment of cubital tunnel syndrome. There is a lack of consensus regarding the most appropriate procedure owing to similar rates of operative success and strong proponents for each technique. Our aim was to examine trends in and determinants of the use of different procedures for treatment of cubital tunnel syndrome. Methods We performed a retrospective cross-sectional analysis of the Healthcare Cost and Utilization Project Florida State Ambulatory Surgery Database for 2005 to 2012. We selected all patients who underwent in-situ decompression, transposition, or other surgical treatments for cubital tunnel syndrome. We tested trends in the use of these techniques and performed a multivariable analysis to examine associations between patient characteristics and surgeon case volume and the use of different techniques. Results Of the 26,164 patients who underwent surgery for cubital tunnel syndrome, 79.7% underwent in-situ decompression, 16.2% underwent transposition, and 4.1% underwent other surgical treatment. Over the study period, there was a statistically significant increase in the use of in-situ release and a decrease in the use of transposition. Females and patients treated by surgeons with a higher cubital tunnel surgery case volume underwent in-situ release at a statistically higher rate than other techniques. Conclusions In Florida, surgeon practice reflects the widespread adoption of in-situ release as the primary treatment for cubital tunnel syndrome and these numbers are increasing. Patient demographics and surgeon-level factors influence procedure selection. Level of Evidence III, Therapeutic

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Section: Discussionmentioning

confidence: 98%

Surgical Treatment of Cubital Tunnel Syndrome: Trends and the Influence of Patient and Surgeon Characteristics

Adkinson

Zhong

Aliu

et al. 2015

The Journal of Hand Surgery

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“…Thus, only a minority of surgical practice is based on high-quality evidence [3,4,5]. In this study, we discussed some of the frequent problems in clinical research, especially focusing on difficulties in surgical trials.…”

Section: Discussionmentioning

confidence: 99%

“…In the era of evidence-based medicine, clinical decision-making should be based on the best available evidence arising from clinical trials, systematic reviews and meta-analyses [2]. However, a major part of surgical interventions is still lacking assessment in high-quality trials [3,4,5]. Even though the number and quality of surgical RCTs has been rising in the last decades, there are some difficulties to overcome, which are especially present in the evaluation of surgical interventions.…”

Section: Introductionmentioning

confidence: 99%

Study Methods in Evidence-Based Surgery: Methodological Impediments and Suggested Approaches for the Creation and Transfer of Knowledge in Surgery

et al. 2014

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Background: Since its introduction more than 20 years ago, evidence-based medicine has become an important principle in the daily routine of clinicians around the globe. Nevertheless, many surgical interventions are still not based on high-quality evidence from clinical trials. This is partially due to the fact that surgical trials pose some specific obstacles, which have to be overcome during the planning and conduct of such a trial. Objective: In this study, we will highlight specific challenges and discuss explicit obstacles of surgical clinical research. Moreover, potential solutions will be substantiated by the experience of the Study Centre of the German Surgical Society (SDGC) in surgical clinical research. Conclusions: Surgical researchers should be equipped with a basic knowledge of research methodology to be able to overcome the common impediments posed by surgical trials. Collaborations between surgeons and methodologists as well as trial networks have proven to be useful in accomplishing high-quality surgical research in various randomized controlled trials. By maintaining and refining this work and with sufficient and prompt translation of investigational knowledge into daily practice, the treatment of surgical patients should result in an improved outcome in the future.

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Barriers to Evidence Synthesis

Ahmed

Sevdalis²,

Darzi³

et al. 2011

Evidence Synthesis in Healthcare

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Treatment of Surgical Patients is Evidence-based

Abstract: Everyday surgical practice in our unit is supported by good quality evidence from recent publications.

Cited by 23 publications

References 56 publications

Surgical Treatment of Cubital Tunnel Syndrome: Trends and the Influence of Patient and Surgeon Characteristics

Surgical Treatment of Cubital Tunnel Syndrome: Trends and the Influence of Patient and Surgeon Characteristics

Study Methods in Evidence-Based Surgery: Methodological Impediments and Suggested Approaches for the Creation and Transfer of Knowledge in Surgery

Barriers to Evidence Synthesis

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