Perceptions and Competence in Evidence-Based Medicine: Are Surgeons Getting Better?

Poolman, Rudolf W.; Sierevelt, Inger N.; Farrokhyar, Forough; Mazel, J. Adriaan; Blankevoort, Leendert; Bhandari, Mohit
January 2007
Journal of Bone & Joint Surgery, American Volume;Jan2007, Vol. 89-A Issue 1, p206
Academic Journal
Background: The Journal of Bone and Joint Surgery, American Volume (The Journal) recently initiated a section called "Evidence-Based Orthopaedics." Furthermore, a level-of-evidence rating is now used in The Journal to help readers in clinical decision-making. Little is known about whether this recent emphasis has influenced surgeons' perceptions about and competence in evidence-based medicine. Therefore, we examined perceptions and competence in evidence-based medicine among Dutch orthopaedic surgeons. Methods: Members of the Dutch Orthopaedic Association were surveyed to examine their attitudes toward evidence- based medicine and their competence in evidence-based medicine. We evaluated competences using a newly developed instrument tailored to surgical practice. Results: Of the 611 members, 367 surgeons (60%) responded. Orthopaedic surgeons welcomed evidence-based medicine. Practical evidence-based medicine resources were perceived as the best method to move from opinion- based or experience-based to evidence-based practice. Four variables were significantly and positively associated with the competence instrument: (1) a younger age, particularly between thirty-six and forty-five years (p = 0.007), (2) experience of less than ten years (p = 0.032), (3) having a PhD degree (p < 0.001), and (4) working in an academic or teaching setting (p = 0.004). The majority of the respondents were aware of The Journal's evidence-based medicine section (84%) and level-of-evidence ratings (65%), and 20% used The Journal's evidence-based medicine abstracts in clinical decision-making. This increased awareness of evidence-based medicine was also reflected in the frequent use of Cochrane reviews in clinical decision-making (27% of the respondents). Surgeons who used and those who were aware of but did not use The Journal's evidence-based medicine abstracts or Cochrane reviews in clinical decision-making had significantly higher competence instrument scores than those who were unaware of these resources (p = 0.03 and p < 0.001, respectively). Conclusions: Evidence-based medicine is welcomed by Dutch orthopaedic surgeons. The recent emphasis on evidence-based medicine is reflected in an increased awareness about The Journal's evidence-based medicine section, levels of evidence, and the largest evidence-based medicine resource: the Cochrane reviews. Younger orthopaedic surgeons had better knowledge about evidence-based medicine. The development and use of evidence-based resources as well as preappraised summaries such as The Journal's evidence-based medicine abstracts and Cochrane reviews were perceived as the best way to move from opinion-based to evidence-based orthopaedic practice.


Related Articles

  • Evidence-based surgical practice in academic medical centers: consistently anecdotal? Melis, Marcovalerio; Karl, Richard C.; Wong, Sandra L.; Brennan, Murray F.; Matthews, Jeffrey B.; Roggin, Kevin K. // Journal of Gastrointestinal Surgery;May2010, Vol. 14 Issue 5, p904 

    Introduction: Randomized trials, meta-analyses, and guidelines form the basis of clinical decision making. We queried a small sample of surgeons at three academic medical centers to determine whether key elements of surgical practice were concordant with available...

  • Canadian Association of General Surgeons and American College of Surgeons Evidence Based Reviews in Surgery. 18. Kirkpatrick, Andrew W.; van Wijngaarden Stephens, Mary; Fabian, Tim // Canadian Journal of Surgery;Oct2006, Vol. 49 Issue 5, p358 

    The article presents the evidence based reviews in surgery by the Canadian Association of General Surgeons (CAGS). The term "evidence-based medicine" has been coined as the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual...

  • Ulusal Cerrahi Kongreleri'nde sunulan randomize kontrollü çalışma özetlerinin raporlama kalitesi: CONSORT kılavuzuna dayalı deÄŸerlendirme. Can, Mehmet Fatih; Öztaş, Muharrem; Yağcı, Gökhan; Öztürk, Erkan; Yıldız, Ramazan; Peker, Yusuf; Çetiner, Sadettin // Turkish Journal of Surgery / Ulusal Cerrahi Dergisi;2011, Vol. 27 Issue 2, p67 

    Purpose: Randomized controlled trial (ACT) is considered as the most reliable source of in formation in evidence-based medicine, provided that clear, transparent and detailed information are transferred to the reader. Sometimes, an abstract is the only accessible source of an RCT result. The aim...

  • Changing the orthopaedic culture to evidence-based medicine. Brox, W. Timothy // AAOS Now;Nov2010, Vol. 4 Issue 11, p43 

    The article discusses the use of evidence-based practice to orthopedic culture. It is suggested that orthopedic surgeons must engaged in changing culture of evidence-based medicine (EBM) to provide advanced quality health care for musculoskeletal disorders. It also presents suggestions in order...

  • Canadian Association of General Surgeons and American College of Surgeons Evidence-Based Reviews in Surgery. 25. Henteleff, Harry; Malthaner, Richard; Barnett, Carlton // Canadian Journal of Surgery;Aug2008, Vol. 51 Issue 4, p302 

    The article offers information on the program "Evidence-Based Reviews in Surgery (EBRS)," which is jointly sponsored by the Canadian Association of General Surgeons and the American College of Surgeons. It mentions that the objective of the program is to help practising surgeons improve their...

  • Introduction. Rutka, John // ENT: Ear, Nose & Throat Journal;Oct2006 Supplement 1, Vol. 85, p1 

    The article reflects on the role of evidence-based medicine (EBM) in using ototopical therapy in discharging ear. It argues that the application of EBM approach to ototopical therapy is not practical as treatment continually changes. It contends that the application of EBM is not sufficient in...

  • Evidence-based Medicine in Surgical Decision Making. Lacaine, François // World Journal of Surgery;May2005, Vol. 29 Issue 5, p588 

    There are now five classic steps for analysis of diagnostic and therapeutics medical decision-making policies: (1) formulate a clear clinical question based on a particular patient's problems; (2) search the literature for relevant clinical articles; (3) evaluate the evidence for its validity...

  • Transcatheter device versus surgical closure of ventricular septal defects: a clinical decision analysis.  // Cardiology in the Young;May2005 Supplement 2, Vol. 15 Issue S2, p16 

    The article presents a study related to device closure of ventricular septal defects (VSDs) which is gaining popularity versus surgical closure, despite the absence of randomized trials. Evidence-based medicine seeks to integrate the best research evidence with clinical expertise and patient...

  • Half full or half empty VATS? McCulloch, Peter // BMJ: British Medical Journal (International Edition);10/30/2004, Vol. 329 Issue 7473, p1012 

    Comments on several articles about video assisted thoracic surgery. Question about the effectiveness of evidence based medicine in changing clinical practice; Assertion that evidence never was and never will be the whole story in medical decision making.; How some physicians fear change despite...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics