Using evidence-based medicine principles to improve quality of patient care in pediatric surgery

Evidence-based medicine (EBM) is defined strictly as "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients." A requirement for the successful implementation of EBM principles, with the goal of improving patient care, is knowledge related to the hierarchy of evidence and other concepts. The highest level of evidence is produced from prospective, hypothesis-testing research protocols, which currently are rare in the pediatric surgery literature. There are obstacles to conducting these studies in pediatric surgery because of the rarity of many disease conditions; however, with careful planning and funding, such studies can and should be performed.