Applying evidence-based surgery in daily clinical routine: a feasibility study.

Area of Science:

• Orthopaedic Surgery
• Medical Informatics

Background:

• Evidence-based medicine (EBM) is increasingly popular, yet its practical application in clinical settings requires further evaluation.
• Limited studies have assessed the feasibility and impact of EBM in real-world clinical practice.

Purpose of the Study:

• To prospectively evaluate the feasibility of implementing evidence-based trauma surgery in orthopaedic practice.
• To determine the rate of available relevant evidence and the time required for its retrieval and appraisal.

Main Methods:

• Orthopaedic trauma surgeons generated clinical questions regarding patient treatment.
• An informaticist systematically searched medical literature, including Medline, Cochrane Library, guidelines, and textbooks.
• Key endpoints included the availability of evidence (level >V) and the time spent on searching and critical appraisal.

Main Results:

• Forty-four EBM questions were formulated, primarily concerning treatment options.
• Relevant evidence was found for 68% of questions, utilizing various sources like journal articles and textbooks.
• Answering each question took an average of 53 minutes, including database searches and full-text retrieval.

Conclusions:

• Time commitment is a significant barrier to the widespread adoption of clinical EBM.
• Clinicians may limit EBM use to situations where evidence is readily accessible.
• Despite limited immediate impact on patient care, the EBM concept was successfully implemented in this study.