The current state of evidence-based pediatric surgery

Area of Science:

• Surgical Research
• Evidence-Based Medicine
• Pediatric Surgery

Background:

• Healthcare efficiency is under scrutiny, emphasizing the need for evidence-based medicine.
• Prospective trials are crucial for generating the best evidence.
• This study evaluates evidence-based practice in pediatric surgery over the past decade.

Purpose of the Study:

• To assess the current state of evidence-based practice in pediatric surgery.
• To identify trends in randomized controlled trials (RCTs) within pediatric general surgery.
• To review challenges hindering evidence-based surgical practices.

Main Methods:

• Literature search of English-language randomized controlled trials (RCTs) from January 1999 to December 2009.
• Included studies focused on pediatric general surgery, excluding transplant, oncology, and other subspecialties.
• PubMed database was utilized for the literature search.

Main Results:

• 56 manuscripts were identified, with 51 employing appropriate randomization.
• Only 34% of studies had a definitive trial design and sample size calculation.
• Randomized controlled trials constituted less than 0.05% of all pediatric surgery publications.
• Appendicitis and pyloric stenosis were the most frequently studied conditions.
• The United States, United Kingdom, and Turkey were leading countries in trial origin.

Conclusions:

• Evidence-based surgery in pediatric surgery has shown limited growth in the first decade of the 21st century.
• Randomized controlled trials remain a small fraction of pediatric surgery publications.
• Hurdles to implementing evidence-based surgery were identified and discussed.