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Evidence-based surgery: interventions in a regional paediatric surgical unit
S E Kenny1, K R Shankar, R Rintala
1Department of Paediatric Surgery, Alder Hey Children's Hospital, Liverpool.
Archives of Disease in Childhood
|January 1, 1997
Summary
Most paediatric surgical procedures have evidence backing them, but only 11% use randomized controlled trials (RCTs). Further research is needed for some interventions lacking substantial evidence.
Area of Science:
- Pediatric Surgery
- Evidence-Based Medicine
Background:
- Assessing the evidence base for pediatric surgical interventions is crucial for improving patient outcomes.
- Understanding the proportion of procedures supported by robust scientific evidence guides future research priorities.
Purpose of the Study:
- To quantify the evidence-based proportion of pediatric surgical interventions.
- To identify areas within pediatric surgery requiring further research, particularly randomized controlled trials (RCTs).
Main Methods:
- A prospective review of 281 consecutive pediatric general surgical inpatients was conducted.
- Interventions were categorized based on the level of supporting evidence: RCTs, convincing non-experimental evidence, or lacking substantial evidence.
Main Results:
- 11% of pediatric surgical interventions were supported by randomized controlled trial (RCT) evidence.
- 66% of interventions had convincing non-experimental evidence, while 23% lacked substantial supportive evidence.
Conclusions:
- The majority of pediatric surgical interventions are supported by sound evidence, aligning with other medical fields.
- The low proportion of RCT-based interventions highlights the unique challenges in surgical research.
- Further research, including RCTs, is recommended for interventions categorized as lacking substantial evidence.