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. 1997 Jan;76(1):50–53. doi: 10.1136/adc.76.1.50

Evidence-based surgery: interventions in a regional paediatric surgical unit

S Kenny 1, K Shankar 1, R Rintala 1, G Lamont 1, D Lloyd 1
PMCID: PMC1717052  PMID: 9059162

Abstract

Accepted 18 September 1996


OBJECTIVES—To determine the proportion of paediatric surgical interventions that are evidence-based and to identify areas where randomised controlled trials (RCTs) or further research are required.
DESIGN—Prospective review of paediatric general surgical inpatients.
SETTING—A regional paediatric surgical unit.
SUBJECTS—All consecutive paediatric general surgical patients admitted in November, 1995.
MAIN OUTCOME MEASURES—Each patient on whom a diagnosis had been made was allocated a primary diagnosis and primary intervention (n=281). On the basis of expert knowledge, Plusnet Medline, and ISI Science Citation database searches, each intervention was categorised according to the level of supporting evidence: category 1, intervention based on RCT evidence; category 2, intervention with convincing non-experimental evidence such that an RCT would be unethical and unjustified; category 3, intervention without substantial supportive evidence.
RESULTS—Of 281 patient interventions, 31 (11%) were based on controlled trials and 185 (66%) on convincing non-experimental evidence. Only 23% of interventions were category 3.
CONCLUSIONS—In common with other medical specialties, the majority of paediatric surgical interventions are based on sound evidence. However, only 11% of interventions are based on RCT data, perhaps reflecting the nature of surgical practice. Further RCTs or research is indicated in a proportion of category 3interventions.



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Selected References

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