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. 2018 Oct 12;7(2):e16.
doi: 10.2196/ijmr.9617.

Importance and Presence of High-Quality Evidence for Clinical Decisions in Neurosurgery: International Survey of Neurosurgeons

Jill Martens #  1 , Guido de Jong #  1 , Maroeska Rovers #  1 , Gert Westert #  1 , Ronald Bartels #  1
Affiliations

Importance and Presence of High-Quality Evidence for Clinical Decisions in Neurosurgery: International Survey of Neurosurgeons

Jill Martens et al. Interact J Med Res. .

Abstract

Background: The publication rate of neurosurgical guidelines has increased tremendously over the past decade; however, only a small proportion of clinical decisions appear to be based on high-quality evidence.

Objective: The aim was to evaluate the evidence available within neurosurgery and its value within clinical practice according to neurosurgeons.

Methods: A Web-based survey was sent to 2552 neurosurgeons, who were members of the European Association of Neurosurgical Societies.

Results: The response rate to the survey was 6.78% (173/2552). According to 48.6% (84/173) of the respondents, neurosurgery clinical practices are based on less evidence than other medical specialties and not enough high-quality evidence is available; however, 84.4% (146/173) of the respondents believed neurosurgery is amenable to evidence. Of the respondents, 59.0% (102/173) considered the neurosurgical guidelines in their hospital to be based on high-quality evidence, most of whom considered their own treatments to be based on high-quality (level I and/or level II) data (84.3%, 86/102; significantly more than for the neurosurgeons who did not consider the hospital guidelines to be based on high-quality evidence: 55%, 12/22; P<.001). Also, more neurosurgeons with formal training believed they could understand, criticize, and interpret statistical outcomes presented in journals than those without formal training (93%, 56/60 and 68%, 57/84 respectively; P<.001).

Conclusions: According to the respondents, neurosurgery is based on high-quality evidence less often than other medical specialties. The results of the survey indicate that formal training in evidence-based medicine would enable neurosurgeons to better understand, criticize, and interpret statistical outcomes presented in journals.

Keywords: evidence-based medicine; levels of evidence; neurosurgery.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Levels of evidence used by neurosurgeons in clinical practice. The results are presented on a five-item Likert scale: (1) strongly agree, (2) agree, (3) indifferent, (4) disagree, or (5) strongly disagree.
See this image and copyright information in PMC

References

    1. Haines S, Walters B. Evidence-Based Neurosurgery: An Introduction. New York: Thieme Medical Publishers; 2006.
    1. Rycroft-Malone J, Seers K, Titchen A, Harvey G, Kitson A, McCormack B. What counts as evidence in evidence-based practice? J Adv Nurs. 2004 Jul;47(1):81–90. doi: 10.1111/j.1365-2648.2004.03068.x.JAN3068 - DOI - PubMed
    1. Carnwell R. Essential differences between research and evidence-based practice. Nurse Researcher. 2001 Jan;8(2):55–68. doi: 10.7748/nr2001.01.8.2.55.c6150. - DOI
    1. Goodman Kw. Ethics and Evidence-Based Medicine: Fallibility and Responsibility in Clinical Science. Cambridge: Cambridge University Press; 2002.
    1. Yarascavitch BA, Chuback JE, Almenawer SA, Reddy K, Bhandari M. Levels of evidence in the neurosurgical literature: more tribulations than trials. Neurosurgery. 2012 Dec;71(6):1131–1137. doi: 10.1227/NEU.0b013e318271bc99. - DOI - PubMed