Search PubMed⌕ Search
Home/Archive/PubMed

PubMed · 11228797

[Evidence-based surgery].

P A Wille-Jørgensen·P C Gøtzsche
View original source ↗Export metadata ↓

Abstract

The justification for performing surgery on patients most often rests on observational studies and rarely on correctly conducted randomised trials, which is the highest level of evidence. For methodological and ethical reasons, surgical trials can be problematic. However, the ethical problems are greater if trials are not performed, since it will then not be possible to find out which of the available interventions have no effect or are harmful. The problems can be overcome in many cases, and by intra- and international co-operation it would be possible to carry out many more trials, which would increase the level of evidence for surgery in daily practice. When randomised trials have not been performed, one is obliged to look for the evidence in prospective cohort studies, e.g. clinical databases, which, however, are more suitable for evaluating complications to surgery under routine circumstances than for evaluating useful effects.

Explore related subjects

Cohort StudiesDecision MakingEvidence-Based MedicineHumansProspective StudiesSurgical Procedures, OperativeEnglish AbstractJournal ArticleReview

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

P A Wille-Jørgensen, P C Gøtzsche. 2001-02-05. [Evidence-based surgery].. https://pubmed.ncbi.nlm.nih.gov/11228797/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2002

Validity of self-reporting of episodes of external genital warts.

To determine whether men are able to self-diagnose external genital warts (EGWs), we studied data from 1115 men with and without human immunodeficiency virus infection. Men were largely unable to accurately assess the presence of EGWs. Self-reporting of EGWs was not a sensitive tool; only 38% of men who had EGWs diagnosed by a trained examiner who used bright light and visual inspection also reported having them. When we controlled for other covariates in a multivariate model, men who had EGWs diagnosed by an examiner were 14 times less likely to show concordance between examiner findings and self-report than were men who did not have EGWs diagnosed by an examiner (odds ratio, 0.07; 95% confidence interval, 0.06-0.09). Self-diagnosis and self-assessment may not accurately reflect the presence of EGWs, and self-diagnosis should not be used in place of an examiner's findings for epidemiologic studies that seek to determine the cause of disease.

Cohort Studies↗
PubMed2002

Prospective study of hepatitis C viral infection as a risk factor for subsequent B-cell neoplasia.

Several case-control studies have found increased prevalence of hepatitis C virus (HCV) in patients with non-Hodgkin lymphoma (NHL) and other B-cell lymphoproliferative disorders. We examined whether HCV infection preceded the development of these neoplasms in a prospective cohort study of 48 420 individuals in northern California. Stored sera from 95 subjects with NHL (n = 57), multiple myeloma (n = 24), or Hodgkin disease (n = 14) diagnosed a mean of 21 years after phlebotomy were screened for antibodies to HCV as well as viral RNA, based on previous reports of antibody-negative viremia. Sera from 4 cases and one of 95 age-, sex-, and race-matched controls were repeatedly reactive by enzyme immunoassay, but none were confirmed by recombinant immunoblot assay; none of the case sera had HCV RNA by reverse transcription- polymerase chain reaction. Although acquisition in later life cannot be ruled out, these prospective data do not support a substantial role of chronic HCV infection in the etiology of B-cell neoplasia.

Cohort Studies↗