Clinical Research and Evidence-Based Pediatric Surgery

Abstract

Evidence-based medicine (EBM) is the process of acquiring the best available research evidence and applying this evidence to inform the best practice in a defined problem in clinical practice. The widespread popularization of the concept of EBM since its first introduction more than three decades ago has resulted in a paradigm shift in biomedicine from a largely experience- and opinion-based practice toward one based increasingly on objective scientific evidence. Properly designed and implemented clinical research represents the best way to provide high-quality scientific evidence for informing the practice of EBM. Among different study designs, prospective randomized controlled trial (RCT) is regarded as the gold standard of clinical research and gives the highest level of evidence (Class I evidence). For specialties that are progressing faster in the practice of EBM, the rapid accumulation of research finding also highlights the importance of critical appraisal skill for assessing the quality of available evidence. In many surgical settings including pediatric surgery, however, important barriers that may hinder the proper design and implementation of RCTs are still common. A better understanding of the concept of clinical research and EBM would thus serve to equip researchers in these settings to produce better scientific evidence and for practitioners to incorporate the best available evidence into their clinical practice.