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Opinion Pieces in Surgery

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Evidence-Based Surgery

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Abstract

David Sackett, the father of evidence-based medicine once said, “Good doctors use both individual clinical expertise and the best available external evidence, and neither alone is enough”. This quote represents the delicate balance of evidence and opinion in the practice of evidence-based medicine (EBM) and evidence-based surgery (EBS). Doctors and surgeons alike are constantly dealing with an ever-changing environment, as well as individual patients who require individualized care. Therefore, while evidence from high-quality clinical trials should be considered, some evidence may not be applicable for an individual patient or situation. It is times like these, where a surgeon may need to seek out an expert opinion, either in person or within the literature. Currently, expert opinion is at the bottom of the hierarchy of evidence, yet it remains to be an integral part of the practice of EBS. Due to the importance of expert opinion in the practice of EBS, surgeons and surgeon-researchers need to understand what makes a reliable and trustworthy source. This chapter will outline, for the reader, the value and limitations of expert opinion, where expert opinion fits into surgery, and if it applies to the readers’ practice. Lastly, the reader will be given a set of questions that can be used to appraise the article, and the author of that article to ensure that the opinions stated can be trusted.

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Author information

Authors and Affiliations

  1. Division of Orthopaedics, Dartmouth-Hitchcock, Lebanon, NH, USA

    M. Torchia, D. Austin & I. L. Gitajn

Authors
  1. M. Torchia
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  2. D. Austin
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  3. I. L. Gitajn
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Corresponding author

Correspondence to I. L. Gitajn .

Editor information

Editors and Affiliations

  1. Department of Surgery, Division of Plastic Surgery, Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, Hamilton, ON, Canada

    Achilles Thoma

  2. Department of Surgery, Division of Orthopaedic Surgery, Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, Hamilton, ON, Canada

    Sheila Sprague

  3. Department of Surgery, Division of Plastic Surgery, McMaster University, Hamilton, ON, Canada

    Sophocles H. Voineskos

  4. Department of Health Research Methods, Evidence and Impact (HEI), McMaster University, Hamilton, ON, Canada

    Charles H. Goldsmith

Appendix 1: Articles Identified in Literature Search

Appendix 1: Articles Identified in Literature Search

  1. 1.

    LaMartina J 2nd, Christmas KN, Simon P, Streit JJ, Allert JW, Clark J, et al. Difficulty in decision making in the treatment of displaced proximal humerus fractures: the effect of uncertainty on surgical outcomes. J Shoulder Elbow Surg. 2018;27(3):470–77.

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    Bhat SB, Secrist ES, Austin LS, Getz CL, Krieg JC, Mehta S, et al. Displaced proximal humerus fractures in older patients: shoulder surgeons versus traumatologists. Orthopedics. 2016;39(3):e509–13.

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    Li Y, Zhao L, Zhu L, Li J, Chen A. Internal fixation versus nonoperative treatment for displaced 3-part or 4-part proximal humeral fractures in elderly patients: a meta-analysis of randomized controlled trails. PLoS One. 2013;8(9):e75464.

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Torchia, M., Austin, D., Gitajn, I.L. (2019). Opinion Pieces in Surgery. In: Thoma, A., Sprague, S., Voineskos, S., Goldsmith, C. (eds) Evidence-Based Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-05120-4_26

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  • DOI: https://doi.org/10.1007/978-3-030-05120-4_26

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-030-05120-4

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