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Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Evidence-based medicine in rapidly changing technologies

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Type V Collagen is Persistently Altered after Inguinal Hernia Repair

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. The Implementation Gap in Laparoscopic Simulation Training

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Micro-Lightguide Spectrophotometry (O2C) for Lower Limb Perfusion: Effects of Exercise Walking in Claudicants

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Endovascular aortic repair reduces gluteal oxygenation

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Assessment of EVAR Competence: Validity of a Novel Rating Scale (EVARATE) in a Simulated Setting

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Assessment of Competence in EVAR Procedures: A Novel Rating Scale Developed by the Delphi Technique

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Assessment of Competence in EVAR Stent Graft Sizing and Selection

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer
Evidence-based medicine (EBM) is not a randomised controlled trial (RCT), but EBM seeks to apply evidence gained from scientific methods - which could be RCT - to daily medical practice. Any surgical treatment reflects a certain development technically as well as skills based. The procedure may be modified and refined and the device may be developed and inherent technical weaknesses may need to be corrected. Therefore the best time to conduct a trial may be discussed. The appropriate time to initiate a RCT is when all the participating surgeons or therapists have gone through their learning curve. Special considerations should be given in rapidly developing fields. If started too early the resulting comparison will likely turn out to be irrelevant because the new technology is not fully developed, not mastered or the device may have undergone major modifications rendering the results obsolete. On the other hand, if started too late there is a chance that data may be lost because the technology has already been introduced into the daily clinics and physicians may be unwilling to recruit patients. Or the opposite, that the technique may have been rejected without a proper trial. In this situation it has been suggested to perform a so called tracker trial. In such trials protocols are more flexible without prefixed sample size and will require repeated interim analyses. Often, it will be relevant to supplement the clinical trials with data from large clinical databases - in particular when long term results are needed.
OriginalsprogEngelsk
TidsskriftScandinavian Journal of Surgery
Vol/bind97
Udgave nummer2
Sider (fra-til)100-4
Antal sider5
ISSN1457-4969
StatusUdgivet - 1 jan. 2008

ID: 32242396