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Chapter 11 - Evidence-Based Neurosurgery: Principles, Applicability, and Challenges

from Part II - Neurosurgery-Specific Bioethics

Published online by Cambridge University Press:  29 May 2020

By
Ignatius Esene
Edited by
Stephen Honeybul
Stephen Honeybul
Affiliation:
Sir Charles Gairdner Hospital, Royal Perth and Fiona Stanley Hospitals
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Summary

Evidence-based neurosurgery (EBN) is a paradigm of practicing neurosurgery which integrates the current best research evidence; surgical expertise, experience, and judgement; patient values, expectations, and preferences; and clinical circumstances to provide a framework for optimal patient care. Sources of evidence range from expert opinions via randomized control trials to systematic reviews and meta-analyses. The evidence is usually categorized and ranked into ‘level or class of evidence’, evaluated for quality and graded into ‘strength of recommendation’.The process of EBN involves several steps that include using experience to identify knowledge gaps and information needs, formulating answerable questions, identifying potentially relevant research, assessing the validity of evidence and results, developing clinical policies that align research evidence and clinical circumstances, and applying research evidence to individual patients with their specific expectations and values. Evidence-based neurosurgical practice is the use of current best evidence in helping individual patients make decisions about their care in the light of their personal values and beliefs.Evidence-based neurosurgery is a tool of considerable value for neurosurgical practice, albeit not without limitations and challenges. Neurosurgeons should cultivate sound evidence-based practice for effective and safe neurosurgical practice.

Keywords

evidence-based medicineethicsneurosurgery
Type
Chapter
Information
Ethics in Neurosurgical Practice , pp. 101 - 111
Publisher: Cambridge University Press
Print publication year: 2020

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