Evidence-based neurosurgery.

Abstract

The evidence-based medicine movement is gaining influence in many medical specialties. Although many think that clinical medicine always has been based on evidence, the discipline of evidence-based medicine places particular emphasis on a defined set of principles of critical analysis of individual research reports, methodologically rigorous synthesis of multiple reports, and the collection and dissemination of evidence repositories that allow rapid application of evidence in practice. This article provides a selective introduction to the discipline of evidence-based medicine as it applies to neurological surgery. The vast literature on evidence-based medicine has been reviewed selectively to identify resources that are readable, accessible, and relevant to neurosurgery. The history, concepts, and techniques of evidence-based medicine are presented in brief, and educational and methodological resources, as well as evidence repositories, are introduced. The techniques of evidence-based medicine are relevant to neurological surgery. There is a relatively large repository of critically analyzed and summarized evidence that is useful to the neurosurgical practitioner. Familiarity with these techniques and repositories can help the neurosurgeon bring the best available evidence to bear on the care of individual patients.