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Oct 2012

Equipoise, Ethics, and the Necessity of Randomized Trials in Surgery

Author Affiliations

Author Affiliations: Division of Pediatric Surgery, Duke University Medical Center, Durham, North Carolina (Dr Adibe); and Department of Surgery, Children's Mercy Hospitals and Clinics, Kansas City, Missouri (Dr St Peter).

Arch Surg. 2012;147(10):899-900. doi:10.1001/archsurg.2012.1796

Evidence-based medicine is defined as the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients.1 Stated another way, it means treating patients based on application of evidence rather than the surgeon's thoughts or beliefs. However, prior to application of evidence toward the goal of optimal patient care, the evidence must exist. The treating physicians are therefore responsible for conducting the research that will allow for evidence on which better care may be based. Patient care will otherwise be limited by the lack of comparative data. This is especially true in the field of surgery, where:

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