1. Evidential Strength of Research in the Field of Surgery: Will We Meet the IOM Goals? Geneva Wahl BS, Avishkar Sharma BA, Thejus T. Jayakrishnan MBBS, Timothy M. Pawlik MD MPH PhD FACS, Steven Goodman MD MHS PhD, T. Clark Gamblin MD MS, Kiran K. Turaga MD MPH

2. Disclosure We have no relevant financial disclosures

3. Evidence Based Medicine Definition: The use of current best evidence in making decisions about the care of individual patients – Provides a standardized form of care – Integrates the best research evidence with clinical expertise

4. 2007 IOM Conference Goal : All clinical decisions will be supported by research reflecting the best available evidence by 2020

5. CEBM Levels of Evidence I II III IV

6. Objectives 1.Describe the evidential strength of published literature in the field of surgery in 2011 2.Understand the differences in the evidence published with regards to – Reporting – Precision – Accuracy

7. Methodology Identify top 5 clinical journals in Surgery from 2011Extract all clinical articles from each journalRandomly select 200 articles for data abstraction

8. Methodology Primary outcome measure – Level of Evidence Covariates – Confidence intervals – P-value – Number of patients – Abstract quality – Study design – Concordance of the reported and the author assessed study design – Number of citations of the article

9. Selected Clinical Journals

12. Quality of Abstract Quality VariableN=200 (%) Structured Abstract192 (96%) Specify Study Design71 (35.5%) Concordance183 (91.5%) CI Reported49 (24.5%) P-value Reported126 (63%)

13. Funding N = 200 (%) Funded66 (33%) Not Funded13 (6.5%) Not Reported121 (60.5%)

14. Results Level 1 evidence articles: – List p-value within the abstract (88% vs. 57%, P =.001) – Specify study design (94% vs. 19%, P =.001) – Higher number of citations (18 vs. 14, P =.001)

15. Conclusions Majority of published surgical literature provides low level of evidence While reporting standards have led to increase in structured abstracts, reporting of measures of precision and accuracy remains low

16. Acknowledgements Mentors Kiran K. Turaga MD MPH T. Clark Gamblin MD MS Fabian Johnston MD MHS Research Fellows Thejus Jayakrishnan MBBS John Miura MD Funding Lundman Foundation

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