Clinical application of evidence-based surgery: the role of audits in surgical practice

Deposited with permission of the author. © 2008 Dr. David Ting-Wei ChiangEvidence-Based Medicine (EBM) is the integration of clinical practice with research evidence. The development aims to respond to the limitations of traditional expert recommendations as a guide to clinical practice. It has become a paradigm shift in the way clinicians learn and practice medicine [1-3]. Audit has been recognized as a form of EBM. Although the basic form has been practiced by some great surgeons since last century, often surgical practice has been based on ‘the tradition‘. The universal acceptance and practice of audits in surgery is only recent [4-6]. The aim of the project was to conduct audits for current surgical practice, and observe whether the evidence influence its practice. To achieve the aim, the thesis consisted of six studies, which were designed to investigate three aspects of surgical practice, including quality care assurance, cost-effectiveness of healthcare resources in surgical practice, and validation of a new surgical technique