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DOI: 10.1055/s-0030-1263129
© Georg Thieme Verlag KG Stuttgart · New York
Evidenz-basierte Medizin – Prinzipien und Bedeutung für die Plastische Chirurgie
Evidence-Based Medicine – Principles and Impact on Plastic SurgeryPublikationsverlauf
eingereicht 15.5.2010
akzeptiert 22.7.2010
Publikationsdatum:
02. September 2010 (online)

Zusammenfassung
Die zunehmende Bedeutung der Evidenz-basierten Medizin (EbM) hat als eine Ursache die immer lauter werdende Forderung nach rationalen Begründungen für das ärztliche Handeln. Es ist erkannt worden, dass lediglich 15–40 % medizinischer Entscheidungen eine solide wissenschaftliche Basis haben. Umso mehr ist dies von Bedeutung, da in Zeiten knapper finanzieller Ressourcen das Vergütungsverhalten für erbrachte ärztliche Leistungen immer mehr davon abhängen wird, wie „Evidenz-basiert” die jeweils durchgeführte Behandlung ist. Die Anwendung von EBM in der plastisch-chirurgischen Praxis ist keine Option mehr. Die Forderung nach Anwendung der besten Evidenz auf die jeweilige klinische Situation setzt jedoch ein Grundverständnis über die existierende Hierarchie hinsichtlich der Qualität von Studien voraus. In dem vorliegenden Beitrag werden Prinzipien der EBM vorgestellt, sowie die Bedeutung von randomisiert kontrollierten Studien und systematischen Übersichtsarbeiten für die plastische Chirurgie diskutiert. Die Qualität plastisch-chirurgischer Publikationen wird anhand von Ergebnissen systematischer Analysen vorgestellt. Zusammenfassend lässt sich festhalten, dass die plastische Chirurgie die Zeichen der Zeit erkannt hat und zunehmend bestrebt ist, klinische Forschung mit höherem Evidenzlevel durchzuführen. Eine Verbesserung der Qualität der Berichterstattung von Studienergebnissen ist in diesem Rahmen jedoch unabdingbar.
Abstract
The increasing importance of evidence-based medicine (EBM) is the result of an increasing demand for a rational decision-making process in healthcare. It has been demonstrated that 15–40% of decisions made in healthcare do not have a solid scientific basis. This is particularly problematic in times of limited financial resources, when reimbursement increasingly depends on how “evidence-based” a particular treatment is. Application of EBM principles in plastic surgery is therefore no longer an option. This, however, requires a basic understanding of the existing levels of evidence. In the present article, principles of EBM will be presented. The importance of randomized controlled trials and systematic reviews for plastic surgery will be highlighted along with a discussion of the quality of the plastic surgical literature based on results of recent systematic analyses. The plastic surgical community has appreciated the need for higher quality clinical studies. Improvement of the quality of reporting is, however, critical.
Schlüsselwörter
plastische Chirurgie - Evidenz-basierte Medizin - randomisiert kontrollierte Studien - systematische Übersichtsarbeiten
Key words
plastic surgery - evidence-based medicine - randomised controlled trials - systematic reviews
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Korrespondenzadresse
Dr. med. Arash Momeni
Stanford University Medical
Center
Division of Plastic and
Reconstructive Surgery
770 Welch Road, Suite 400
Palo Alto, CA 94304-5714
USA
eMail: amomeni@stanford.edu