History of Evidence-Based Surgery (EBS)

Before the introduction of Evidence-Based Surgery (EBS) and its predecessor, Evidence-Based Medicine (EBM), the art and knowledge of surgery was passed from teacher to student. A paradigm shift occurred in the 1980s and 90s when the “experiential” nature of the development of surgery in a hierarchical environment was supplanted by evidentiary rules. The EBS Movement, following the footsteps of EBM, was introduced to ensure that patients were, in fact, treated with the best available treatment, based on evidence. In this chapter, readers are introduced to a brief history of the paradigm shift of valuing evidence over authority. They will also learn about the five pillars of decision-making in practising EBS. The importance of research and EBS is highlighted in this chapter by outlining surgical training programs that have introduced EBM and EBS in their educational curricula. Finally, we highlight research guidelines and initiatives such as OMERACT, GRADE, Cochrane Collaboration, COSMIN, and EQUATOR that have been designed to improve the methodological quality and reporting of clinical research.