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Evidence-based medicine
at the 16th IPRAS
congress in Vancouver, BC
Striving for high levels of evidence-based medicine
clinical trials is key to guide and support clinical decision
making 1 . As such, monthly journal clubs and self-directed
assignements have been shown, in a recent study from
London, Ontario, Canada 2 , to improve evidence-based
skills in Plastic Surgery residency training. Randomizedcontrolled
trials (RCTs) are believed to reflect the
gold-standard in plastic surgery 3 an beyond. However,
the conception, planning and execution, as well as the
reporting of RCT in plastic surgery is challenging 4 . As
such, Dr. Rohrich stated: “So you want to be an evidencebased
plastic surgeon? A lifelong journey” 5 .
Evidence-based medicine
in Plastic Surgery journal publications
Given the broad field of Plastic Surgery, with its
subdisciplines of reconstructive surgery, aesthetic surgery,
hand as well as burn surgery, a lack of randomizedcontrolled
trials (RCTs) is evident. As far as journal
publications in the four major plastic surgery journals
are concerned (Plastic Reconstructive Surgery, Annals
of Plastic Surgery, Journal of Plastic, Reconstructive
and Aesthetic Surgery, American Journal of Aesthetic
Surgery) a survery among all published clinical trials
in 2007 revealed that only 2.2% of those were Level I
evidence studies 6 (i.e. meta-analyses and randomized
controlled trials with narrow confidence intervals). The
average level of evidence was Level III, which are cohort
studies. Comparing the Level I evidence from 1978 to
2009 among various Plastic Surgery Journals, there was
a steady increase of such studies 7 , a fact supported by
two other studies 8,9 .
Evidence-based medicine
in plastic surgical conferences
As far as conference abstracts are concerned, the
reporting rate of randomized-controlled trials is generally
36 IPRAS Journal www.ipras.org Issue 5
low, often lower than 10%. As such, at the ASPS 2008
meeting, a total number of 9% of all conference 159
abstracts were randomized-controlled trials, with 5%
being presented as oral abstracts and 4% as poster
presentations 10 . As far as burn surgery is concerned,
the American Burn Association (ABA) meeting in
2008 included 252 abstracts with a total number of
7% being RCTs (5% oral presentations, 2% poster
presentations) 11 . In line, the 2008 annual meeting of t
he American Society for Surgery of the Hand (ASSH)
included 10% RCTs.
Evidence-based medicine
at the IPRAS 2011 congress
Prof. Dr. Karsten Knobloch, FACS
Plastic, Hand and Reconstructive Surgery
Hannover Medical School, Germany
The recent IPRAS 2011 meeting in Vancouver, BC
produced 697 published abstracts in the Canadian
Journal of Plastic Surgery 12 (figure 1). Five hundred and
Figure 1. 697 IPRAS abstracts published with 84% clinical trials,
8% experimental studies and others.