Löfgren J, Nordin P, Ibingria C, et al. A randomized trial of low cost mesh in groin hernia repair. N Engl J Med 2016;374(2):146-153
Methodological Reviewer: Andy Kirkpatrick CD, MD, MHSc, FRCSC, FACS, Department of Surgery and Critical Care Medicine, University of Calgary
Clinical Reviewer: Fred Brenneman MD, FRCSC, FACS, Department of Surgery, University of Toronto
Clinical Reviewer: Leigh Neumayer MD, MS, FACS, Department of Surgery, University of Arizona
Clinical Reviewer: Kjetil Söreide MD, PhD, Department of Surgery, Royal Infirmary of Edinburgh and University of Edinburgh
Urschel JD, Goldsmith CH, Tandan VR, et al; for the Evidence-Based Surgery Working Group. Users’ guide to evidence-based surgery: how to use an article evaluating surgical interventions. Can J Surg 2001;44(2):95-100
Please read the above articles and be prepared to discuss the following:
- What is the clinical question being addressed?
- Was the assignment of patients to treatment randomized and concealed?
- Were all patients who entered the trial properly accounted for and attributed for at its conclusion?
- Were patients, their clinicians and study personnel “blind” to treatment?
- Were the groups similar at the start of the trial?
- Aside from the experimental intervention, were the groups treated equally?
- How large and precise was the treatment effect?
- Were the study patients similar to my patients?
- Were the measured outcomes clinically relevant?
- Were all clinically important outcomes considered?
- Are my surgical skills similar to those of the study surgeons?
- State the conclusion. Have the authors addressed the clinical question posed?
- Does the evidence support the conclusion?