Low Cost Mesh in Groin Hernia Repair


Featured Article

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

Expert Reviews

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

Supplementary Article

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:

  1. What is the clinical question being addressed?
  2. Was the assignment of patients to treatment randomized and concealed?
  3. Were all patients who entered the trial properly accounted for and attributed for at its conclusion?
  4. Were patients, their clinicians and study personnel “blind” to treatment?
  5. Were the groups similar at the start of the trial?
  6. Aside from the experimental intervention, were the groups treated equally?
  7. How large and precise was the treatment effect?
  8. Were the study patients similar to my patients?
  9. Were the measured outcomes clinically relevant?
  10. Were all clinically important outcomes considered?
  11. Are my surgical skills similar to those of the study surgeons?
  12. State the conclusion. Have the authors addressed the clinical question posed?
  13. Does the evidence support the conclusion?