Canadian Association of General Surgeons, the American College of Surgeons, the Canadian Society of Colorectal Surgeons, and the American Society of Colorectal Surgeons Evidence Based Reviews in Surgery – Colorectal Surgery

DiSEASES OF THE COLON & RECTuM VOLuME 55: 10 (2012) The term “evidence-based medicine” was first coined by Sackett and colleagues as “the conscientious, explicit and judicious use of the current best evidence in making decisions about the care of individual patients.” The key to practicing evidence-based medicine is applying the best current knowledge to decisions in individual patients. Medical knowledge is continually and rapidly expanding and reading all of the medical literature is impossible for an individual clinician. For clinicians to practice evidence-based medicine, they must have the skills to read and interpret the medical literature so they can determine the validity, reliability, credibility and utility of individual articles, ie, critical appraisal skills. in general, critical appraisal requires that the clinician have some knowledge of biostatistics, clinical epidemiology, decision analysis, and economics, and clinical knowledge, as well. The Canadian Association of General Surgeons and the American College of Surgeons jointly sponsor a program entitled “Evidence Based Reviews in Surgery" (EBRS), supported by an educational grant from Ethicon Endo Surgery inc and Ethicon Endo Surgery Canada. The primary objective of this initiative is to help practicing surgeons improve their critical appraisal skills. EBRS has a module covering topics in colorectal surgery. Each academic year, 6 clinical articles are chosen for review and discussion. The articles are selected not only for their clinical relevance to colorectal surgery, but also to cover a spectrum of methodological issues important to surgeons; for example, causation or risk factors for disease, natural history, or prognosis of disease, quantifying disease (measurement issues), diagnostic tests and the diagnosis of disease, and the effectiveness of treatment. Both methodological and clinical reviews of the article are performed by experts in the relevant areas and posted on the Evidence Based Reviews in Surgery-Colorectal Surgery (EBRS-CRS) Web site. in addition, a listserv discussion is held where participants can discuss the monthly article. Members of the Canadian Association of General Surgeons (CAGS) and the American College of Surgeons (ACS) can access EBRS-CRS through the Canadian Association of General Surgeons Web site (www.cags-accg.ca), the American College of Surgeons Web site (www.facs.org/education/ebrs. html), the Canadian Society of Colon and Rectal Surgeons (CSRCS) Web site (www.cscrs.ca), and the American Society of Colon and Rectal Surgeons (ASCRS) Web site (www. fascrs.org), All journal articles and reviews are available electronically through the Web site. Surgeons who participate in the monthly packages can receive 6 CME and/ or Maintenance of Certification credits by completing an evaluation and a series of multiple-choice questions each month. For further information about EBRS-CRS, readers are directed to the CAGS, ACS, CSCRS, and ASCRS Web sites or should email the administrative coordinator, Marg McKenzie at mmckenzie@mtsinai.on.ca in addition to making the reviews available through the CAGS and the ACS Web sites, a condensed version of the reviews will be published in the Diseases of the Colon & Rectum. EBRS is useful in improving your critical appraisal skills, in keeping abreast of new developments in colorectal surgery, and, most importantly, in being able to obtain 6 CME credits each month from anywhere that you have access to a computer. Comments about EBRS may be directed to mmckenzie@mtsinai.on.ca

[1]  R. Madoff.  The uses of surgical history. , 2012, Diseases of the colon and rectum.

[2]  R. McLeod,et al.  The cluster-randomized Quality Initiative in Rectal Cancer trial: evaluating a quality-improvement strategy in surgery , 2010, Canadian Medical Association Journal.

[3]  C. Bernstein,et al.  A Population-Based Study of Health-Care Resource Use Among Infliximab Users , 2010, The American Journal of Gastroenterology.

[4]  M. Papp,et al.  Early azathioprine/biological therapy is associated with decreased risk for first surgery and delays time to surgery but not reoperation in both smokers and nonsmokers with Crohn's disease, while smoking decreases the risk of colectomy in ulcerative colitis , 2010, European journal of gastroenterology & hepatology.

[5]  N. Baxter,et al.  Variability in Reconstructive Procedures Following Rectal Cancer Surgery in the United States , 2010, Diseases of the colon and rectum.

[6]  R. Beart,et al.  Inflammatory Bowel Disease in the United States from 1998 to 2005: Has Infliximab Affected Surgical Rates? , 2009, The American surgeon.

[7]  A. Oxman,et al.  Continuing education meetings and workshops: effects on professional practice and health care outcomes. , 2009, The Cochrane database of systematic reviews.

[8]  J. Monson,et al.  Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and NCIC-CTG C016): a multicentre, randomised trial , 2009, The Lancet.

[9]  J. Monson,et al.  Effect of the plane of surgery achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from the MRC CR07 and NCIC-CTG CO16 randomised clinical trial , 2009, The Lancet.

[10]  G. D'Haens,et al.  Effects of adalimumab therapy on incidence of hospitalization and surgery in Crohn's disease: results from the CHARM study. , 2008, Gastroenterology.

[11]  S. Finlayson,et al.  Trends in Surgery for Crohn's Disease in the Era of Infliximab , 2008, Annals of surgery.

[12]  M. Vos,et al.  Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn's disease: an open randomised trial , 2008, The Lancet.

[13]  S. Brant,et al.  Rising hospitalization rates for inflammatory bowel disease in the United States between 1998 and 2004# , 2007, Inflammatory bowel diseases.

[14]  J. Morales,et al.  Resource use in patients with Crohn’s disease treated with infliximab , 2007, Alimentary Pharmacology and Therapeutics.

[15]  J. Lewis,et al.  Trends in hospitalization rates for inflammatory bowel disease in the United States. , 2007, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[16]  William J. Tremaine,et al.  Update on the incidence and prevalence of Crohn's disease and ulcerative colitis in Olmsted County, Minnesota, 1940–2000 , 2007, Inflammatory bowel diseases.

[17]  M. Bala,et al.  Infliximab maintenance treatment reduces hospitalizations, surgeries, and procedures in fistulizing Crohn's disease. , 2005, Gastroenterology.

[18]  B. Cedermark,et al.  Prognostic significance of both surgical and pathological assessment of curative resection for rectal cancer , 2004, The British journal of surgery.

[19]  P. Rutgeerts,et al.  Infliximab maintenance therapy for fistulizing Crohn's disease. , 2004, The New England journal of medicine.

[20]  M. Bala,et al.  Remission in Patients with Crohn's Disease is Associated with Improvement in Employment and Quality of Life and a Decrease in Hospitalizations and Surgeries , 2004, American Journal of Gastroenterology.

[21]  O. Søreide,et al.  Total mesorectal excision for rectal cancer – what can be achieved by a national audit? , 2003, Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland.

[22]  S. Hanauer,et al.  Infliximab in the treatment of Crohn's disease: a user's guide for clinicians , 2002, American Journal of Gastroenterology.

[23]  M. Cottone,et al.  Maintenance infliximab for Crohn's disease , 2002, The Lancet.

[24]  G. Noël,et al.  Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer , 2002 .

[25]  J. Rubenstein,et al.  Infliximab Decreases Resource Use Among Patients With Crohn's Disease , 2002, Journal of clinical gastroenterology.

[26]  Rieken,et al.  [Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer]. , 2001, Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al].

[27]  A. Detsky,et al.  Evidence-based medicine. A new approach to teaching the practice of medicine. , 1992, JAMA.

[28]  R. Fedorak.  Canadian Association of Gastroenterology Clinical Practice Guidelines: the use of infliximab in Crohn's disease. , 2001, Canadian journal of gastroenterology = Journal canadien de gastroenterologie.

[29]  S. Targan,et al.  A short-term study of chimeric monoclonal antibody cA2 to tumor necrosis factor alpha for Crohn's disease. Crohn's Disease cA2 Study Group. , 1997, The New England journal of medicine.