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In our view the publication of the second edition of Evidence-Based Surgery: Understanding and Interpreting the Surgical Literature is of great relevance to surgeons of all specialties.
Although the terms Evidence-Based Medicine (EBM) and Evidence-Based Surgery (EBS) are mentioned often in the literature, there persists a gap in the understanding of what these terms and their underlying philosophy mean despite the introduction of this new method of learning and teaching three decades earlier.
The first and second edition have their roots in the EBS surgery workshops we undertook to teach surgeons at McMaster University and other institutions since the 1990s.
Since the first edition was published, there have been methodological advances in the various study designs. Large surgical trials that use new ways of data acquisition or that demonstrate different methods of obtaining informed consent have been developed. New types of surgical clinical trials have been developed, especially in surgical oncology, involving multidisci¬plinary teams (i.e., radiation oncology or medical oncology). These will be addressed in the individual chapters.
We have added four new chapters in the 2nd edition. The chapter on Cluster RCTs will complement the other Randomized Controlled Trial (RCT) designs (superiority RCT, non-inferiority RCT, expertise-based RCTs, and Pilot RCT). The chapter on Network Meta-analysis will complement the chapter of Systematic Reviews and meta-analysis. The chapter of Enhanced Recovery After Surgery (ERAS) is an important advance in standardizing surgical care in many specialties and hence of clinical relevance. We have added a chapter on Core Outcome Sets (COS). As the inclusion of critically important outcomes in any surgical research project is of paramount impor¬tance for credible research, we believe that surgeons should be familiar with this presently evolving area.
In the second edition we made some aesthetic changes to improve the readability of the figures. Each chapter will start with a glossary of the terms used in the chapter and will include as an appendix the literature search strat¬egy for interested readers who may wish to replicate the findings.
Another big change from the first edition is the addition of Pablo E. Serrano as a fifth co-editor who provides the perspective of a new generation of sur¬geon methodologists with emphasis in surgical oncology, bringing the basic concepts of surgical trials to oncology research.