We suggest a three-step approach when using an article from the
surgical literature to guide your patient care: (1) assess whether
the study can provide valid results, (2) review the results, and
(3) consider how the results might be applied to your patient.
Randomization, concealment, intention-to-treat analysis, similarity
of patients for known prognostic factors, blinding of patients and
outcome assessors, and completeness of follow-up are important guides
to study validity.
The 95% confidence interval around the treatment effect
is a measure of precision.
Consider whether all of the clinically important outcomes were
reported and whether the likely benefits of treatment outweigh the
potential harm and costs.