Application de la médecine factuelle à la chirurgie de la lithiase biliaire

Abstract

Evidence based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients This must go through four steps. 1. The formulation of a clear clinical question 2. Research of facts documented 3. Analysis of the results 4. Application of the results in clinical practice. Our choice of application has been the surgery of biliary tract stones given its frequency, its complexity which involves answering several clinical questions. Our experimental schema has been likened to a non-comparative cohort study (patients were «exposed to evidence-based medicine».) Need to calculate the percentage of patients who could join this particular approach and observe a follow-up (not very long given the mildness of the disease) No special statistical study has been mandatory since it is an observational study. The application should pass through - The formulation is possible or not and under what conditions. - Documentary research on MEDLINE and Cochrane - Results analysis: through the critical reading of the articles collected Finally, practical applications in analyzing the results as a percentage of membership or not. The conclusion this work is that evidence-based medicine is always applicable using a phenomenon of weighting between different tripods of evidence-based medicine, the research of documentary sources, the status and competence, and values of the patient. The educational component was of capital importance, for applying evidence- based medicine, he must teach students everything confused levels Key words: evidence-based medicine, biliary tract stones, non-comparative cohort, weighting, pedagogy.