title: [Is laparoscopic surgical practice "factual" (evidence based)? Results of a prospective regional survey].
abstract: OBJECTIVE
  Evidence-based medicine is a growing paradigm in health care. We conducted a prospective study to determine whether laparoscopic surgery is truly evidence-based in everyday practice.
  
  
  METHODS
  A prospective regional survey was performed in 11 French hospitals (one university and 10 district hospitals) to ascertain how general laparoscopic surgery was conducted during the last 3 months of 1997. We also searched the electronic databases for original articles on laparoscopic procedures. The methodology of randomized trials was analyzed and procedures were classed by level of evidence. We assumed that an evidence-based procedure was which had been validated by well-designed randomized controlled or prospective trials giving homogeneous results.
  
  
  RESULTS
  One half of the procedures performed had been evaluated by randomized controlled trials. Among the 428 laparoscopic procedures, 334 (78%) were found to be evidence-based (CI 74.1-81.9%). Twelve of the 18 indications for laparoscopy (67%) were evidence based (CI: 62.5%-71.5). There was no difference between university teaching hospitals and general district hospitals.
  
  
  CONCLUSIONS
  Contrary to initial criticisms, the practice of laparoscopic surgery appears to be truly evidence-based in the majority of cases.
authors.affiliation: Services de Chirurgie générale et digestive, CHU de Clermont-Ferrand. Kslim@u-clermont1.fr
authors.forename: K
authors.initials: K
authors.lastname: Slim
authors.forename: G
authors.initials: G
authors.lastname: Lescure
authors.forename: M
authors.initials: M
authors.lastname: Voitellier
authors.forename: P
authors.initials: P
authors.lastname: Ferrandis
authors.forename: S
authors.initials: S
authors.lastname: Le Roux
authors.forename: P J
authors.initials: PJ
authors.lastname: Dumas
authors.forename: J M
authors.initials: JM
authors.lastname: Lère
authors.forename: P
authors.initials: P
authors.lastname: Patouillard
authors.forename: A
authors.initials: A
authors.lastname: Caburet
authors.forename: B
authors.initials: B
authors.lastname: Baudet
authors.forename: J P
authors.initials: JP
authors.lastname: Rolet
authors.forename: M
authors.initials: M
authors.lastname: Prat
authors.forename: D
authors.initials: D
authors.lastname: Pezet
authors.forename: J
authors.initials: J
authors.lastname: Chipponi
mesh_terms: D019317:Evidence-Based Medicine / Q000706:statistics & numerical data*; D005602:France; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic
vernacular_title: La pratique de la chirurgie coelioscopique est-elle "factuelle" (evidence-based)? Résultats d'une enquête prospective régionale.