title: [Pioneering surgical innovations in Germany : Part 1: generation of medical evidence].
abstract: BACKGROUND
  In recent years research which conforms to evidence-based medicine (EBM) has been required even in surgery. Prospective, randomized studies are carried out in order to provide justification for the benefits of new procedures.
  
  
  OBJECTIVE
  The acquisition of special features in surgery with respect to the application of EBM.
  
  
  METHODS
  The investigation period selected was from1933 to 2013; therefore, all disciplines within the German Society of Surgery were questioned on the achievement of revolutionary innovations. The investigation was carried out utilizing personal interviews and a questionnaire. Only novel methods which were developed in Germany were considered. The survey was completed by carrying out research in database files.
  
  
  RESULTS
  During the past 80 years 15 pioneering innovations have been published in surgical research, although the prerequisites of EBM were only partly met. They appear to be based on the lowest level of evidence as these methods were mostly published as case reports or case series in journals with a low impact factor.
  
  
  CONCLUSIONS
  In general, innovative surgical procedures through top level research are still being published in the form of case reports or case series. This allows a rapid distribution of research results to the surgical community. Controlled studies still do not represent an alternative for the introduction of pioneering surgical innovations.
authors.affiliation: Klinik für Thorax-, Herz- und Gefäßchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
authors.forename: S
authors.initials: S
authors.lastname: Weber
authors.affiliation: Klinik für Thorax-, Herz- und Gefäßchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland. Haverich.Axel@mh-hannover.de.
authors.forename: A
authors.initials: A
authors.lastname: Haverich
mesh_terms: D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine; D005858:Germany; D006801:Humans; D011643:Publishing; D012955:Societies, Medical; D013514:Surgical Procedures, Operative
keywords: Evidence based medicine; Publications; Questionnaire; Revolutionary Innovations; Surgery