Understanding Diagnosis, Therapy, and Prognosis

Orthopaedic surgeons wishing to practice evidence-based medicine (EBM) must integrate the best available research evidence with their own surgical expertise and their patient's goals and values. Critical appraisal of the best evidence requires an understanding of the hierarchy of research design, as well as asking three fundamental questions about study validity, results, and applicability to an individual's patients. Through this three-step process of critical appraisal surgeons are best informed to select appropriate diagnostic tests for making a sound diagnosis, selecting the best therapy, and determining the most likely prognosis for their patients.