The Nature Of Scientific Inquiry

The Nature of Scientific Inquiry (borrowed from some of my recent writings)

The process of discovery in medicine/surgery usually starts with a case report ( how to perform a new operation), further series, then well planned trials( prospective, controlled and blinded trials) to verify the procedure (surgeons maybe be surprised to learn that the major biological discovery of the 20th Century, the description of DNA in 1953 was not peer-reviewed, as considered self-evident, before its publication in Nature, 1953 Apr 25;171(4356):737-8. LOE V).In a similar way, John Charnley’s case series fundamentally changed the course of orthopaedics (Charnley, 1972. LOE IV). It maybe that the statistical technique for medical papers are not applicable to surgical techniques/papers. Surgical studies may not obtain a high level of evidence as defined by the JBJS(Horan, 2005) or the status ands credibility of a randomized controlled study(RCT) but still contain important and useful information for practicing surgeons(Malik et al, 2006; Lubick, 2006).