Evidence-based medicine in practice--surgery.

Initial reticence on the part of some surgeons, combined with a lack of, or unsuitability of, randomised controlled trial evidence, has slowed the uptake of the evidence-based revolution in surgery. An important positive step has been the establishment of the Australian Safety and Efficacy Register of New Interventional Procedures--Surgical (ASERNIP-S) to evaluate new surgical procedures in an evidence-based manner. To supplement information from systematic reviews, ASERNIP-S has been involved in national data collection, which is important for production and evaluation of clinical practice guidelines. Evidence-based practice in surgery, as in other disciplines, must be adequately resourced if it is to be widely and successfully applied.