Where do we find the best evidence?

SUMMARY: As pressure on resources increases, decision makers in health care are increasingly seeking high-quality, scientific evidence to support clinical and health policy choices. Ultimately, legislators will look to develop performance measures based on evidence, rather than on consensus or commonality of practice. As plastic surgeons, we can take an increased role in producing impartial evidence on the efficacy of our surgical interventions. We can move away from the retrospective reporting of cases and nonrandomized studies and instead rely on prospective, randomized trials addressing important clinical issues. In doing so, we will challenge the common practice of basing clinical decisions solely on what we are taught, procedures we are most comfortable doing, or procedures that are most financially rewarding. These efforts will not only afford us the best opportunity to provide optimal care to patients but also allow us to demonstrate the inherent quality of our surgical specialty.