27 - Freie Mitteilung
15. Mai 2019, 15:30 - 17:00, Bellavista 2, 6. OG
Evidence 4.0 - Mapping of pancreatic surgery literature
P. Probst, F. J. Hüttner, T. Hackert, M. W. Büchler, M. K. Diener, Presenter: P. Probst (Heidelberg/DE)
Existing medical databases contain an unstructured overflow of literature. Therefore, the identification of objective outcome benchmarks and of priorities for future research is impeded. The aim of this project was to create an objective evidence map of quantity, quality and outcomes of randomised controlled trials (RCT) in pancreatic surgery.
PubMed, CENTRAL and Web of Science were searched systematically. Quantity and quality of every existing RCT were assessed. Evidence maps were constructed to identify gaps in evidence. Pancreas-surgery specific outcomes were pooled and presented with a 99% confidence interval (CI).
The search yielded 8210 results, of which 246 trials containing data on 26154 patients were finally included. Most trials were conducted in Europe (46%), followed by Asia (35%) and North America (14%). The quality of the included RCT was moderate. As an example, the pooled rate of postoperative pancreatic fistula in 9555 partial pancreatoduodenectomy patients was 15% (99%-CI 12%-17%). A lack of evidence exists for operations other than pancreatoduodenectomy and for specific diseases such as neuroendocrine neoplasms or intraductal papillary mucinous neoplasms.
Evidence mapping gives a systematic and comprehensive overview of the available literature. The maps give a hard reference to benchmark individual centre outcomes against pooled outcomes. Moreover, through an intuitive display of the existing literature they uncover gaps in existing evidence and serve as an objective basis for decisions about future research priorities.