Evidence-based practice and health technology assessment: a call for anesthesiologists to engage in knowledge translation.

摘要

How often have senior leaders in your hospital asked you to cut drug and equipment costs? Can we justifiably afford depth of anesthesia monitoring equipment for each operating room? Based on the benefits and risks, is the routine use of inhaled nitric oxide properly justified in patients who experience difficulty in weaning from cardiopulmonary bypass? Healthcare in North America is clearly at a crux. On the one hand, there is the pressing need to do all that we can to justify the increasing costs and efforts expended to implement new drugs, technologies, and techniques into practice. On the other hand, we need to respect that we cannot (and should not) "do it all", especially if the new techniques or technologies will achieve only marginal benefits at best and at greater risk and cost compared with the existing status quo.