{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:37:33Z","timestamp":1760150253448,"version":"build-2065373602"},"reference-count":72,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T00:00:00Z","timestamp":1698364800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Evidence-based medicine integrates results from randomized controlled trials (RCTs) and meta-analyses, combining the best external evidence with individual clinical expertise and patients\u2019 preferences. However, RCTs of surgery differ from those of medicine in that surgical performance is often assumed to be consistent. Yet, evaluating whether each surgery is performed to the same standard is quite challenging. As a primary issue, the novelty of this review is to emphasize\u2014with a focus on orthopedic trauma\u2014the advantage of having complete intra-operative image documentation, allowing the direct evaluation of the quality of the intra-operative technical performance. The absence of complete intra-operative image documentation leads to the inhomogeneity of case series, yielding inconsistent results due to the impossibility of a secondary analysis. Thus, comparisons and the reproduction of studies are difficult. Access to complete intra-operative image data in surgical RCTs allows not only secondary analysis but also comparisons with similar cases. Such complete data can be included in electronic papers. Offering these data to peers\u2014in an accessible link\u2014when presenting papers facilitates the selection process and improves publications for readers. Additionally, having access to the full set of image data for all presented cases serves as a rich resource for learning. It enables the reader to sift through the information and pinpoint the details that are most relevant to their individual needs, allowing them to potentially incorporate this knowledge into daily practice. A broad use of the concept of complete intra-operative image documentation is pivotal for bridging the gap between clinical research findings and real-world applications. Enhancing the quality of surgical RCTs would facilitate the equalization of evidence acquisition in both internal medicine and surgery. Joint effort by surgeons, scientific societies, publishers, and healthcare authorities is needed to support the ideas, implement economic requirements, and overcome the mental obstacles to its realization.<\/jats:p>","DOI":"10.3390\/jcm12216809","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T11:50:18Z","timestamp":1698407418000},"page":"6809","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Evidence-Based Surgery: What Can Intra-Operative Images Contribute?"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5028-5946","authenticated-orcid":false,"given":"Pietro","family":"Regazzoni","sequence":"first","affiliation":[{"name":"Department of Trauma Surgery, University Hospital Basel, 4031 Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesse B.","family":"Jupiter","sequence":"additional","affiliation":[{"name":"Hand and Arm Center, Department of Orthopedics, Massachusetts General Hospital, Boston, MA 02114, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Chih","family":"Liu","sequence":"additional","affiliation":[{"name":"Hand and Arm Center, Department of Orthopedics, Massachusetts General Hospital, Boston, MA 02114, USA"},{"name":"Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan"},{"name":"School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80756, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto A.","family":"Fern\u00e1ndez dell\u2019Oca","sequence":"additional","affiliation":[{"name":"Department of Traumatology, Hospital Britanico, Montevideo 11600, Uruguay"},{"name":"Residency Program in Traumatology and Orthopedics, University of Montevideo, Montevideo 11600, Uruguay"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1002\/bjs5.50240","article-title":"Systematic review of reporting benefits and harms of surgical interventions in randomized clinical trials","volume":"4","author":"Stubenrouch","year":"2020","journal-title":"BJS Open"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1136\/bmjebm-2018-110965","article-title":"What is a \u2018complex systematic review\u2019? 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