Surgical conditions span a broad spectrum of health states that result in morbidity and resource utilization. For patients and physicians, identifying the risks and benefits of interventions can be difficult. Selecting the best treatment for a particular clinical situation from the vast array of available options can be confusing. Health care providers, policy makers, and educators are focusing on evidence-based health care, the integration of the best research evidence with clinical expertise and patient values. Because they represent the gold standard for testing new interventions, randomized or controlled clinical trials (RCT/CCTs) are the centerpiece of research evidence. Systematic reviews and quantitative meta-analyses have been suggested as an even higher level of evidence, because they provide scientifically rigorous synthesis of all the known evidence from RCT/CCTs or other best evidence.