[Diurnal frequency patterns of errors made in ophthalmo-surgery. A clinical analysis related to evidence based medicine].

Background And Objectives: Three factors are usually considered in determining optimal patient care, the goal of evidence based medicine (EBM): (1) approximation to the best medical knowledge, (2) clinical competence of the doctor and self reflection, (3) taking into account the individual values and beliefs of the patient. Must the limited loading capacity of the doctor also be considered as the fourth factor in ophthalmic surgery?

Methods: Follow-up examination of 8,212 cataract operation reports was carried out. We recorded complications (active errors) and specific intra-operative features (latent errors).

Results: The errors were not distributed evenly between 07.45 h and 13.14 h (chi(2)-test: P<0.001). They reach a maximum around 11 h.

Conclusions: Usual recommendations by EBM claim a surgeon to be a machine. They should, however, take into account systematic changes in efficiency that can probably be reduced by simple nutritive interventions.