Historically, the surgical literature was defined based on a predominance of case series, case reports, and anecdotal experiences of surgical investigators. But over the past several decades, the methodologic quality of surgical research has significantly improved, concurrent with increasing use of more robust study designs.¹ Contemporary evidence published to support the use of surgical interventions now routinely comes from randomized clinical trials, meta-analyses, qualitative studies, cost-effectiveness analyses, and comparative effectiveness research studies, to name a few. Many of these study designs and advanced methodologies were highlighted in the most recent Guide to Statistics and Methods series published in JAMA Surgery this past year.