Trials in surgery

Author:

Lilford R1,Braunholtz D1,Harris J1,Gill T1

Affiliation:

1. Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK

Abstract

Abstract Background Trials in surgery pose some special problems. This paper examines these with reference to 10 years of methodological research sponsored by the UK National Health Service Research and Development programme. Methods Solutions to common problems encountered in surgical studies were considered, such as issues of blinding, dependence of results on technical skill and continued evolution of technology. Results Numerous methodological developments are described, including the tracker trial concept in which trial design can be adapted to take account of technical developments and interim results. The governance of trials, solutions to ethical conundra and the rising importance of databases are also discussed. Conclusion Like surgery itself, the methodological toolkit for evaluation of surgical procedures continues to evolve. The rules of statistical and scientific probity provide plenty of scope for imaginative design solutions for surgical trials.

Publisher

Oxford University Press (OUP)

Subject

Surgery

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