Journal
LANCET
Volume 374, Issue 9695, Pages 1097-1104Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/S0140-6736(09)61086-2
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Funding
- Ethicon UK
- National Institute of Health Research Health Technology Assessment Programme
- Nuffield Department of Surgery at the University of oxford
- Department of Surgery at McGill University
- Medical Research Council UK
- Chief Scientist Office of the Scottish Government Health Directorates
- Societe Francaise de Rhumatologie and Lavoisier Program (Ministere des Affaires Etrangeres et Europeennes)
- MRC [G0601938, G0800808] Funding Source: UKRI
- Chief Scientist Office [HSRU1] Funding Source: researchfish
- Medical Research Council [G0800808, G0601938] Funding Source: researchfish
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Research on surgical interventions is associated with several methodological and practical challenges of which few, if any, apply only to surgery. However, surgical evaluation is especially demanding because many of these challenges coincide. In this report, the second of three on surgical innovation and evaluation, we discuss obstacles related to the study design of randomised controlled trials and non-randomised studies assessing surgical interventions. We also describe the issues related to the nature of surgical procedures-for example, their complexity, surgeon-related factors, and the range of outcomes. Although difficult, surgical evaluation is achievable and necessary. Solutions tailored to surgical research and a framework for generating evidence on which to base surgical practice are essential.
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