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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.

Original publication

DOI

10.1016/S0140-6736(09)61086-2

Type

Journal article

Journal

Lancet

Publication Date

26/09/2009

Volume

374

Pages

1097 - 1104

Keywords

Attitude of Health Personnel, Bias, Biomedical Research, Clinical Competence, Clinical Trials as Topic, Evaluation Studies as Topic, General Surgery, Humans, Observation, Postoperative Complications, Randomized Controlled Trials as Topic, Surgical Procedures, Operative, Technology Assessment, Biomedical