Should we be performing more randomized controlled trials evaluating surgical operations ?
The objective of this study was, first, to determine what proportion of clinical treatment evaluation questions involving surgical operations could be answered by a randomized controlled trial (RCT).
Second, for those questions not amenable to a RCT, to determine the problems that potentially preclude the initiation of RCT in an ideal clinical research setting.
A sample of treatment evaluation questions involving a surgical procedure was obtained by a computerized search of the surgical literature.
Problems precluding a RCT were defined.
By use of these criteria, the sample questions were evaluated to determine whether a RCT could be performed and, if not, the predominant reasons precluding RCT of surgical procedures.
Only 38.8% of treatment evaluation questions could have been answered by a RCT in an ideal clinical research setting.
Patient preference was the most common precluding problem encountered (40% of all problems).
The principal precluding problem was patient preference in 23.1%, an uncommon condition in 24.2%, and lack of community (clinical) equipoise in 10%. Conclusions.
In the ideal situation RCT can be performed to evaluate only 40% of treatment questions involving surgical procedures.
Patient preferences, uncommon conditions, and lack of surgical community equipoise appear to be the most common reasons precluding the performance of RCT of surgical operations. (SURRGERY 1995 ; 118 : 459-67.).
Mots-clés Pascal : Traitement, Homme, Chirurgie, Essai thérapeutique contrôlé, Evaluation, Canada, Amérique du Nord, Amérique
Mots-clés Pascal anglais : Treatment, Human, Surgery, Controlled therapeutic trial, Evaluation, Canada, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0527589
Code Inist : 002B30A01C. Création : 01/03/1996.