Interventions in randomised controlled trials in surgery: issues to consider during trial design

Natalie S Blencowe, Julia M Brown, Jonathan A Cook, Chris Metcalfe, Dion G Morton, Jon Nicholl, Linda D Sharples, Shaun Treweek, Jane M Blazeby, Members of the MRC Hub for Trials Methodology Research Network Workshop

Research output: Contribution to journalArticle

21 Citations (Scopus)
4 Downloads (Pure)

Abstract

Until recently, insufficient attention has been paid to the fact that surgical interventions are complex. This complexity has several implications, including the way in which surgical interventions are described and delivered in trials. In order for surgeons to adopt trial findings, interventions need to be described in sufficient detail to enable accurate replication; however, it may be permissible to allow some aspects to be delivered according to local practice. Accumulating work in this area has identified the need for general guidance on the design of surgical interventions in trial protocols and reports. Key issues to consider when designing surgical interventions include the identification of each surgical intervention and their components, who will deliver the interventions, and where and how the interventions will be standardised and monitored during the trial. The trial design (pragmatic and explanatory), comparator and stage of innovation may also influence the extent of detail required. Thoughtful consideration of surgical interventions in this way may help with the interpretation of trial results and the adoption of successful interventions into clinical practice.

Original languageEnglish
Article number392
Number of pages9
JournalTrials
Volume16
Early online date4 Sep 2015
DOIs
Publication statusPublished - 4 Sep 2015

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Pragmatic Clinical Trials
Clinical Protocols
Randomized Controlled Trials
Surgeons

Keywords

  • surgical trials
  • trial design
  • complex interventions
  • methodology
  • standardisation
  • adherence/fidelity
  • expertise

Cite this

Blencowe, N. S., Brown, J. M., Cook, J. A., Metcalfe, C., Morton, D. G., Nicholl, J., ... Members of the MRC Hub for Trials Methodology Research Network Workshop (2015). Interventions in randomised controlled trials in surgery: issues to consider during trial design. Trials, 16, [392]. https://doi.org/10.1186/s13063-015-0918-4

Interventions in randomised controlled trials in surgery : issues to consider during trial design. / Blencowe, Natalie S; Brown, Julia M; Cook, Jonathan A; Metcalfe, Chris; Morton, Dion G; Nicholl, Jon; Sharples, Linda D; Treweek, Shaun; Blazeby, Jane M; Members of the MRC Hub for Trials Methodology Research Network Workshop.

In: Trials, Vol. 16, 392, 04.09.2015.

Research output: Contribution to journalArticle

Blencowe, NS, Brown, JM, Cook, JA, Metcalfe, C, Morton, DG, Nicholl, J, Sharples, LD, Treweek, S, Blazeby, JM & Members of the MRC Hub for Trials Methodology Research Network Workshop 2015, 'Interventions in randomised controlled trials in surgery: issues to consider during trial design', Trials, vol. 16, 392. https://doi.org/10.1186/s13063-015-0918-4
Blencowe NS, Brown JM, Cook JA, Metcalfe C, Morton DG, Nicholl J et al. Interventions in randomised controlled trials in surgery: issues to consider during trial design. Trials. 2015 Sep 4;16. 392. https://doi.org/10.1186/s13063-015-0918-4
Blencowe, Natalie S ; Brown, Julia M ; Cook, Jonathan A ; Metcalfe, Chris ; Morton, Dion G ; Nicholl, Jon ; Sharples, Linda D ; Treweek, Shaun ; Blazeby, Jane M ; Members of the MRC Hub for Trials Methodology Research Network Workshop. / Interventions in randomised controlled trials in surgery : issues to consider during trial design. In: Trials. 2015 ; Vol. 16.
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abstract = "Until recently, insufficient attention has been paid to the fact that surgical interventions are complex. This complexity has several implications, including the way in which surgical interventions are described and delivered in trials. In order for surgeons to adopt trial findings, interventions need to be described in sufficient detail to enable accurate replication; however, it may be permissible to allow some aspects to be delivered according to local practice. Accumulating work in this area has identified the need for general guidance on the design of surgical interventions in trial protocols and reports. Key issues to consider when designing surgical interventions include the identification of each surgical intervention and their components, who will deliver the interventions, and where and how the interventions will be standardised and monitored during the trial. The trial design (pragmatic and explanatory), comparator and stage of innovation may also influence the extent of detail required. Thoughtful consideration of surgical interventions in this way may help with the interpretation of trial results and the adoption of successful interventions into clinical practice.",
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