The meta-analysis by Pronk et al.1 highlights that, despite previous pessimism regarding the quality of RCTs in surgery, the proportion of RCTs with a low risk of bias increased significantly between 2009 and 2019. Still, a number of factors, such as low patient accrual, surgeon preferences, and variations in surgical expertise, quality control, and procedural standardization, make RCTs difficult to implement in practice. Besides this, interpretation of RCTs may vary according to type of analysis (intention to treat (ITT) versus per protocol) and inadequate handling of drop-outs
Comment on: Two decades of surgical randomized controlled trials: worldwide trends in volume and methodological quality / A. Aiolfi, G. Bonitta, D. Tosi, E. Rausa, M. Nosotti, D. Bona, L. Bonavina. - In: BRITISH JOURNAL OF SURGERY. - ISSN 0007-1323. - (2023), pp. znad251.1-znad251.1. [Epub ahead of print] [10.1093/bjs/znad251]
Comment on: Two decades of surgical randomized controlled trials: worldwide trends in volume and methodological quality
M. Nosotti;D. Bona;L. Bonavina
Ultimo
2023
Abstract
The meta-analysis by Pronk et al.1 highlights that, despite previous pessimism regarding the quality of RCTs in surgery, the proportion of RCTs with a low risk of bias increased significantly between 2009 and 2019. Still, a number of factors, such as low patient accrual, surgeon preferences, and variations in surgical expertise, quality control, and procedural standardization, make RCTs difficult to implement in practice. Besides this, interpretation of RCTs may vary according to type of analysis (intention to treat (ITT) versus per protocol) and inadequate handling of drop-outs
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