ArticleTrials2014
Time to be BRAVE: is educating surgeons the key to unlocking the potential of randomised clinical trials in surgery? A qualitative study.
Article in Trials, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05865964 (Evaluation of Anthropological, Socio-cultural and Psychological Factors of Surgeons Practising in Oncology Which Condition Brakes in the Evaluation of Surgical Innovations), which is not on this map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation of Anthropological, Socio-cultural and Psychological Factors of Surgeons Practising in Oncology Which Condition Brakes in the Evaluation of Surgical Innovations
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Exploring qualitative methods reported in registered trials and their yields (EQUITY): systematic review.Trials · 2018Pooled it
- Different types of implants for reconstructive breast surgery.The Cochrane database of systematic reviews · 2016Pooled it
- Hybrid versus cemented implants for total hip replacement: a randomised feasibility study with embedded qualitative research.BMC musculoskeletal disorders · 2026Trial
- Posterior cervical foraminotomy versus anterior cervical discectomy for Cervical Brachialgia: the FORVAD RCT.Health technology assessment (Winchester, England) · 2023Trial
- Can engineers represent surgeons in usability studies? Comparison of results from evaluating augmented reality guidance for laparoscopic surgery.Computers & graphics · 2024Article
- Secondary healthcare costs after mastectomy and immediate breast reconstruction for women with breast cancer in England: population-based cohort study.The British journal of surgery · 2023Article
- Short-term safety outcomes of mastectomy and immediate prepectoral implant-based breast reconstruction: Pre-BRA prospective multicentre cohort study.The British journal of surgery · 2022Article
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- A review of informed consent and how it has evolved to protect vulnerable participants in emergency care research.EFORT open reviews · 2020Article
- Facilitating trial recruitment: A qualitative study of patient and staff experiences of an orthopaedic trauma trial.Trials · 2019Article
- Short-term safety outcomes of mastectomy and immediate implant-based breast reconstruction with and without mesh (iBRA): a multicentre, prospective cohort study.The Lancet. Oncology · 2019Article
- Challenges to and Facilitators of Recruitment to an Alzheimer's Disease Clinical Trial: A Qualitative Interview Study.Journal of Alzheimer's disease : JAD · 2019Article
- Using evidence when planning for trial recruitment: An international perspective from time-poor trialists.PloS one · 2019Article
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- Training health professionals to recruit into challenging randomized controlled trials improved confidence: the development of the QuinteT randomized controlled trial recruitment training intervention.Journal of clinical epidemiology · 2018Article
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- Identifying barriers to accrual in radiation oncology randomized trials.Current oncology (Toronto, Ont.) · 2017Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundWell-designed randomised clinical trials (RCTs) provide the best evidence to inform decision-making and should be the default option for evaluating surgical procedures. Such trials can be challenging, and surgeons' preferences may influence whether trials are initiated and successfully conducted and their results accepted. Preferences are particularly problematic when surgeons' views play a key role in procedure selection and patient eligibility. The bases of such preferences have rarely been explored. Our aim in this qualitative study was to investigate surgeons' preferences regarding the feasibility of surgical RCTs and their understanding of study design issues using breast reconstruction surgery as a case study.
methodsSemistructured qualitative interviews were undertaken with a purposive sample of 35 professionals practicing at 15 centres across the United Kingdom. Interviews were transcribed verbatim and analysed thematically using constant comparative techniques. Sampling, data collection and analysis were conducted concurrently and iteratively until data saturation was achieved.
resultsSurgeons often struggle with the concept of equipoise. We found that if surgeons did not feel 'in equipoise', they did not accept randomisation as a method of treatment allocation. The underlying reasons for limited equipoise were limited appreciation of the methodological weaknesses of data derived from nonrandomised studies and little understanding of pragmatic trial design. Their belief in the value of RCTs for generating high-quality data to change or inform practice was not widely held.
conclusionThere is a need to help surgeons understand evidence, equipoise and bias. Current National Institute of Health Research/Medical Research Council investment into education and infrastructure for RCTs, combined with strong leadership, may begin to address these issues or more specific interventions may be required.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.