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J Thorac Cardiovasc Surg 2006;132:243-244
© 2006 The American Association for Thoracic Surgery

Statistics for the Rest of Us

Randomized controlled trials in surgery: Comic opera no more?

Department of Neurological Surgery, University of Virginia School of Medicine, Charlottesville, Va.

Received for publication January 4, 2006; accepted for publication March 3, 2006.

^_* Address for reprints: Neal F. Kassell, MD, Box 800212, Department of Neurological Surgery, UVA Health Sciences Center, Charlottesville, VA 22908 (Email: nfk8g@virginia.edu).

The first 20% of the full text of this article appears below.

The ultimate goal of clinical research is to provide the best information to optimally guide the management of a given patient with a particular problem confronting us. Specifically, surgeons might wish to compare medications, surgical techniques, or combinations thereof for a given condition. Randomized controlled trials (RCTs) help to circumvent several major obstacles hindering investigations of this nature. Through randomization, selection bias is theoretically removed, and confounding factors are distributed evenly among groups to mitigate their potential influences. Hence RCTs have emerged as the most efficient and rigorous way to generate robust scientific evidence of safety and efficacy necessary to prove whether a therapeutic intervention works.

However, such trials are expensive, time consuming, difficult to perform, and potentially dangerous. They are obviously not the only way to determine whether a given therapeutic intervention is efficacious.

Surgery has been . . . [Full Text of this Article]

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