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Novel approaches to surgical trials and the assessment of new surgical technologies

Clinical research activity in surgery in the UK is at an all-time high, reflecting engagement between the National Institute of Health Research, the Royal College of Surgeons of England and major charitable funders, to create a system for the development and delivery of multicentre clinical trials. This initiative, with support from surgical specialty groups, led to the development of national research leads in all major specialties and the creation of five dedicated surgical clinical trials units1. In addition, trainee-led research collaboratives now exist across the country in both general and subspecialist branches of surgery. These groups have demonstrated the power of ground-level dissemination and rapid recruitment capabilities in several recently completed projects2–4. There are few reasons why similar strategies could not be applied to other healthcare systems in developed countries. It now seems appropriate to look at ways of increasing the efficiency and expanding the boundaries of surgical trials.