Statistical methods for randomised surgical trials

随机对照试验（RCT）在推进医疗保健方面发挥了非常重要的作用，通过与标准治疗进行比较，可以准确评估新治疗。外科领域使用随机对照试验的速度比一般医学领域慢。手术有许多特点，使其更难以评估，并影响试验的计划阶段，日常运行以及结果分析。进行手术的外科医生可能在经验和固有的手术能力方面有所不同。手术室和手术团队的可用性有限，因此手术可能会延迟。外科手术的不同之处还在于它的管理方式，并且特定程序的许多明显有效的变化可能是可能的。这些问题单独和共同抑制了外科RCT。这项工作将从统计学的角度来解决这些问题，并通过进一步的理解，可以促进吸收和提高手术中RCT的质量。通过这样做，我们将扩大对手术是一种选择的患者的最佳治疗方法的了解。

Randomised Controlled Trials (RCTs) have played a very important role in advancing health care by allowing accurate assessment of a new treatment by comparison with a standard treatment. The field of surgery has been slower to use RCTs than Medicine in general. There are number of features about surgery which make it more difficult to assess, and influence the planning stage of a trial, the day to day running, and also the analysis of the results. The surgeons undertaking the procedure may vary in both experience and inherent surgical ability. The availability of a surgical theatre and the surgical team are limited and therefore the surgery may be delayed. Surgery also differs is in the way that it is administered and a number of apparently valid variations of a particular procedure may be possible. Individually and collectively these issues have inhibited surgical RCTs. This work would look to address each of these issues from a statistical point of view and, by furthering our understanding, can facilitate the uptake and enhance the quality of RCTs in surgery. By doing so our knowledge of the best way to treat patients where surgery is an option will be enlarged.