The Bristol Surgical Trials Centre, based at the University of Bristol, is bringing together expert surgeons and scientists to design and deliver studies to evaluate new operations, and to compare standard procedures to answer research questions that are important to patients and the NHS. It will also provide training opportunities and develop a new generation of surgeons that understand and participate in interdisciplinary high-quality research.

The gold standard way of evaluating new healthcare interventions and comparing standard treatments is to perform randomised trials. This is challenging in surgery for several reasons. Firstly, surgeons can find it difficult to talk to patients about treatment uncertainties and the need for treatment to be allocated by randomisation. Secondly, it is difficult, or often impossible, to compare an operation with a ‘placebo’ or ‘sham’ procedure, which can more easily be done in trials of new drugs where a ‘placebo’ can be used.

These challenges mean that historically few surgical randomised trials have been undertaken. Therefore practice is not based on scientific evidence from trials, but rather on individual surgeon or patient preference leading to variation in operations and when to perform them.

Professor Jane Blazeby, Director of the BSTC, said: “Over the next decade the Bristol Surgical Trials Centre, working with other centres, surgeons and scientists, will establish evidence and train a new generation of surgeons who understand and participate in randomised trials. This will ensure that in the 2020s and beyond surgery will be based on evidence and improved standards of surgery will be established.”

The Bristol Surgical Trials Centre, based in the University, is closely linked to the two clinical trials units: the Bristol Randomised Trials Collaboration and the Clinical Trials and Evaluation Unit. It is also closely linked with the ConDuCT-II (Collaboration and innovation in Difficult and Complex randomised controlled Trials In Invasive procedures) MRC Hub for Trials Methdology research.

The Centre works with SPARCS (Severn and Peninsula Audit and Research Collaborative for Surgeons), which is a surgeon trainee-led research collaborative spanning Severn and Peninsula Deaneries. The SPARCS network formed by 90 higher surgical trainees rotating through regional hospitals allows trainees to successfully undertake multi-centre research and to make substantial contributions towards recruitment.

Professor Norman Williams, President of the Royal College of Surgeons, added: “Surgery is under-represented in health service research. In order to address this we are joining forces to ensure that a nationwide network of surgical trials centres, which focus exclusively on clinical trials, will raise surgical standards and transform the quality of patient care across the breadth of surgery.”

The network of surgical trials centres across the UK has been established by the Royal College of Surgeons and partners including the National Institute of Health Research, Cancer Research UK and the Rosetrees Trust.

The surgical trials centres are located in Birmingham, Bristol, Liverpool/Manchester, London and Oxford.

For further details about the Centre, to register for one of our research training days or to discuss an idea for a trial please contact us at csr-bristol@bristol.ac.uk

 

Designing and evaluating surgical research:

A practical ‘how to’ guide

 

 

Designing and Evaluating Surgical Research.

A practical ‘how to’ guide Training Days.