A surgeonAs a surgical researcher, you are the driving force behind evidence-based practice.

You are committed to the scientific method, but likely you are also a clinical surgeon and know first-hand that few of your patient-related decisions are based on double-blinded placebo-controlled randomised trials.

Perhaps you have spent months collecting and interpreting data only to have your abstract rejected for the wrong methodology or study design.

How do you find out the best way to share your important findings with the scientific and clinical community?

  • IDEAL offers recommendations for researchers on study design and reporting.
  • IDEAL is specific to surgery, and understands that many of the strict regulations in medical trials are not applicable to surgical innovation.
  • As a historical example, tracheostomy for tracheal obstruction was an obvious ‘innovation’ that did not require a randomised controlled trial or comparison to non-operative management in order to prove its efficacy.
  • IDEAL has recommendations for all stages of surgical innovation from the initial idea to the established and accepted procedure undergoing long-term studies, and incorporates the notion that each stage is unique and therefore requires different methods of reporting.
  • Alternatives to RCTs, like feasibility RCTs for procedures in the development stage, are proposed. Structured case reports are acceptable for brand new innovations that are limited to one or a few patients.
  • The IDEAL model calls for surgeons to record the goals of the innovation as early as possible to help clarify the research question, and encourages confidential reporting of negative results with impunity.
  • IDEAL recommendations take the learning curve into account and propose statistical analysis of the learning curve as well as the data, with validated methods such as the cumulative sum control chart (CUSUM) for detecting change.
  • Multiple organisations and consortia have set out specific guidelines for methodology and reporting, but IDEAL is a set of flexible recommendations, not rigidly dictated rules that must be followed.

Are you a researcher and want to get involved?

We want to hear your views on the IDEAL framework.  Use the comments box below to tell us how IDEAL measures up in your research activities, and join the discussion forum to find out whether there are others who are working on similar problems.

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