RCT’s are not an appropriate Gold Standard for determining the Effectiveness of Surgical treatment
Presentation given by Dr Sears in a debate about the role of Randomised Controlled Trials in Spinal Surgery.
Medtronic Ageing Spine Symposium
Sydney, August 18th 2017
Medtronic Ageing Spine Symposium
Sydney, August 18th 2017
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The pdf file, which may be downloaded via the link above, is an abbreviated version of the presentation given by Dr Sears in a debate over the role of Randomised Controlled Trials (RCTs) and their place on the Evidentiary Hierarchy when assessing the efficacy of spinal surgical treatment. The debate was part of the 2017 Medtronic Ageing Spine Symposium.
In his presentation, Dr Sears discussed differences between surgical and pharmaceutical research. He explained the significance of heterogeneity when considering surgical conditions and treatment outcomes. The ethics of placebo surgery were discussed. The issue of investigator and participant bias was considered, not only its potential influence on individual trial outcomes, but also the possibility of investigator bias influencing meta-analysis outcomes through choice of statistical methodology.
Well designed, ex vivo research and clinical, observational research (through large prospective databases and registries) should continue to provide real world evidence when considering spinal surgical outcomes.
In his presentation, Dr Sears discussed differences between surgical and pharmaceutical research. He explained the significance of heterogeneity when considering surgical conditions and treatment outcomes. The ethics of placebo surgery were discussed. The issue of investigator and participant bias was considered, not only its potential influence on individual trial outcomes, but also the possibility of investigator bias influencing meta-analysis outcomes through choice of statistical methodology.
Well designed, ex vivo research and clinical, observational research (through large prospective databases and registries) should continue to provide real world evidence when considering spinal surgical outcomes.