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Randomized Clinical Trials in Surgery:Dilemmas and Solutions

Zhang Shimin,Hou Chunlin,Second Military Medical University Shanghai 200433  
Clinical Studies are alway being influenced by epidimiologic theories and methods.Because randomized clinical trial (RCT) creates a well-controlled enviroment which is very similar to animal experimental studies,it has won a great reputation as the golden standard in clinical comparative investigations.Nowadays in clinic,RCT has been extensively applied in many research fields such as selecting diagnostic techniques,evaluating drug effectives and assessing prognoses.However,RCT studies in surgery have run into dilemmas.After a current state review of surgical clinic investigations and a discussion on the specific difficulties of developing surgical RCTs,the authors propose some feasible approaches to solve the problems by adopting the scientific core of RCT methodology,which may greatly improve the scientific value of surgical clinic studies.
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