Diversity Challenges and Opportunities for Randomized Controlled Trials in Cardiothoracic Surgery

Abstract

In this issue of The Annals of Thoracic Surgery, the article by Gaudino and colleagues 1 Gaudino M. Chikwe J. Bagiella E. et al. Challenges to randomized trials in adult and congenital cardiac and thoracic surgery. Ann Thorac Surg. 2022; 113: 1409-1419 Abstract Full Text Full Text PDF PubMed Scopus (5) Google Scholar concerns an expert review of the challenges in randomized controlled trial (RCT) design, conduct, financing, and support base in the setting of adult and congenital cardiac and thoracic surgery. The authors are to be congratulated because it is very informative in touching the major challenges relevant to RCTs in the setting of cardiothoracic surgery. It does leave the reader feeling a bit dispirited, because there seem to be so many challenges and so few (potentially) effective solutions. Challenges to Randomized Trials in Adult and Congenital Cardiac and Thoracic SurgeryThe Annals of Thoracic SurgeryVol. 113Issue 5PreviewRandomized trials in surgery face additional challenges compared with those in medicine. Some of the challenges are intrinsic to the nature of the field (eg, issues with blinding, learning curve and surgeons’ experience, and difficulties in defining the appropriate timing for comparative trials). Other issues are related to the surgical culture, the attitude of surgeons toward randomized trials, and the lack of support by professional and national bodies. In this review, a group of investigators with experience in trials in congenital and adult cardiac and thoracic surgery discusses the key issues with surgical trials and suggests potential solutions. Full-Text PDF