Assessment of risk of bias in randomized clinical trials in surgery

Authors: Gurusamy, K. S.; Gluud, C.; Nikolova, D.; Davidson, B. R.

Source: British Journal of Surgery, Volume 96, Number 4, April 2009 , pp. 342-349(8)

Buy & download fulltext article:

The full text article is not available for purchase.

The publisher only permits individual articles to be downloaded by subscribers.

Abstract:

Background:

Meta-analysis of randomized clinical trials (RCTs) with low risk of bias is considered the highest level of evidence available for evaluating an intervention. Bias in RCTs may overestimate or underestimate the true effectiveness of an intervention.

Methods:

The causes of bias in surgical trials as described by The Cochrane Collaboration, and the methods that can be used to avoid them, are reviewed.

Results:

Blinding is difficult in many surgical trials but careful trial design can reduce the bias risk due to lack of blinding. It is possible to conduct surgical trials with low risk of bias by using appropriate trial design.

Conclusion:

The risk of providing a treatment based on a biased effect estimate must be balanced against the difficulty of conducting trials with very low risk of bias. Better understanding of the risk of bias may result in improved trials with a closer estimate of the true effectiveness of an intervention. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Document Type: Review article

DOI: http://dx.doi.org/10.1002/bjs.6558

Publication date: 2009-04-01

More about this publication?

As of January 2010, this journal will no longer be available on IngentaConnect, please visit Wiley InterScience to arrange continued access to this content
Access this journal at Wiley InterScience
ingentaconnect is not responsible for the content or availability of external websites