The centre will be led by Jane Blazeby, Professor of Surgery at the University of Bristol and Honorary Consultant Surgeon at University Hospitals Bristol NHS Foundation Trust, in collaboration with University academics, Drs Chris Rogers and Alan Montgomery, Senior Statisticians; Gianni Angelini, Professor of Cardiac Surgery and Ashley Blom, Professor of Orthopaedic Surgery. The centre in Bristol is one of five across the country that has been awarded by the Royal College of Surgeons of England.
The gold standard way of evaluating new healthcare interventions and comparing standard treatments is to perform randomised trials. This is challenging in surgery for several reasons. Firstly, surgeons can find it difficult to talk to patients about treatment uncertainties and the need for treatment to be allocated by randomisation. Secondly, it is difficult, or often impossible, to compare an operation with a ‘placebo’ or ‘sham’ procedure, which can more easily be done in trials of new drugs where a ‘placebo’ or sugar tablet can be used.
These challenges mean that historically few surgical randomised trials have been undertaken. Therefore practice is not based on scientific evidence from trials, but rather on individual surgeon or patient preference leading to variation in operations and when to perform them.
Professor Jane Blazeby said: “Over the next decade the Bristol Surgical Trials Centre, working with other centres, surgeons and scientists, will establish evidence and train a new generation of surgeons who understand and participate in randomised trials. This will ensure that in the 2020s and beyond surgery will be based on evidence and improved standards of surgery will be established.”
Professor Norman Williams, President of the Royal College of Surgeons, added: “Surgery is under-represented in health service research. In order to address this we are joining forces to ensure that a nationwide network of surgical trials centres, which focus exclusively on clinical trials, will raise surgical standards and transform the quality of patient care across the breadth of surgery.”
The Bristol Surgical Trials Centre, based in the University, will be closely linked to the two clinical trials units: the Bristol Randomised Trials Collaboration and the Clinical Trials and Evaluation Unit and the MRC COnDuCT Hub for Trials Methodology Research.
The centre will benefit from established local relationships with the NIHR Cardiovascular Biomedical Research Unit, the NIHR Nutritional Biomedical Research Unit, and the NIHR Head and Neck 5000 Programme Grant within University Hospitals Bristol NHS Foundation Trust and the Musculoskeletal Research Unit at North Bristol NHS Trust.
The University of Bristol, University Hospitals Bristol NHS Foundation Trust and North Bristol NHS Trust are also part of the Bristol Health Partners, whose aim is to transform the understanding, prevention and treatment of key health problems in Bristol.
The centre will work with SPARCS (Severn and Peninsula Audit and Research Collaborative for Surgeons), which is a surgeon trainee-led research collaborative spanning Severn and Peninsula Deaneries. The SPARCS natural network formed by 90 higher surgical trainees rotating through regional hospitals allows trainees to successfully undertake multi-centre research and to make substantial contributions towards recruitment.
The network of surgical trials centres across the UK has been established by the Royal College of Surgeons and partners including the National Institute of Health Research, Cancer Research UK and the Rosetrees Trust.
The surgical trials centres will be located in Birmingham, Bristol, Liverpool/Manchester, London and Oxford.
The Bristol centre will open this year and is funded for five years.