Charles Knowles 1The Trials Methodology Symposium returns to the ESCP Annual Meeting in Vienna this September, following its first outing at last year’s congress in Nice.

Professor Charles Knowles is Chair of the ESCP research committee and one of the speakers at the 2019 Trials Methodology Symposium. He believes the session will build on the success of the session in France in 2018.

Prof Knowles said:

“The Trials Methodology session builds on our first symposium last year in Nice, which we were thrilled to see was very popular and well attended. We attracted some great feedback and discussions as a result and we’ve no doubt the same will follow the sessions scheduled for Vienna this September.”

Prof Knowles believes trials methodology is a hugely underrated aspect of surgical research and its importance is often underplayed by clinical and surgical communities. He said:

“Many see the acquisition, cleaning and analysis of trial data as an unhelpful annoyance that should be left to a statistician to sort out. I wholeheartedly believe this to be the wrong approach. These factors are often the final arbiters of trial interpretation and as colorectal surgeons, we all need to hold a firm understanding of trial design and data analysis.”

In Vienna this September, Prof Knowles will open the Trials Methodology session by addressing bias in surgical research. This will look at the impact of poorly designed and constructed trials and the challenges relating to the overall standard of observational studies. Prof Knowles added:

“Surgical trials are frequently riddled with almost every known form of bias from patient selection to publication. Frankly, there are whole areas of the practice of surgery where we are completely unsure where the truth lies as a result.”

Despite this, Prof Knowles believes there is a solution. He explained:

“It is not just about randomised trial design, but revisiting how we can perform cohort studies to higher standards that mitigate nearly all of the bias in the same way a randomised trial would (with the exception of experimental allocation). We call these Enhanced Cohort Studies and they will undoubtedly form an important part of the future of surgical research.”

The session will be chaired by Professors Dion Morton and Oded Zmora and will see Prof Knowles joined by Professors Richard Hooper and Christianne Buskens on the stage. Prof Hooper, a pioneer of innovative trial design, will discuss how sequential ‘marginal gains’ can have a big impact on trial efficiency (and thus meeting recruitment targets). Prof Busjkens will then look at the issues around trial recruitment and how to build a system to recruit for randomised controlled trials and what lessons can be learned from the successful shift in the culture around trial involvement in the Netherlands.


The Trials Methodology Symposium is being held in the Plenary Hall F2 on Friday 27 September 10:20-11:40

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