Null Seeking Trials General Randomised Model of Research

Null Seeking Trials

A new method of conducting clinical trials in surgery.  Randomized control trials have been successful in medical research over the past hundred years, but surgery has not enjoyed the same benefit as medicine. Few trials have been conducted within surgical specialties and the large majority of those that have, have been conducted on medicinal products rather than operations. Significantly less than 1% of all trials conducted in health care have been done on surgical operations. The reason for this is that the standard randomized controlled trial method uses a mathematical model which is a good fit to the decision making process about administering a drug, but is a poor fit to the process about doing an operation.

Therefore we developed a new model that is a good fit to the surgical decision making process. However, this model significantly departs from standard healthcare epistemology in that it does not seek to demonstrate a significant treatment benefit in a predefined group of patients, but rather it seeks to establish the range of circumstances over which an operation may be beneficial and the range over which it may be harmful. It does this by establishing the circumstances in which the operation has the same net effect as no operations, hence term "Null Seeking Trial".  

Though this is a potentially powerful research technique that could bring to surgery the benefits that medicine has already enjoyed from randomized trials, it is conceptually difficult to understand because if its novel epistemology.