The influence of carrying out multicentre trials on surgical practice in general surgery departments

Introduction: Despite the introduction of treatment guidelines, hospital practice differs from the described standard. Data reported by the Polish National Fund of Health show that only about 50% of hernias are repaired using an implant. This study evaluates the influence of multicentre trials on daily practice in general surgery wards. Material and methods: In the years 2002-2006, the Polish Hernia Study Group conducted 3 randomised trials involving the use of implants used in tension-free methods. Seventy-two doctors were questioned before the trial and at the end of the study. In the questionnaire, factors influencing the choice and the trust in the operating method, the sources and the accessibility of scientific information, the doctors' educational needs and factors able to influence the change of the operating technique were studied. Results: Information from the literature was noted as the most important factor influencing the choice of operating method (64%). Also 70% of respondents based their decision on trust in the operating method. Trust in the results of research available in the literature grew considerably (from 65 to 95% of respondents), as did trust in the information delivered by the representatives of medical companies (from 8 to 39%). Level of confidence in older colleagues, that is in the trends dictated in respective centres by ward heads, fell from 78 to 21%. Conclusions: Carrying out multicentre trials on surgical practice in general surgery departments increases the standard of treatment and motivates surgeons to research modern operative techniques.