Equipoise and randomisation in surgery

Abstract

In science, when a prevailing model does not fit reality the model is changed to fit better. The process is often accompanied by noisy attempts from some quarters to change reality to fit the model. So it is with randomised trials in surgery, the letter of Helmy et al. being an example. The randomised model used in drug trials does not fit surgery well for several well-rehearsed reasons, a significant point of poor fit being the question of equipoise.

Key words:

• Equipoise
• randomisation
• trial
• surgery
• uncertainty principle

Declaration of interest: The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper.