Randomised Trials in Surgery: Problems and Possible Solutions: At last, Sense and Diamonds have been Recovered from an Ocean of Nonsense | Biomed Grid

I read with interest this excellent article [1] on which I congratulate and commend the authors for diving deep and wide in order to recover sense and diamonds from an ocean of irrelevant nonsense. I fully support the reported views and recommendations. It is a shame that such landmark articles are not immediately implemented by concerned bodies to become standard law of medical research and advancement, surgical research. The authors correctly concentrated on problems facing therapeutic surgical studies, and the need to differentiate from drug studies. However, it has perhaps already been realized that prospective observational diagnostic studies do significantly contribute to evidence-based medicine (EBM), with or without randomization or statistics. Such studies also start from the day of encountering the first case, does not require the approval of anybody or committee and only patients' consent is required when and as interference with approved diagnostic or therapeutic procedures is indicated.