RSTN Trials Day 2017

RSTN TeamClinical trials, Scientific Meeting

The 2017 Trials Day was very well received by delegates and sponsors alike. Following an introduction from the organising committee and Mr Stephen Hamilton on behalf of the primary sponsor, PRASIS, we kicked off the day with the sandpit session.

There were 5 tables: Suits, Scar Free, Adelaide, Wound Busters and Dress to Impress. Facilitated by Professor Jane Nixon and Mr Matt Gardiner, each team worked to develop a trial idea around the theme of wound healing. Suits put forward a trial on the use of negative pressure wound therapy in contaminated wounds. Scar Free were interested in looking at the use of topical antimicrobial ointment versus paraffin ointment on the hands and face. The Adelaide team proposed a trial comparing absorbable and non-absorbable sutures on the face in both elective and traumatic wounds. Wound Busters looked at prevention of wounds in high risk patients. The Dress to Impress team proposed a trial to investigate surgical wounds following groin dissection. Each team refined their proposed population, intervention, comparison group and outcome measures using the PICO format before presenting their ideas to the rest of the delegates. Using interactive online voting, Team Adelaide with their idea of absorbable vs non-absorbable sutures on the face for elective and traumatic wounds were voted the winners.

Following the tea break, Mr Richard Wilkin gave the first key note speech on GlobalSurg and their international success. He discussed the history of GlobalSurg and some of the ways the team overcame early obstacles to build their network from a regional team into an international organisation. Richard  emphasised the power of collaboration and the importance of allowing large numbers of citable authors on publications when appropriate. He has also had strong links with patient advocates which has enhanced the success of GlobalSurg’s projects.

We then moved on to the Bell session, where updates were provided for many of the RSTN studies. Please see the Trials Day abstracts for further details. After lunch, Professor Xavier Griffin from the University of Oxford gave a key note speech on his experience with clinical trials in Orthopaedics, specifically as part of the UK Trauma Research Network. He discussed the importance of picking an inclusive first trial idea to encourage recruitment of surgeons to the trial and collaborative working practices. He described the success of DRAAFT trial, an orthopaedic trauma trial comparing Kirchner wire and volar locking plate fixation of distal radius fractures – one of the most common orthopaedic injuries. The impact of the study was evident on national statistics of distal radius management, which demonstrated a huge shift in management and change in practice. Professor Griffin also discussed the use of nested studies and multi-arm multi-stage trial design to maximise output from large clinical trials.

The next session ‘Ideas to RCT’ session was chaired by Professor Jane Nixon. A panel of experts built on the winning trial idea from the sandpit session to demonstrate the next steps needed to develop this idea further. Professor Jane Nixon refined the PICO format, and elaborated on the importance of equipoise before embarking on a study. Professor Jonathan Cook highlighted the importance of careful trial design early on. He advised that analysis cannot rescue a poorly planned trial, and that with a well-designed study, it is possible to maximise value whilst maintaining scientific integrity. Professor Xavier Griffin reinforced that a good systematic review is important, but requires careful planning and organisation. Claire Thomson advised on how to ensure effective patient and public involvement in developing a trial idea and where to look for appropriate funding streams. Finally, Mr Saahil Mehta provided the trainee perspective on many of the common pitfalls encountered in developing a trial idea and bringing it into clinical practice.

The day concluded with the annual Vipers’ Nest session. Four trial ideas were pitched to the Vipers, further information for which can be found within the Trials Day abstracts. Following interactive voting, Anita Dijksterhuis from the Netherlands won for her pitch ‘Trigger’, investigating the best way to treat trigger finger: surgical release versus steroid injection therapy. The event concluded with a reception at Tom’s Terrace, Somerset House.