Collaborative research in surgery: a rising tide lifts all boats

Abstract

Collaborative research is not about authorship.It is about delivering rapid benefit to patients and engagement of wider communities.Single-centre publications of highly selective, niche populations are common, but inefficient and weak.Research that unnecessarily excludes women, the elderly, or ethnic groups further reduces the validity of any findings and cannot be applied to other settings.The balance of power skewed towards a small number of top-line authors removes benefits from patients.Finally, research using data that are many years old is increasingly lacking relevance.Collaborative research solves these problems, and fundamentally prioritizes delivering tangible outputs on behalf of patients.Any benefits to surgeons are secondary.Collaborative research studies are multicentre and often multicountry 1-4 .This means a diverse range of patients is included, typically from different resource settings and socioeconomic statuses.This makes the findings representative of wider populations, meaning that the results are generalizable and relevant to more patients.The scale of collaborative studies can efficiently generate high-quality prospective data while maintaining a low burden of commitment for individual collaborators.The subsequent large data sets reduce outlying results, provide the opportunity to answer multiple research questions, and are relevant to numerous subgroups of patients.In short, collaborative research is a highly efficient method of generating research data using streamlined and available resources.As a community, collaborative researchers are also learning to publish more rapidly.Working with journal editors, the release of data is fast approaching real-time findings.This has been shown to be invaluable in rapidly evolving situations, the most recent and prominent example being the COVID-19 pandemic 1,2,5 .Collaborative research is not restricted by study type or structure, and is both randomized and non-randomized.The FALCON 2 , ROSSINI 6 , FOxTROT 7 , and STAR-TREC 8 trials are examples of collaborations that are producing practice-changing research.FALCON completed recruitment of 5800 patients in 24 months and published within 3 months of closing.It is relevant to patients all over the world.The COVIDSurg Collaborative is an example of non-randomized collaborative study 1,3,5 .In the wake of the COVID-19 pandemic, these studies united surgeons from 116 counties and rapidly produced patient-level data which changed practice across the world.The first protocol was developed in 3 days, and the results were published in 30 days

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