Surgical Randomised Controlled Trials

Randomised controlled trials are considered the reference standard for generating high-quality surgical evidence. PPI in surgical RCTs has been reported inconsistently and lacks a standardized implementation framework. No previous systematic evaluation of PPI has focused specifically on general and abdominal surgery. Earlier evidence found scarce PPI reporting in surgical trials and suboptimal reporting quality when PPI was described. Surgical RCTs face recruitment, attrition, blinding, outcome selection, industry bias, and patient-relevance challenges. Some criticism of PPI concerns superficial compliance, tokenism, and feasibility.