Dear Editor
Thank you for your interest in the discussion1,2. The opposing views are the energy of any debate. My role was to highlight the potential pitfalls of the collaborative research1 that my opponents strongly advocated2. Authorship was discussed because my opponents boasted about being awarded the Guinness World Record for having the most collaborators on a scientific paper, with 15 000 authors2. Authorship is serious, not to be confounded with collaboratorship, or being acknowledged.
Selection bias has haunted clinical research since its very beginning. Even when RCTs are performed, the entire population at risk is seldom reported; often less than 10 per cent of eligible patients are randomized. This explains why the registry-based RCT is such a smart innovation3. When endovascular repair of abdominal aortic aneurysms was still young, the Eurostar registry was created4. We soon realized, however, that selection bias was a major limitation of this registry. The population-based registry collaboration Vascunet, however, still prevails. It produced many high-quality scientific reports, improving healthcare worldwide5.
In the aforementioned debate, I mentioned that we did not have much help from the COVER initiative6 when we updated the European Society for Vascular Surgery 2020 clinical practice guidelines on the management of acute limb ischaemia7 in light of the COVID-19 pandemic8. We performed a scoping review, based on a systematic, yet focused, review of published data. Thus, it would have been a violation of the methodology had we included unpublished data. We did actually cite this tier 2 publication in our update: ‘Acute limb ischaemia was seen in 18.5 per cent (93 patients) of presentations for lower limb, with a documented mortality of 20.4 per cent’9. No further details were reported, however, and we were unable to draw any conclusions regarding the recommendations of the guidelines, which was the purpose of the update.
Research collaboration is great but collecting random data without necessary detail and validation is a waste of time.
Disclosure. The author declares no conflict of interest.
References
- 1. Björck M. Collaborative research: population-based data and validation are necessary. Br J Surg 2022:znac100; Doi: 10.1093/bjs/znac100 [Epub ahead of print] [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2. Li E, Bhangu A. Collaborative research in surgery: a rising tide lifts all the boats. Br J Surg 2022:znac099; Doi: 10.1093/bjs/znac099 [Epub ahead of print] [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3. Björck M, Dick F. No increased mortality risk following paclitaxel treatment in a large Swedish registry based randomised controlled trial—reassuring patient safety. Eur J Vasc Endovasc Surg 2021;61:5–6 [DOI] [PubMed] [Google Scholar]
- 4. Harris PL. The highs and lows of endovascular aneurysm repair: the first two years of the Eurostar Registry. Ann R Coll Surg Engl 1999;81:161–165 [PMC free article] [PubMed] [Google Scholar]
- 5. D’Oria M, Scali S, Mao J, Szeberin Z, Thomson I, Beiles B et al. Association between hospital volume and failure to rescue after open or endovascular repair of intact abdominal aortic aneurysms in the VASCUNET and International Consortium of Vascular Registries. Ann Surg 2021;274:e452––e459. [DOI] [PubMed] [Google Scholar]
- 6. Vascular and Endovascular Research Network Cover study collaborative . Global impact of the first coronavirus disease 2019. (COVID-19) pandemic wave on vascular services. Br J Surg 2020;107:1396–1400 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 7. Björck M, Earnshaw JJ, Acosta S, Bastos-Goncalves F, Cochennec F, Debus ES et al. European Society for Vascular Surgery (ESVS) 2020 clinical practice guidelines on the management of acute limb ischaemia. Eur J Vasc Endovasc Surg 2020;59:173–218 [DOI] [PubMed] [Google Scholar]
- 8. Jongkind V, Earnshaw JJ, Bastos Gonçalves F, Cochennec F, Debus ES, Hinchliffe R et al. Editor's choice—update of the European Society for Vascular Surgery (ESVS) 2020 clinical practice guidelines on the management of acute limb ischaemia in light of the COVID-19 pandemic, based on a scoping review of the literature. Eur J Vasc Endovasc Surg 2022;63:80–89 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 9. Benson RA, Nandhra S; Vascular and Endovascular Research Network (VERN) COVID-19 Vascular Service (COVER) Tier 2 Study . Outcomes of vascular and endovascular interventions performed during the coronavirus disease 2019 (COVID-19) pandemic. Ann Surg 2021;273:630–635 [DOI] [PMC free article] [PubMed] [Google Scholar]