LAUSR

Crocker et al. have highlighted an important issue faced by institutions running surgical trials. Recruitment challenges can prevent trials from running, rendering all the time and expertise taken to design the trial fruitless. There has been a surge in investment in surgical trials in the past 5 years and so the demand on the public to become participants has increased. As the number of trials running increases, so does the importance of understanding the current barriers to recruitment and retention. Crocker et al. designed their study with advice from published reviews and then adjusted according to feedback from one-toone cognitive debriefing. Only three members out of the 18 in the pilot sample represented patients or the public; they felt that the survey should not be sent to patients as they did not feel sufficiently involved in the process to offer valuable feedback. It would be difficult to cater for both professionals and patients in the same form as they represent different experiences, but I wonder if there are issues including convenience barriers for which patients have a better insight as they have known them themselves through experience. Participants forgetting to return their questionnaires were reported as a serious to moderate problem by the majority of responders, which could encompass a wide variety of reasons only known to the participants themselves. The study involved 151 respondents with a wide range of professional backgrounds and geographical locations within the UK. This study shows that similar issues are being faced consistently across different centres. This valuable study offers an insight into the scope of common issues and a basis to spark discussions on how to deal with complex issues including lack of equipoise, small pools of eligible patients, and several practical issues associated with running a trial.