Abstract
Surgeons have long worked to produce objective evidence of the efficacy of their operations. In the nineteenth century, they increasingly used quantification and careful controls to analyse the outcomes of case series. In the twentieth century, sceptics demanded that surgeons perform randomized control trials to determine if operations relieved symptoms and improved survival. The history of these trials and the ensuing controversies has not been well studied by historians, even though it presents a valuable opportunity to examine how and why surgical judgement and standards of knowledge changed over time. Histories of surgical trials can broaden our knowledge of surgical practice and point to the limits of evidence-based medicine.
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Further Reading
Barnes, Benjamin A. and Frederick Mosteller, eds. Costs, Risks, and Benefits of Surgery. New York: Oxford University Press, 1977.
Jones, David S. Broken Hearts: The Tangled History of Cardiac Care. Cambridge: Harvard University Press, 2013.
Lerner, Barron H. The Breast Cancer Wars: Fear, Hope, and the Pursuit of a Cure in Twentieth-Century America. New York: Oxford University Press, 2011.
Marks, Harry M. The Progress of Experiment: Science and Therapeutic Reform in the United States, 1900–1990. Cambridge: Cambridge University Press, 1997.
Pressman, Jack. Last Resort: Psychosurgery and the Limits of Medicine. Cambridge: Cambridge University Press, 1998.
Schlich, Thomas and Christopher Crenner (eds.). Technological Change in Modern Surgery: Historical Perspectives on Innovation. Rochester, NY: University of Rochester Press, 2017.
The James Lind Library, Illustrating the Development of Fair Tests of Treatments in Health Care. Available at http://www.jameslindlibrary.org.
Tröhler, Ulrich. ‘To Improve the Evidence of Medicine’: The 18th century British origins of a critical approach. Edinburgh: Royal College of Physicians of Edinburgh, 2000.
Wilde, Sally and Geoffrey Hirst. ‘Learning from Mistakes: Early Twentieth Century Surgical Practice’. Journal of the History of Medicine and Allied Sciences 64 (2009): 38–77.
Acknowledgments
Funding for this “Scholarly Works” project was made possible by grant 1G13LM012053 from the National Library of Medicine, NIH, DHHS. The views expressed in any written publication, or other media, do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention by trade names, commercial practices, or organizations imply endorsement by the U.S. Government.
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Jones, D.S. (2018). Surgery and Clinical Trials: The History and Controversies of Surgical Evidence. In: Schlich, T. (eds) The Palgrave Handbook of the History of Surgery. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-349-95260-1_23
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DOI: https://doi.org/10.1057/978-1-349-95260-1_23
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