The Vascular and Endovascular Research Network (VERN)

The Vascular and Endovascular Research Network (VERN) was set up to promote research, to improve the treatment of vascular diseases and to improve the synthesis and dissemination of evidence. The network represents a particular form of collaboration involving trainee doctors and specialists from a wide variety of medical disciplines. It undertakes multicentre projects, which are mostly observational studies and the data collected are analysed and published in a short period of time. This form of research has several advantages including fostering collaboration between different institutes, countries and researchers with different levels of expertise. It also promotes accelerated delivery of evidence and individual professional development. The network has an executive committee that meets every 2 weeks to discuss projects and the entire committee meets every month. An appointed member of the executive committee coordinates the centres participating in projects. Although there has been some scepticism with respect to research collaboratives, raising concerns over the accountability and the contribution of authors, it is paramount that research conducted by a collaborative maintains the same scientific rigour and ethical standards as research conducted by individual academic units.

The Vascular and Endovascular Research Network (VERN) was formed in 2013 and is a trainee surgeon-led research collaborative.VERN aims to undertake and promote high quality research across the United Kingdom (UK) and beyond, to improve the care of people with vascular diseases through evidence synthesis and dissemination.Although led by vascular surgeons in training, members of the multidisciplinary team joining in the care of vascular patients are welcome on the executive committee.

Surgical research collaboratives
A research collaborative describes a group of individuals who work together to un-dertake a project to produce new knowledge.Whilst collaboration is commonplace within all spheres of research, this model describes a particular type of collaboration, which harnesses the enthusiasm of trainee doctors and other allied healthcare professionals.Projects are almost always observational, follow a predefined protocol, require only simplistic data collection from each centre over a relatively short period of time, and are centrally analysed and disseminated.To recognise contributions, all individuals participating in the study receive co-authorship on final published outputs.This model of research has several advantages.

Interorganisational partnerships.
Collaboration between trainee surgeons at different institutions fosters working relationships with the exchange of ideas and resources.The experience of individual members will vary, offering the opportunity for idea generation and mentorship which continues into consultancy practice, harmonising care across regions and even nations.These skills help to promote future healthy working ecosystems [1].
Accelerated outputs and impact.The productivity and power of research outputs from collaboratives is multiplied.They offer an opportunity for distribution of the workload over a team of individuals, making collaborative research costeffective, and access to a greater pool of potential participants/patients, increasing the volume of data gathered in a short space of time.The COVER study, which went from conception to recruitment in approximately 3 weeks [2], is an example of this.For example, the GIVE study recruited 1039 patients in 9 months [3] and international data were gathered in the COVER study, which recruited 1801 patients from 19 countries [2].Additionally, the dissemination of study findings is substantially increased as there are many collaborators who are invested to share their work and ultimately improve patient care.This accelerated delivery of evidence is a key advantage to collaboration [4].

Individual professional development.
There are also advantages to the individual vascular surgeon in training by contributing to research collaboratives.For those starting out in research, participating in collaborative-led projects offers a supportive environment to learn how research is undertaken, contribute to research, building knowledge and confidence to design their own projects.For the more experienced academic vascular surgeons in training, a research collaboration offers the opportunity to widen participation in their own research project by providing access to multicentre data and enables contribution to studies in multiple areas of interest.Collaborative research also encourages the development of key interpersonal and team working skills that can be applied to day to day clinical and academic practice.
Some researchers have expressed scepticism in research collaboratives, raising concerns over the accountability of research collaboratives and the contribution of authors [5].It is paramount that research conducted by a collaborative maintains the same scientific rigour and ethical standards as research conducted by individual academic units.Projects must have a predetermined purpose, rationalised data collection, data validation, and authorship criteria.Accountability of research collaboratives is best placed in a committeebased model to mitigate the risk of individual malpractice [6].

The Vascular and Endovascular Research Network model
The Vascular and Endovascular Research Network is a committee-based surgical research collaborative.A core executive committee, led by a president supported by a vice president, collaborates with external vascular groups to deliver multicentre national and international studies.Since VERN's inception, original members of the executive committee have completed their training and begun work as consultant vascular surgeons.Several of these remain in VERN as senior committee members and provide invaluable advice and guidance to the trainee committee members.The executive committee meets every 2 weeks to discuss projects and the entire committee meets monthly.The conduct of members and running of the collaborative is outlined in the VERN constitution.The VERN projects are developed by members of the committee, or in collaboration with an external project lead, and can be a survey, audit, observational study or trial.This has been refined and developed over time and is now a very efficient and effective process.The composition of the executive committee has also matured in recent times and now includes specific roles, for example the communications lead whose role is to communicate upcoming studies via social media and the VERN website (www.vascular-research.net).Once the design of the project is finalised, it is advertised to the wider vascular community through mailing lists, newsletters and social media to recruit interested centres and individuals to contribute to the research project locally.An appointed member of the executive committee is the point of contact for the collaborating centres.Their role is to facilitate new centres joining and provide support to centres during the study period.Thereafter, publication is synergistic across the executive committee with an effective working environment encouraged through proactive leadership [7].
Study collaborators are recognised through the collaborative authorship model.All those meeting the International Committee of Medical Journal Editors (ICMJE) requirements for authorship are listed in the published manuscript and are searchable on databases such as PubMed.This is an incentive to participate in research, as in the UK vascular curriculum collaborative research authorship is a recognised academic output when completing vascular training, thus supporting career development of vascular surgeons.
VERN also offers support to individual researchers across the vascular community.This includes the distribution of e-surveys, projects and providing advice when designing and delivering research.The committee invites anyone requiring research assistance to approach the committee without expectations, the academic world can seem a little daunting to some and speaking to trainees in the same situation is often fruitful.
There is a close professional relationship between VERN and the Royal College of Surgeons of England surgical specialty leads, the Vascular Society of Great Britain and Ireland, and the Vascular Society Specialist Interest Groups in the development and delivery of projects.This is a mutually beneficial partnership where academic leaders, trainees/early career academics, and the wider vascular surgery community, have the resources to deliver high quality, impactful research.Furthermore, this adds external validity to the work of the collaborative and provides a vehicle for dissemination or promotion.

Outputs from the Vascular and Endovascular Research Network
With the support of hundreds of collaborators from around the globe, VERN has been able to deliver a number of impactful research studies.The Groin Incision in Vascular Exposure (GIVE) study [3] and the COVID-19 and Vascular Service Study (COVER) [2,8,9] are two of the largest studies that VERN has delivered to date, both recruiting over 4200 patients across 19 different countries.Outputs from these studies have informed grant applications, trial designs, as well as helped to shape guidelines, such as the Vascular Society of Great Britain and Ireland guidance during the COVID-19 pandemic [10].All information on past and current projects and publications is available on the VERN website (http://vascular-research.net/).
The VERN executive committee hosts a yearly research competition at the Vascular Society Annual Scientific Meeting.Vascular healthcare professionals, including vascular surgeons in training, are invited to submit an abstract outlining a research proposal.Short-listed proposals present their idea to a panel of eminent vascular healthcare professionals and researchers in a "Dragons' Den" style event to win a research grant and VERN support for their research.Previous winning projects include the FAVE [11], VISTA [12] and DRESSINg [13] projects.This is an exciting opportunity and encourages engagement from the wider vascular community, promotes vascular research as something attainable by all, and is an entertaining part of the scientific meeting.
In summary, research collaboratives offer vascular surgeons in training the opportunity to develop their research experience, contribute to high quality multicentre trials and lead impactful research studies in a supportive setting.The VERN collaborative has demonstrated that vascular surgeons in training are able to work together to successfully deliver surveys, audits and research projects that contribute to the wider knowledge of vascular disease and impact clinical practice.Many of these collaborative relationships have continued into consultant practice, both clinically and academically.In our view research collaboratives are essential contemporary tools that not only provide accelerated knowledge but also ensure a harmonious and vibrant interinstitutional vascular community.For this article no studies with human participants or animals were performed by any of the authors.All studies mentioned were in accordance with the ethical standards indicated in each case.

Das vaskuläre und endovaskuläre Forschungsnetzwerk (VERN). Ein multidisziplinärer Verbund für Gefäßchirurgen in der Ausbildung
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