A comparison of the colorectal surgical research across Europe, USA and Australasia

Aim The annual scientific meetings of the Association of Coloproctology of Great Britain and Ireland (ACPGBI), the American Society of Colon and Rectal Surgeons (ASCRS), the European Society of Coloproctology (ESCP) and the Royal Australasian College of Surgeons (RACS) are the major fora for presentation of colorectal surgical research. Thus, their content could be a proxy of the content and quality of colorectal surgical research worldwide. We aimed to critically appraise the quantity, quality and topics of colorectal surgical research over the previous 5 years for the above meetings. Method All published abstracts from the ACPGBI, ASCRS, ESCP and the colorectal-specific component of the RACS from 2006 to 2010 were appraised. Abstracts were coded by predefined categories pertaining to study type and topic. Results Level 1 evidence (systematic reviews/meta-analyses) and level 2 evidence (randomized controlled trials) comprised 3% (95% CI 19%) and 5% (95% CI 211%), respectively, of research presented at the meetings. There was a predominance of level 4 evidence (retrospective studies) across all years (mean 54%, 95% CI 4468%). Operative management was most commonly studied (mean 43%, 95% CI 3649%). There was minimal research in perioperative care (mean 6%, 95% CI 213%) and basic surgical science (mean 6%, 95% CI 211%). Research related to perioperative care was significantly higher at the ACPGBI and RACS meetings than the ASCRS and ESCP meetings (P < 0.01). Conclusion The research at these meetings consists largely of retrospective reviews exploring operative management with minimal high quality scientific content. Active steps need to be taken to increase the quantity of high level evidence especially in topics other than operative management.