Moving forward: ensuring quality research in vascular surgery during COVID-19

Abstract

In their article, Valdivia and Chaudhuri discuss the impact of deaths from the coronavirus disease 2019 (COVID-19) on the outcomes of trials and registries, importantly highlighting the negative impact on the accuracy of databases and calling for improved guidelines surrounding mortality reporting. 1 COVID-19 is a double-edged sword: while it has brought new research questions amidst times of uncertainty, it has equally complicated traditional academic pursuits. Although trials and registries should be considered in a case-by-case manner, timely interventions are needed to protect participants’ safety first and foremost. Studies, where possible, should consider halting or delaying the recruitment of new patients, establishing on-site precaution measures, and maximizing follow-ups via telemedicine. 2 , 3 Revision of statistical analyses, data interpretation, and protocols is unavoidable as, similar to patient safety, integrity in research should remain prioritized. This pandemic can, however, also become an opportunity to revisit how clinical research is conducted. Learning from current challenges in accounting for heightened mortality due to COVID-19, trials and registries need to be structured for unexpected events that would significantly influence the number of participants or their outcomes. Future pandemics and global crises are bound to occur and devising pre-specified protocols for patient follow-up, data storage, and human resource management will be crucial in ensuring the consistency of clinical research when resources are redirected towards emergency response. 3 , 4 Furthermore, there is potential for a larger role for citizen-driven science and self-reported outcomes in advancing pandemic-related research and beyond, reducing the burden on clinical providers and scientists whilst still ensuring the advancement of our field. One silver lining of the pandemic for research will be the vast body of literature that is being generated on disease-specific outcomes affected by COVID-19. 5 New international collaboratives like the Vascular Surgery COVID-19 Collaborative (VASCC) and the COvid-19 Vascular sERvice (COVER) are actively collecting information on the consequences of surgery delays and COVID-19 infections in vascular patients. 6 , 7 Only through cooperation, transparency, and solidarity between researchers will we be able to bounce back from the darkness of the COVID-19 era and build resiliency into surgical research to navigate future crises.