High-quality randomized clinical trials provide the stimulus for quality improvement and are critical for the generation of best practices in surgery. However, despite their profound impact on patient care there remains a scarcity of these studies. While this is well recognized, the considerable time commitment and prerequisite research infrastructure are significant challenges to their design and execution. The paucity of high-quality clinical trials to help guide surgical technique and perioperative care has led to substantial healthcare practice variability and inefficiency.

The Innovative, Multicentre, Patient-centred Approach to Clinical Trials in Surgery (IMPACTS) program was established with the purpose of conducting patient-important and pragmatic clinical trials more efficiently by addressing the current barriers that exist in the current clinical trial paradigm using novel approaches to research methodology and technology. A robust clinical trial infrastructure and new innovative clinical trial design will allow IMPACTS to increase patient accrual and optimize efficiency, thus reducing the time to achieve meaningful results.

IMPACTS is currently collecting questions pertaining to areas of uncertainty in surgical technique and perioperative care in order to create a database of high impact issues that exist currently in the surgical community. We invite you to contribute to this “database of uncertainty.” Your questions will be systematically assessed to determine if relevant evidence exists and whether the topic would benefit from a clinical trial. You will also have the opportunity to be involved in any future research your question generates. Questions can be submitted through the survey on our website (, by email at or via twitter (@impactsprogram).