Table 1 Participants’ perceived potential advantages and disadvantages of an expertise-based versus a standard trial design

Advantages

 Greater accommodation of surgeons’ treatment preferences

 Treatments performed in their ‘best light’

 More appealing to patients

 Better suited to some clinical settings

Disadvantages

 Added complexity in terms of site set and administration, including greater co-ordination between surgeons required

 Design specific challenges which need to be addressed (e.g. defining an expert)

 Impact upon the patient-surgeon relationship

 Relation to clinical practice

 Perception of stakeholders