Randomized Clinical Trials in Surgery

To the Editor: In the Sounding Board that appeared in the July 5 issue, Dr. Bonchek compares coronary bypass to accepted operations such as appendectomy and pneumonectomy, indicating that we would not have these valued procedures if controlled randomized trials had been required for their acceptance. He would include one operation (appendectomy) that is curative and used to treat an acute illness associated with a high mortality rate if not treated surgically. In the second case, he mentions a neoplastic disease that is fatal if it cannot be treated with pneumonectomy. He would have us put these two procedures and.