Standardization of surgical procedures is both feasible and necessary in clinical trials. To the extent that an operation may influence prognosis, identify prognostic factors, or reveal variables upon which additional treatment is contingent, the operation must be defined precisely enough to permit the determinations to be made uniformly and to enable the surgeons to meet the necessary standardization. If uniform procedures are to be applied widely, surgeons who participate in therapeutic trials must meet the standards of clinical scientists and accept special obligations for eduction and self-discipline.
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