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Invited Critique
November 17, 2008

A Randomized Controlled Trial to Improve Lymph Node Assessment in Stage II Colon Cancer—Invited Critique

Arch Surg. 2008;143(11):1055-1056. doi:10.1001/archsurg.143.11.1055

In this article, Wright et al report their findings addressing a quality of care improvement initiative in Ontario and share important discoveries that are appropriate to the current environment of health care quality evaluation. The authors are to be congratulated for their efforts in bringing this work forward. There are several things to appreciate in this study.

First, it is a collaborative effort of clinical health services researchers and the community (Ontario). This community-based participatory research effort, where researchers partner with a community to provide improved quality of care,1 is one that we hope will be performed with increasing frequency. The simple concept is to demonstrably improve care in an identified community, but importantly, working with the community such that the improvement has traction and is sustained. For many of the partnerships that have been established in this regard, a simple but powerful vision is for researchers to improve the level of quality of care beginning in their own backyard, not just in their own institution (although that may be included) but in the communities in proximity to their institution. It is a relatively new and important wave of research in surgery. It is an achievable and meaningful way to perform research, and one that Wright et al have nicely undertaken.

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