From Short-term Surgical Missions Towards Sustainable Partnerships: Complete Statistical Analysis

1. Trial at a Glance

This page covers the registry results for From Short-term Surgical Missions Towards Sustainable Partnerships (NCT04450823), a registered phase not stated study. The primary outcome is Q7: Country Where the Last Mission Took Place.

2. Clinical Question

3. Trial Design

The registry describes “From Short-term Surgical Missions Towards Sustainable Partnerships” as a survey among members of foreign teams. It lists no intervention other than “no intervention,” consistent with an observational survey rather than a clinical treatment trial. The study status is completed. The registry lists enrollment of 61; it does not say whether that figure represents people approached, enrolled, responding, or included in the final analysis.

The record gives a start date of 2019-06-01 and a primary completion date of 2019-10-30. It describes an online questionnaire covering basic characteristics of missions, main activities, follow-up and reporting, the local registration process for foreign teams, and collaboration with local stakeholders. The survey’s stated aim was to develop recommendations for people and organizations involved in surgical missions, with the broader goal of strengthening surgical care in low- and middle-income countries.

No randomization, allocation, control group, or treatment arms are described; allocation is not stated. The record explicitly notes that this is not a randomized comparison and that any arms are not a like-for-like control comparison. Recruitment methods, participating locations, survey distribution, response rate, and the approach to incomplete questionnaires are not reported in the registry record. The record also does not describe a protocol for sampling, respondent verification, or analysis. Consequently, the registered design supports interpretation as a survey of mission-related experiences, not as a controlled estimate of the effect of a particular mission model.

4. Participant Flow and Accounting

The registry reports how participants moved through each stage of the study. All counts below are exactly as posted; missing counts are not inferred from other stages.

Overall Study

5. Baseline Characteristics

The table reproduces the baseline characteristics posted in the registry, which describe the participants analysed at baseline and help show whether the randomized groups were comparable.

6. Primary Endpoint

The registry lists the primary outcome as Q7: Country Where the Last Mission Took Place, measured over approximately 20 minutes.

The primary measure is titled “Q7: Country Where the Last Mission Took Place.” It asks respondents which country hosted their most recent mission, and the listed unit is participants. The measure is therefore a count of participants’ answers to a descriptive question, not a measure of health status, surgical outcomes, or change over time. The registry gives a timeframe of approximately 20 minutes, but does not clarify how that timeframe relates to the question beyond listing it alongside the primary measure.

Recording the country of a respondent’s last mission can help describe where the surveyed foreign-team members had recent mission experience. In general, a location question can provide context for interpreting other survey answers, since reported activities and collaborations may be situated in different settings. However, the primary question alone cannot establish how representative the respondents are of all foreign teams or missions, nor can it measure the sustainability or consequences of those missions.

The country responses and the number of people answering the item are not reported in the registry record. Without those results, the registered endpoint cannot be interpreted as a distribution of missions across countries. It remains a description of what the survey intended to ask, rather than a reported finding.

7. Why No Re-analysis Is Shown

8. Statistical Interpretation

9. Statistical Methods Explained

The registered primary measure is a count of participants answering a question about the country of their last mission. A count describes the number of responses meeting a defined condition. For a question with country responses, a full descriptive account would ordinarily identify the response categories and report the number of answers in each category, along with the number of missing or unusable answers. The registry record does not report those values, so no country-level distribution can be interpreted.

General explanation: counts are often accompanied by percentages when the denominator is known and clearly defined. The denominator might be all enrolled participants, all survey respondents, or only people who answered a particular item. These denominators answer different questions. They should not be treated as interchangeable, and counts should not be added or compared without knowing whether response categories are mutually exclusive and whether all participants were included. The registry record does not identify an analyzed denominator for the primary question.

The primary question is descriptive, not a treatment contrast. A treatment-effect estimate generally compares outcomes between groups under a design that defines those groups and the intended comparison. Here, the registry does not report a randomized allocation or a like-for-like control group. Consequently, a difference between any groups that might be constructed from survey responses would not automatically be an effect of a mission strategy. Such an interpretation would depend on the question, group definitions, relevant confounding factors, and the analysis plan, none of which are reported for a comparative analysis.

The registry lists 0 analyses. This is not a reported estimate of zero effect or a finding that no outcomes occurred. It means that no analyses are listed in the record’s analysis information. The record does not provide p-values, confidence intervals, model estimates, standard errors, or other inferential results. A p-value, in general, summarizes how incompatible data are with a specified statistical model and null hypothesis; it is not a measure of effect size or practical importance. A confidence interval gives a range of values compatible with the data and model at a stated confidence level, but its width depends on the data and assumptions. Neither statistic can be interpreted for this survey from the registry information.

General explanation: count outcomes may be analyzed with methods suited to discrete data. A basic count model can be inadequate when the variability in counts exceeds what that model assumes; this is called over-dispersion. If over-dispersion is present, uncertainty estimates from an overly restrictive model can be misleading. There is no reported count-model analysis, distributional assessment, or evidence about over-dispersion in the registry record. In any case, the primary measure is a count of participants’ answers, and no model-based result is reported.

The registry includes planning assumptions for an illustrative sample-size calculation: a two-sided significance level of 0.05, equal allocation between two arms, a normal approximation, and an effect defined as a stated fraction of an observed effect. It also distinguishes participant-per-arm illustrations from total-event illustrations for time-to-event outcomes. These are general planning assumptions, not evidence that the survey used two arms or had a randomized design. The record does not report a trial-specific sample-size justification, and the enrollment figure alone does not show that a particular power target was achieved. A sample-size illustration is not observed power and does not establish that a result is precise.

General explanation: a planned sample size is chosen before data collection to address a specified question under assumptions about the outcome, effect of interest, variability, significance threshold, and analysis. Changing those assumptions changes the planning result. In a survey, the ability to describe a population also depends on how respondents are selected and whether people who do not respond differ from those who do. The sampling and response information needed to assess those issues is not reported in the registry record. No conclusions about the precision or generalizability of the survey estimates can therefore be drawn from enrollment alone.

The registry does not report an analysis model or an approach to missing questionnaire items. General methods for missing data depend on why responses are absent and on the estimand—the quantity the analysis is intended to describe. Treating missing answers as if they were observed, or using an unclear denominator, can distort a descriptive result. Since item completion and missing-data handling are not documented, the possible influence of missing responses cannot be assessed.

10. Multiplicity, Missing Data and Analysis Populations

The registry lists 14 outcome measures, while no analyses are listed. It does not report which measures were designated as primary or secondary beyond the named primary question, nor does it give results for the other listed measures. The presence of multiple outcomes can create a multiplicity issue when many hypotheses are tested: the chance of at least one apparently unusual result can increase as the number of tests grows. In general, a prespecified analysis plan may identify a primary question, limit confirmatory testing, or use an adjustment strategy. No multiplicity strategy is reported in the registry record, so it is not possible to determine whether or how multiple outcomes were handled.

Missing-data information is also absent. The record does not report how many participants completed the survey, how many answered the primary item, whether questions could be skipped, or how incomplete responses were treated. Those details matter because a count of responses needs a clearly defined denominator. If people who do not answer differ systematically from those who do, the observed answers may not reflect the experience of all enrolled participants or all mission-team members. This is a general concern; the registry record does not establish that such a pattern occurred.

The analysis population is not described. The registry does not specify whether analyses were intended to include all enrolled participants, all respondents, or only participants with complete answers to a particular item. Nor does it report exclusions or a flow from enrollment to analysis. Enrollment of 61 should not be treated as the analysis denominator without that information. The registry’s listing of 0 analyses indicates that analysis details and results are not recorded there; it does not establish that no analysis was conducted outside the registry.

11. What the Result Does, and Does Not, Mean

The record supports a limited description of the study’s purpose and registered design: an online survey of members of foreign teams, focused on surgical-mission characteristics and collaboration, with a primary question asking where a respondent’s last mission took place. It also records enrollment of 61 and a completed study status. These details do not supply the survey’s findings.

The result does not show how many respondents named any particular country, how many answered the primary question, or what proportion of the enrolled group completed the survey. No primary estimate or statistical uncertainty is reported. Therefore, the registry record cannot establish how mission experiences were distributed across countries or how precisely that distribution was measured. It also cannot support comparisons among locations or participant groups.

The stated aim was to inform recommendations for people and organizations involved in surgical missions. An aim is not a reported outcome. The registry does not show that recommendations were generated, adopted, or evaluated, and the primary country question does not measure sustainability, partnership quality, or improvements in surgical care. In general, survey descriptions can document reported experiences, but causal claims about the effects of a program need evidence that addresses alternative explanations and a well-defined comparison.

The absence of analysis results in the registry should not be read as evidence of no effect, no response, or no events. It is an absence of reported statistical results in this record. Likewise, the study’s completion does not establish that the survey responses were complete or representative. Interpretation should remain limited to what the registry documents: a survey project, its intended topics, and its named primary question, without a reported numerical answer to that question.

12. Why This Trial Matters Statistically

This study is statistically distinct from a conventional clinical trial because its registered primary measure is a survey response rather than a clinical outcome under an assigned treatment. Recognizing that distinction prevents readers from interpreting enrollment as a randomized sample size or treating an absent comparator as if it were a control group. The study can be understood as a descriptive investigation of the experiences of foreign-team members, not as a controlled estimate of a clinical intervention.

The primary question also illustrates why an endpoint’s definition matters. Asking for the country of the last mission produces a descriptive answer whose meaning depends on who was surveyed, who responded, and how missing answers were handled. Without those details and the actual response counts, the item cannot describe the distribution of missions in a wider population. Clear denominators and transparent reporting are central to interpreting even a simple count.

The registry record’s lack of analysis results is important in its own right. Readers should distinguish a registered aim and outcome from a reported finding. The record names a broad goal of informing recommendations, but gives no statistical evidence about whether mission practices or partnerships differ, or whether any approach changes access to care. This distinction helps prevent intentions from being mistaken for conclusions.

For biostatistical interpretation, the record highlights three foundational questions: what population is represented, what exactly is counted, and what comparison—if any—is justified by the design. Those questions apply broadly to surveys and clinical studies alike. Here, the available details answer only part of the endpoint-definition question and provide no reported response distribution or inferential analysis. Transparent reporting of sampling, completion, denominators, and analysis would be necessary to assess precision and generalizability.

13. Limitations

• The posted summary statistics are the only data these results rest on; patient-level data, full protocols and statistical analysis plans are not available.
• Recalculated results are simple, unadjusted calculations from posted summaries. They do not replace the sponsor's prespecified analysis.

The central limitation for interpreting the registered primary measure is that no country responses or response counts are reported. Although enrollment is listed as 61, the registry does not state how many participants completed the survey or answered the primary item. The analyzed denominator, missing-item handling, and reasons for nonresponse are also not reported. Thus, neither the endpoint’s observed distribution nor its precision can be assessed.

The population and recruitment process are described only broadly as members of foreign teams. Eligibility criteria, sampling methods, recruitment channels, participating teams or countries, and response rate are not reported in the registry record. Without those details, it is not possible to judge whether respondents represent a wider population of surgical mission team members. Any selection or nonresponse bias is a possibility to assess, not an established finding.

The record lists multiple outcome measures but no analyses or results. It does not describe a statistical analysis plan, outcome hierarchy beyond the named primary measure, multiplicity handling, or analysis populations. The other outcome definitions and their results are not reported in the registry record. These omissions limit interpretation of both the primary question and the survey’s broader topics.

Finally, the descriptive survey design does not provide a randomized comparison, and no control group is described. The record therefore cannot establish causal effects of mission models or partnerships. The stated timeframe of approximately 20 minutes does not add information about response quality or completeness. These limitations arise from what is documented in the registry; they do not demonstrate that information was not collected or that analyses were not performed elsewhere.

14. Related Tutorials

15. Related Statistical Calculators

16. Sources

• ClinicalTrials.gov: From Short-term Surgical Missions Towards Sustainable Partnerships — NCT04450823.
• Registry record last updated 2020-12-19; status last verified 2020-11.
• Results first posted 2020-08-05.
• Data retrieved from ClinicalTrials.gov on 2026-11-09.
• Group sizes, means, event counts and sponsor-reported p-values are reproduced as posted. Effect estimates, confidence intervals and p-values not attributed to the sponsor are independently calculated from the posted summary statistics.

17. Record Summary

The registry identifies NCT04450823 as “From Short-term Surgical Missions Towards Sustainable Partnerships,” a completed online survey among members of foreign teams. The sponsor is Global Surgery Amsterdam. The record lists enrollment of 61, a start date of 2019-06-01, and a primary completion date of 2019-10-30. No clinical intervention or randomized comparison is described.

The survey covered mission characteristics and activities, follow-up and reporting, local registration of foreign teams, and collaboration with local stakeholders. Its primary measure asks participants where their last mission took place and is recorded as a count of participants. The registry lists 14 outcome measures and 0 analyses, but does not report the primary responses, analysis denominators, or statistical results. Accordingly, the record documents the study’s purpose and intended measurement, but not a numerical finding about the countries reported or the broader effects of surgical missions.