An international consensus panel on the potential value of Digital Surgery

ObjectivesThe use of digital technology in surgery is increasing rapidly, with a wide array of new applications from presurgical planning to postsurgical performance assessment. Understanding the clinical and economic value of these technologies is vital for making appropriate health policy and purc...

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Vydané v:BMJ open Ročník 14; číslo 9; s. e082875
Hlavní autori: Erskine, Jamie, Abrishami, Payam, Bernhard, Jean-Christophe, Charter, Richard, Culbertson, Richard, Hiatt, Jo Carol, Igarashi, Ataru, Purcell Jackson, Gretchen, Lien, Matthew, Maddern, Guy, Soon Yau Ng, Joseph, Patel, Anita, Rha, Koon Ho, Sooriakumaran, Prasanna, Tackett, Scott, Turchetti, Giuseppe, Chalkidou, Anastasia
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: England British Medical Journal Publishing Group 05.09.2024
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ISSN:2044-6055, 2044-6055
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Shrnutí:ObjectivesThe use of digital technology in surgery is increasing rapidly, with a wide array of new applications from presurgical planning to postsurgical performance assessment. Understanding the clinical and economic value of these technologies is vital for making appropriate health policy and purchasing decisions. We explore the potential value of digital technologies in surgery and produce expert consensus on how to assess this value.DesignA modified Delphi and consensus conference approach was adopted. Delphi rounds were used to generate priority topics and consensus statements for discussion.Setting and participantsAn international panel of 14 experts was assembled, representing relevant stakeholder groups: clinicians, health economists, health technology assessment experts, policy-makers and industry.Primary and secondary outcome measuresA scoping questionnaire was used to generate research questions to be answered. A second questionnaire was used to rate the importance of these research questions. A final questionnaire was used to generate statements for discussion during three consensus conferences. After discussion, the panel voted on their level of agreement from 1 to 9; where 1=strongly disagree and 9=strongly agree. Consensus was defined as a mean level of agreement of >7.ResultsFour priority topics were identified: (1) how data are used in digital surgery, (2) the existing evidence base for digital surgical technologies, (3) how digital technologies may assist surgical training and education and (4) methods for the assessment of these technologies. Seven consensus statements were generated and refined, with the final level of consensus ranging from 7.1 to 8.6.ConclusionPotential benefits of digital technologies in surgery include reducing unwarranted variation in surgical practice, increasing access to surgery and reducing health inequalities. Assessments to consider the value of the entire surgical ecosystem holistically are critical, especially as many digital technologies are likely to interact simultaneously in the operating theatre.
Bibliografia:Original research
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ST is an employee of Intuitive Surgical and as such he receives compensation and benefits as part of his employment agreement, as well as stock from Intuitive Surgical. GJ is employee of Intuitive Surgical and as such she receives compensation and benefits as part of her employment agreement, as well as stock from Intuitive Surgical. She also owns stock or stock options from IBM and Kyndryl and is President and Chair, of the Board of Directors for the American Medical Informatics Association. ML is an employee of Intuitive Surgical and as such he receives compensation and benefits as part of his employment agreement. JE is an employee of Alira Health. Alira Health received consulting fees from Intuitive Surgical for the coordination of the panel. RCulbertson and AC are the co-chairs of the HTAi Medical Device Interest Group. RCulbertson has received payment from the American College of Healthcare Executives for past publications. KHR is an execute of NAVER. JSYN is a board member of the Asian Society for Gyn Robotic Surgery and the Robotic Surgery Society of Singapore. J-CB has received consulting fees and honoraria from Intuitive Surgical, and his institution has received equipment, materials, drugs, medical writing, gifts or other services. PS has received consulting fees from Cambridge Medical Robotics. He has also received an Intuitive Surgical Clinical Research Grant and a Urology Foundation Research & Innovation Grant. Authors who travelled to panel meetings in person received reimbursement for their travel and accommodation from Alira Health. AC did not receive any reimbursement for contribution, travelling or accommodation to the panel meetings.
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2023-082875