Challenges in evaluating surgical innovation.

نویسندگان

  • Patrick L Ergina
  • Jonathan A Cook
  • Jane M Blazeby
  • Isabelle Boutron
  • Pierre-Alain Clavien
  • Barnaby C Reeves
  • Christoph M Seiler
  • Douglas G Altman
  • Jeffrey K Aronson
  • Jeffrey S Barkun
  • W Bruce Campbell
  • Liane S Feldman
  • David R Flum
  • Paul Glasziou
  • Guy J Maddern
  • John C Marshall
  • Peter McCulloch
  • Jon Nicholl
  • Steven M Strasberg
  • Jonathan L Meakins
  • Deborah Ashby
  • Nick Black
  • John Bunker
  • Martin Burton
  • Marion Campbell
  • Kalipso Chalkidou
  • Iain Chalmers
  • Marc de Leval
  • Jon Deeks
  • Adrian Grant
  • Muir Gray
  • Roger Greenhalgh
  • Milos Jenicek
  • Sean Kehoe
  • Richard Lilford
  • Peter Littlejohns
  • Yoon Loke
  • Rajan Madhock
  • Kim McPherson
  • Peter Rothwell
  • Bill Summerskill
  • David Taggart
  • Parris Tekkis
  • Matthew Thompson
  • Tom Treasure
  • Ulrich Trohler
  • Jan Vandenbroucke
چکیده

Research on surgical interventions is associated with several methodological and practical challenges of which few, if any, apply only to surgery. However, surgical evaluation is especially demanding because many of these challenges coincide. In this report, the second of three on surgical innovation and evaluation, we discuss obstacles related to the study design of randomised controlled trials and non-randomised studies assessing surgical interventions. We also describe the issues related to the nature of surgical procedures-for example, their complexity, surgeon-related factors, and the range of outcomes. Although difficult, surgical evaluation is achievable and necessary. Solutions tailored to surgical research and a framework for generating evidence on which to base surgical practice are essential.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Responsible Innovation in Children's Surgical Care.

Advances in medical care may occur when a change in practice incorporates a new treatment or methodology. In surgery, this may involve the translation of a completely novel concept into a new procedure or device or the adaptation of existing treatment approaches or technology to a new clinical application. Regardless of the specifics, innovation should have, as its primary goal, the enhancement...

متن کامل

Innovation, Demand, and Responsibility: Some Fundamental Questions About Health Systems; Comment on “What Health System Challenges Should Responsible Innovation in Health Address? Insights From an International Scoping Review”

In this commentary on the exercise of Lehoux et al (this volume) I argue that in discussions on the current challenges of health systems, a better diagnosis of the health system is required. The cause of responsible innovation in health (RIH) requires a better understanding of the dynamics of health systems, in particular how innovation, demand, and responsibility are m...

متن کامل

Nurturing Societal Values in and Through Health Innovations; Comment on “What Health System Challenges Should Responsible Innovation in Health Address?”

Aligning innovation processes in healthcare with health system demands is a societal objective, not always achieved. In line with earlier contributions, Lehoux et al outline priorities for research, public communication, and policy action to achieve this objective. We endorse setting these priorities, while also highlighting a ‘commitment gap’ in collectively addressing system-level challenges....

متن کامل

The Co-Constitution of Health Systems and Innovation; Comment on “What Health System Challenges Should Responsible Innovation in Health Address? Insights From an International Scoping Review”

Lehoux et al provide a timely and relevant turn on the broad and ongoing discussion around the introduction of health technology and innovation. More specifically, the authors suggest a demand-driven approach to health innovation that starts from identifying challenges and demands at the health system level. In this commentary, I review a number of underlying implications of their study in rela...

متن کامل

Business as Usual: A Lack of Institutional Innovation in Global Health Governance; Comment on “Global Health Governance Challenges 2016 – Are We Ready?”

There were once again high expectations that a major global health event - the Ebola virus outbreak of 2014-2015 - would trigger meaningfully World Health Organization (WHO) reform and strengthen global health governance (GHG). Rather than a “turning point,” however, the global community has gone back to business as usual. This has occurred against a backdrop of worldwide political turmoil, cha...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Lancet

دوره 374 9695  شماره 

صفحات  -

تاریخ انتشار 2009