An international consensus panel on the potential value of Digital Surgery.

Autor:	Erskine J; Market Access, Alira Health, Boston, Massachusetts, USA jamie.erskine@alirahealth.com., Abrishami P; Erasmus School of Health Policy and Management, National Health Care Institute, Rotterdam, The Netherlands., Bernhard JC; University Hospital Centre Bordeaux, Bordeaux, France., Charter R; Health Technology Assessment International, Edmonton, Alberta, Canada.; CHLOE Healthcare Advisory Group, London, UK., Culbertson R; Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA., Hiatt JC; Health Technology Assessment International, Edmonton, Alberta, Canada., Igarashi A; The University of Tokyo, Tokyo, Japan., Purcell Jackson G; Intuitive Surgical Inc, Sunnyvale, California, USA.; American Medical Informatics Association, Bethesda, Maryland, USA., Lien M; Intuitive Surgical Inc, Sunnyvale, California, USA., Maddern G; Surgery, The Queen Elizabeth Hospital, University of Adelaide, Woodville, Adelaide, Australia., Soon Yau Ng J; National University Cancer Institute, Singapore., Patel A; Anita Patel Health Economics Consulting Ltd, London, UK.; Wolfson Institute of Population Health, Queen Mary University of London, London, UK., Rha KH; Yonsei University Medical Center, Seodaemun-gu, Seoul, Republic of Korea., Sooriakumaran P; University College London, London, UK.; Cleveland Clinic London, London, UK., Tackett S; Intuitive Surgical Inc, Sunnyvale, California, USA., Turchetti G; Institute of Management, Scuola Superiore Sant'Anna, Pisa, Toscana, Italy., Chalkidou A; NICE, London, UK.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2024 Sep 05; Vol. 14 (9), pp. e082875. Date of Electronic Publication: 2024 Sep 05.
DOI:	10.1136/bmjopen-2023-082875
Abstrakt:	Objectives: The 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. Design: A modified Delphi and consensus conference approach was adopted. Delphi rounds were used to generate priority topics and consensus statements for discussion. Setting and Participants: An 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 Measures: A 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. Results: Four 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. Conclusion: Potential 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. Competing Interests: Competing interests: 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. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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