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Network analysis of surgical innovation: Measuring value and the virality of diffusion in robotic surgery

Published on Aug 25, 2017in PLOS ONE2.776
· DOI :10.1371/journal.pone.0183332
George Garas14
Estimated H-index: 14
(RCS: Royal College of Surgeons of England),
Isabella Cingolani5
Estimated H-index: 5
(St Mary's Hospital)
+ 2 AuthorsThanos Athanasiou15
Estimated H-index: 15
(RCS: Royal College of Surgeons of England)
Abstract
Background Existing surgical innovation frameworks suffer from a unifying limitation, their qualitative nature. A rigorous approach to measuring surgical innovation is needed that extends beyond detecting simply publication, citation, and patent counts and instead uncovers an implementation-based value from the structure of the entire adoption cascades produced over time by diffusion processes. Based on the principles of evidence-based medicine and existing surgical regulatory frameworks, the surgical innovation funnel is described. This illustrates the different stages through which innovation in surgery typically progresses. The aim is to propose a novel and quantitative network-based framework that will permit modeling and visualizing innovation diffusion cascades in surgery and measuring virality and value of innovations. Materials and methods Network analysis of constructed citation networks of all articles concerned with robotic surgery (n = 13,240, Scopus®) was performed (1974–2014). The virality of each cascade was measured as was innovation value (measured by the innovation index) derived from the evidence-based stage occupied by the corresponding seed article in the surgical innovation funnel. The network-based surgical innovation metrics were also validated against real world big data (National Inpatient Sample–NIS®). Results Rankings of surgical innovation across specialties by cascade size and structural virality (structural depth and width) were found to correlate closely with the ranking by innovation value (Spearman’s rank correlation coefficient = 0.758 (p = 0.01), 0.782 (p = 0.008), 0.624 (p = 0.05), respectively) which in turn matches the ranking based on real world big data from the NIS® (Spearman’s coefficient = 0.673;p = 0.033). Conclusion Network analysis offers unique new opportunities for understanding, modeling and measuring surgical innovation, and ultimately for assessing and comparing generative value between different specialties. The novel surgical innovation metrics developed may prove valuable especially in guiding policy makers, funding bodies, surgeons, and healthcare providers in the current climate of competing national priorities for investment.
  • References (29)
  • Citations (7)
References29
Newest
#1Karen M. Goldstein (Duke University)H-Index: 10
#2Dawne Vogt (BU: Boston University)H-Index: 27
Last. Elizabeth M. Yano (UCLA: University of California, Los Angeles)H-Index: 42
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Abstract Background Evidence-Based Quality Improvement (EBQI) is a systematic, multilevel approach to implementing research evidence into clinical settings. Little is known about EBQI effectiveness in the context of Practice-Based Research Networks (PBRNs), which are themselves designed to foster practice-based change. We evaluated EBQI implementation in a PBRN setting to determine the extent to which the PBRN infrastructure added value. Methods We conducted a four-site cluster randomized trial ...
3 CitationsSource
The notion of development blocks (Dahmen, 1950, 1991) suggests the co-evolution of technologies and industries through complementarities and the overcoming of imbalances. This study proposes and applies a methodology to analyse development blocks empirically. To assess the extent and character of innovational interdependencies between industries the study combines analysis of innovation biographies and statistical network analysis. This is made possible by using data from a newly constructed inn...
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One difficulty in translating clinical trial findings for target patient populations is that risk factors in trials and electronic health care databases are measured in different ways. We therefore need a way to calibrate our measurements between these two data worlds.
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#1Rachel E. Sherman (FDA: Food and Drug Administration)H-Index: 10
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The FDA is developing guidance on the use of “real-world evidence” — health care information from atypical sources, including electronic health records, billing databases, and product and disease registries — to assess the safety and effectiveness of drugs and devices.
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#1Kathie A. Wong (St Mary's Hospital)H-Index: 1
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Surgeons, as the consumers, must engage in commercial activity regarding medical devices since it directly has impacts on surgical practice and patient outcomes. Unique features defy traditional economic convention in this specific market partly because consumers do not usually pay directly. Greater involvement with commercial activity means better post-market surveillance of medical devices which leads to improved patient safety. The medical device industry has exhibited astonishing levels of g...
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#1Thanos Athanasiou (St Mary's Hospital)H-Index: 60
#2Vanash M. Patel (St Mary's Hospital)H-Index: 18
Last. Sotirios Paroutis (Warw.: University of Warwick)H-Index: 14
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Purpose To determine the association between professors9 self-perception of mentoring skills and their academic performance. Design Two hundred and fifteen professors from Imperial College London, the first Academic Health Science Centre (AHSC) in the UK, were surveyed. The instrument adopted was the Mentorship Skills Self-Assessment Survey. Statement scores were aggregated to provide a score for each shared core, mentor-specific and mentee-specific skill. Univariate and multivariate regression ...
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#1Thanos Athanasiou (St Mary's Hospital)H-Index: 60
#2Vanash M. Patel (St Mary's Hospital)H-Index: 18
Last. Sotirios Paroutis (Warw.: University of Warwick)H-Index: 14
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Objectives The ‘gender gap’ in academic medicine remains significant and predominantly favours males. This study investigates gender disparities in research performance in an Academic Health Science Centre, while considering factors such as mentoring and scientific collaboration. Materials and methods Professorial registry-based electronic survey (n=215) using bibliometric data, a mentoring perception survey and social network analysis. Survey outcomes were aggregated with measures of research p...
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#1Valerio Ciotti (QMUL: Queen Mary University of London)H-Index: 2
#2Moreno Bonaventura (QMUL: Queen Mary University of London)H-Index: 3
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Citation networks have been widely used to study the evolution of science through the lenses of the underlying patterns of knowledge flows among academic papers, authors, research sub-fields, and scientific journals. Here we focus on citation networks to cast light on the salience of homophily, namely the principle that similarity breeds connection, for knowledge transfer between papers. To this end, we assess the degree to which citations tend to occur between papers that are concerned with see...
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#1Asit Arora (Imperial College Healthcare)H-Index: 15
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Abstract Introduction Transaxillary robotic thyroid surgery was pioneered in South Korea where cultural factors, anthropometry and remuneration favour this. Small thyroid nodules account for the majority of cases due to a national thyroid cancer screening programme. However, the technique has not been evaluated in the United Kingdom where larger thyroid nodules tend to undergo surgery in a patient population with a higher body mass index (BMI). Methods Long term prospective non-randomised study....
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#1Lionel Tabourier (University of Paris)H-Index: 7
#2Anne-Sophie Libert (Université de Namur)H-Index: 14
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Link prediction appears as a central problem of network science, as it calls for unfolding the mechanisms that govern the micro-dynamics of the network. In this work, we are interested in ego-networks, that is the mere information of interactions of a node to its neighbors, in the context of social relationships. As the structural information is very poor, we rely on another source of information to predict links among egos' neighbors: the timing of interactions. We define several features to ca...
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Cited By7
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#1Muneer Ahmed (UCL: University College London)H-Index: 14
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Objective To evaluate the role of the European Union (EU) as a research collaborator in the UK’s success as a global leader in healthcare research and innovation and quantify the impact that Brexit may have. Design Network and regression analysis of scientific collaboration, followed by simulation models based on alternative scenarios. Setting International real-world collaboration network among all countries involved in robotic surgical research and innovation. Participants 772 organisations fr...
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#1B. M. Sephton (Imperial College Healthcare)H-Index: 1
Over the last two decades, advances and adaptation of technology have led to a variety of endoscopic thyroidectomy procedures being performed. The drive for extracervical procedures has been predominantly influenced by the desire for improved cosmesis via avoidance of visible scars. Extracervical techniques have shown considerable evolution with approaches that have included transaxillary, breast, postauricular, and transoral routes. There has been a varied evidence base for each of these approa...
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