Beyond IDEAL: the importance of surgical innovation metrics – Authors' reply

We thank George Garas and colleagues for their interest in our paper on IDEAL and progress in clinical research in surgery. We agree that the IDEAL Framework and Recommendations are incomplete because they do not include a stage devoted to the preliminary work, which often precedes the first-in-human event in planned surgical innovation. We discuss this deficit in our recent revision of the IDEAL Recommendations.1Hirst A Philippou Y Blazeby J et...