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Have We Made Progress in Identifying (Surgical) Innovation

Published on Jun 3, 2019in American Journal of Bioethics5.786
· DOI :10.1080/15265161.2019.1602181
Giles Birchley7
Estimated H-index: 7
(UoB: University of Bristol),
Richard Huxtable12
Estimated H-index: 12
(UoB: University of Bristol)
+ 1 AuthorsJane M Blazeby58
Estimated H-index: 58
Abstract
  • References (5)
  • Citations (1)
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References5
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#1Giles Birchley (UoB: University of Bristol)H-Index: 7
#2Jonathan Ives (UoB: University of Bristol)H-Index: 20
Last. Jane M BlazebyH-Index: 58
view all 4 authors...
Improving surgical interventions is key to improving outcomes. Ensuring the safe and transparent translation of such improvements is essential. Evaluation and governance initiatives, including the IDEAL framework and the Macquarie Surgical Innovation Identification Tool have begun to address this. Yet without a definition of innovation that allows non-surgeons to identify when it is occurring, these initiatives are of limited value. A definition seems elusive, so we undertook a conceptual study ...
1 CitationsSource
#1Jake Earl (NIH: National Institutes of Health)H-Index: 1
Innovative practice occurs when a clinician provides something new, untested, or nonstandard to a patient in the course of clinical care, rather than as part of a research study. Commentators have noted that patients engaged in innovative practice are at significant risk of suffering harm, exploitation, or autonomy violations. By creating a pathway for harmful or nonbeneficial interventions to spread within medical practice without being subjected to rigorous scientific evaluation, innovative pr...
12 CitationsSource
#1Allison Hirst (University of Oxford)H-Index: 14
#2Yiannis Philippou (University of Oxford)H-Index: 5
Last. Peter McCulloch (University of Oxford)H-Index: 38
view all 17 authors...
Objective:To update, clarify, and extend IDEAL concepts and recommendations.Background:New surgical procedures, devices, and other complex interventions need robust evaluation for safety, efficacy, and effectiveness. Unlike new medicines, there is no internationally agreed evaluation pathway for gen
35 CitationsSource
#1Katrina HutchisonH-Index: 6
#2Wendy A. RogersH-Index: 26
Last. Mianna LotzH-Index: 6
view all 4 authors...
This article presents an original definition of surgical innovation and a practical tool for identifying planned innovations. These will support the responsible introduction of surgical innovations.Frameworks developed for the safer introduction of surgical innovations rely upon identifying cases of innovation; oversight cannot occur unless innovations are identified. However, there is no consensus among surgeons about which interventions they consider innovative; existing definitions are vague ...
11 CitationsSource
#2Erik K. MayerH-Index: 22
Last. DarziAraH-Index: 100
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26 CitationsSource
#1Wendy A. RogersH-Index: 26
#2Mianna LotzH-Index: 6
Last. A. A. Eyers (Macquarie University)H-Index: 17
view all 5 authors...
Objective: This study explores how surgeons define innovation, critically examines and evaluates these views, and uses the findings to develop practical criteria for identifying surgical innovation for ethical and regulatory purposes. Background: Surgical innovation is crucial for progress in surgery, but can be harmful to patients and difficult to identify and therefore support appropriately. Current attempts to define surgical innovation lack precision, and do not give enough guidance to ident...
29 CitationsSource
#1Wendy A. Rogers (Macquarie University)H-Index: 26
#2Jane Johnson (Macquarie University)H-Index: 8
In this paper we argue that surgeons face a particular kind of within-role conflict of interests, related to innovation. Within-role conflicts occur when the conflicting interests are both legitimate goals of professional activity. Innovation is an integral part of surgical practice but can create within-role conflicts of interest when innovation compromises patient care in various ways, such as by extending indications for innovative procedures or by failures of informed consent. The standard r...
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