Cundiff Geoffrey W
Department of Obstetrics & Gynaecology, University of British Columbia, 1190 Hornby St, 11th Floor, Vancouver, BC, V6Z2H5, Canada.
Int Urogynecol J. 2017 Aug;28(8):1115-1118. doi: 10.1007/s00192-017-3367-7. Epub 2017 Jun 17.
The still unfolding story of mesh use in surgery for pelvic organ prolapse (POP) offers insights into the factors that influence how we interpret evidence in assessing new technology. Our adoption of mesh in prolapse surgery was influenced by a paradigm shift from treating to preventing recurrent prolapse. This shift is largely unsupported by data and fails to account for the added risk associated with mesh use. This commentary explores unconscious factors that influence our interpretation of innovation and proposes a new approach to evaluating new surgical technologies that balances benefit and risk. Counseling patients about treatments using the benefit-risk approach offers a more balanced perspective. Using a formal benefit-risk assessment in the scientific evaluation of treatments will also provide a more balanced approach that supports the scientific process and patients who undergo treatment.
目前仍在不断发展的盆腔器官脱垂（POP）手术中使用网片的故事，为影响我们在评估新技术时如何解读证据的因素提供了见解。我们在脱垂手术中采用网片受到了从治疗复发性脱垂到预防脱垂这一范式转变的影响。这种转变在很大程度上缺乏数据支持，也没有考虑到与使用网片相关的额外风险。本评论探讨了影响我们对创新解读的无意识因素，并提出了一种评估新手术技术的新方法，该方法平衡了益处和风险。使用益处 - 风险方法为患者提供治疗咨询能提供更平衡的观点。在治疗的科学评估中使用正式的益处 - 风险评估也将提供一种更平衡的方法，以支持科学进程和接受治疗的患者。
