Market Access, Alira Health, Boston, Massachusetts, USA
Erasmus School of Health Policy and Management, National Health Care Institute, Rotterdam, The Netherlands.
BMJ Open. 2024 Sep 5;14(9):e082875. doi: 10.1136/bmjopen-2023-082875.
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.
A modified Delphi and consensus conference approach was adopted. Delphi rounds were used to generate priority topics and consensus statements for discussion.
An international panel of 14 experts was assembled, representing relevant stakeholder groups: clinicians, health economists, health technology assessment experts, policy-makers and industry.
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.
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.
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.
手术中数字技术的使用正在迅速增加，从术前规划到术后绩效评估，新应用层出不穷。了解这些技术的临床和经济价值对于制定适当的卫生政策和采购决策至关重要。我们探讨了数字技术在手术中的潜在价值，并就如何评估这种价值达成了专家共识。
采用改良 Delphi 法和共识会议方法。Delphi 轮次用于生成优先主题和共识声明，以供讨论。
国际专家小组由 14 名代表相关利益相关者群体的专家组成：临床医生、卫生经济学家、卫生技术评估专家、政策制定者和行业。
使用范围界定问卷生成要回答的研究问题。第二个问卷用于评估这些研究问题的重要性。第三个问卷用于生成在三次共识会议期间讨论的声明。讨论后，小组对其从 1 到 9 的同意程度进行投票；其中 1 表示强烈不同意，9 表示强烈同意。共识定义为>7 的平均同意水平。
确定了四个优先主题：（1）数字手术中数据的使用方式，（2）数字外科技术的现有证据基础，（3）数字技术如何协助外科培训和教育，以及（4）评估这些技术的方法。生成并完善了七个共识声明，最终的共识水平从 7.1 到 8.6 不等。
数字技术在手术中的潜在益处包括减少手术实践中的不必要差异、增加手术机会和减少健康不平等。评估整个手术生态系统的价值至关重要，特别是因为许多数字技术可能会同时在手术室中相互作用。
