McIntosh Stuart A, Hudson George, Jiang Michael, Palmer Ben, Potter Shelley, Head Michael G, Cutress Ramsey I
Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry, and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Bristol Medical School, University of Bristol, Bristol, UK.
Br J Surg. 2025 May 31;112(6). doi: 10.1093/bjs/znaf089.
Surgery is an intrinsic component of healthcare, estimated to be involved in the treatment of 28-32% of the global burden of disease. Research is crucial to improving the quality of surgical care and thus patient outcomes. The aim of this study was to analyse global patterns of public and philanthropic investment in surgical research.
Publicly available databases of human surgical research funding awards between 2016 and 2020 were searched. Awards were categorized by surgical specialty, cross-cutting research theme, and phase of research.
A total of 8042 awards were identified, with a total investment of $3.48 billion between 2016 and 2020 (approximately $0.7 billion annually), contrasting with $24.5 billion for cancer research in the same interval. Preclinical research received most of the funding ($2.46 billion (70.7%)), clinical trials received $0.72 billion (20.6%), and public health research received $0.30 billion (8.6%). By cross-cutting research theme, the largest investment was into intraoperative research ($1.4 billion (40.94%)), followed by postoperative research ($0.76 billion (21.9%)), preoperative/neoadjuvant studies ($0.43 billion (12.3%)), and interventional radiology ($0.04 billion (1.2%)). Global surgery was the least well-funded area of research ($0.03 billion (0.8%)).
Surgical research remains underfunded in comparison with other specialties, with most investment directed towards preclinical research, not directly involving patients. Only a small proportion was invested in clinical trials, public health, and global surgery. These findings limit the impact of surgical research on improving population health and contrast starkly with the ubiquity of surgical treatments in the management of the global burden of disease. Urgent prioritization of surgical research and evaluation of priorities in research investment are required, to reflect surgery's pivotal role in global healthcare.
手术是医疗保健的一个固有组成部分，估计参与了全球28%-32%的疾病负担治疗。研究对于提高手术护理质量进而改善患者预后至关重要。本研究的目的是分析全球在外科研究方面的公共和慈善投资模式。
检索了2016年至2020年间公开可用的人类外科研究资助奖项数据库。奖项按外科专科、交叉研究主题和研究阶段进行分类。
共确定了8042个奖项，2016年至2020年间的总投资为34.8亿美元（每年约7亿美元），而同期癌症研究的投资为245亿美元。临床前研究获得了大部分资金（24.6亿美元（70.7%）），临床试验获得7.2亿美元（20.6%），公共卫生研究获得3.0亿美元（8.6%）。按交叉研究主题划分，最大的投资是术中研究（14亿美元（40.94%）），其次是术后研究（7.6亿美元（21.9%））、术前/新辅助研究（4.3亿美元（12.3%））和介入放射学（0.4亿美元（1.2%））。全球手术是研究资金最少的领域（0.3亿美元（0.8%））。
与其他专科相比，外科研究的资金仍然不足，大部分投资都指向临床前研究，而临床前研究并不直接涉及患者。只有一小部分投资于临床试验、公共卫生和全球手术。这些发现限制了外科研究对改善人群健康的影响，与手术治疗在全球疾病负担管理中的普遍性形成鲜明对比。需要紧急确定外科研究的优先次序并评估研究投资的优先事项，以反映手术在全球医疗保健中的关键作用。
