Surgeon views regarding the adoption of a novel surgical innovation into clinical practice: systematic review.

BACKGROUND: The haphazard adoption of new surgical technologies into practice has the potential to cause patient harm and there are many misconceptions in the decision-making behind the adoption of new innovations. The aim of this study was to synthesize factors affecting a surgeon's decision to adopt a novel surgical innovation into clinical practice. METHODS: A systematic literature search was performed to obtain all studies where surgeon views on the adoption of a novel surgical innovation into clinical practice have been collected. The databases screened were MEDLINE, Embase, Science Direct, Scopus, the Web of Science, and the Cochrane Library of Systematic Reviews (last accessed October 2022). Innovations covered multiple specialties, including cardiac, general, urology, and orthopaedics. The quality of the papers was assessed using a 10-question Critical Appraisal Skills Programme (CASP) tool for qualitative research. RESULTS: A total of 26 studies (including 1112 participants, of which 694 were surgeons) from nine countries satisfied the inclusion and exclusion criteria. Types of study included semi-structured interviews and focus groups, for example. Themes and sub-themes that emerged after a thematic synthesis were categorized using five causal factors (structural, organizational, patient-level, provider-level, and innovation-based). These themes were further split into facilitators and barriers. Key facilitators to adoption of an innovation include improved clinical outcomes, cost-effectiveness, and support from internal and external stakeholders. Barriers to adoption include lack of organizational support and views of senior surgeons. CONCLUSION: There are multiple complex factors that dynamically interact, affecting the adoption of a novel surgical innovation into clinical practice. There is a need to further investigate surgeon and other stakeholder views regarding the strength of clinical evidence required to support the widespread adoption of a surgical innovation into clinical practice.

Investigation and Management of Apparently Sporadic Central Nervous System Haemangioblastoma for Evidence of Von Hippel-Lindau Disease.

Haemangioblastomas are rare, highly vascularised tumours that typically occur in the cerebellum, brain stem and spinal cord. Up to a third of individuals with a haemangioblastoma will have von Hippel-Lindau (VHL) disease. Individuals with haemangioblastoma and underlying VHL disease present, on average, at a younger age and frequently have a personal or family history of VHL disease-related tumours (e.g., retinal or central nervous system (CNS) haemangioblastomas, renal cell carcinoma, phaeochromocytoma). However, a subset present an apparently sporadic haemangioblastoma without other features of VHL disease. To detect such individuals, it has been recommended that genetic testing and clinical/radiological assessment for VHL disease should be offered to patients with a haemangioblastoma. To assess "real-world" clinical practice, we undertook a national survey of clinical genetics centres. All participating centres responded that they would offer genetic testing and a comprehensive assessment (ophthalmological examination and CNS and abdominal imaging) to a patient presenting with a CNS haemangioblastoma. However, for individuals who tested negative, there was variability in practice with regard to the need for continued follow-up. We then reviewed the results of follow-up surveillance in 91 such individuals seen at four centres. The risk of developing a potential VHL-related tumour (haemangioblastoma or RCC) was estimated at 10.8% at 10 years follow-up. The risks of developing a recurrent haemangioblastoma were higher in those who presented <40 years of age. In the light of these and previous findings, we propose an age-stratified protocol for surveillance of VHL-related tumours in individuals with apparently isolated haemangioblastoma.

Open access availability of anatomy papers presented at meetings of the American and British Associations of Clinical Anatomists.

INTRODUCTION: Dissemination of research depends on published work being accessible. In many disciplines open access (OA) research is more frequently cited, although this has never before been demonstrated amongst anatomy publications. The objective of this study was to assess a selection of published anatomy papers to determine the effect of gold and bronze OA availability on citation rates. MATERIALS AND METHODS: Taken together, 625 peer-reviewed publications were identified from 2927 abstracts presented at meetings of AACA (2003-2010) and BACA (2000-2015). RESULTS: In total 18.75% (69 of 368) of papers presented at BACA and 21.79% (56 of 257) of those presented at AACA reached OA publication.  Citation rates are significantly higher amongst OA papers as compared to non-OA papers presented at these two anatomy conferences (OA 18.95, Non-OA 15.14 p = 0.047). OA papers were most commonly themed around education and pure anatomy. CONCLUSIONS: The average OA publication rate of 20.0% in anatomical research arising from these conferences is significantly lower than the average rate for scientific research. Citation rates are significantly higher amongst OA anatomy papers presented at these two conferences.

Adoption of a novel surgical innovation into clinical practice: protocol for a qualitative systematic review examining surgeon views.

INTRODUCTION: Efficient adoption of clinically effective novel surgical innovations has great potential benefits for patients. Factors affecting the adoption of surgical innovation are not well understood and proposed models of adoption do not accurately correlate with historical evidence. This protocol is for a systematic review that aims to identify the qualitative evidence relating to surgeon views regarding the adoption of novel surgical innovation into clinical practice. METHODS AND ANALYSIS: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance will be performed. Two independent reviewers will search the following databases: MEDLINE, Embase, Science Direct, Scopus, Web of Science and the Cochrane Library of Systematic Reviews. Inclusion criteria are studies which report on the views of surgeons who adopt a novel surgical innovation into clinical practice. Each article will be screened for inclusion and assessed according to a Critical Appraisal Skills Programme tool. Data will be synthesised and analysed according to thematic analysis. Given the anticipated yield of a small heterogeneous body of evidence meeting the eligibility criteria for the review, a narrative-based summary is planned. ETHICS AND DISSEMINATION: This review does not require formal ethical approval as it does not involve direct patient contact or patient-identifiable data. The results of this review will be published in a peer-reviewed journal and presented at relevant conferences. The results will also inform an empirical qualitative study exploring surgeon and other stakeholder views regarding the introduction of novel surgical technology and procedures into clinical practice. PROSPERO REGISTRATION NUMBER: CRD42017076715.

Fate of abstracts presented at the annual meetings of the American association of clinical anatomists.

A recent study examined the rate of full-length research paper publication following abstract presentation at the British association of clinical anatomists (BACA) annual meetings. The accepted standard for research dissemination is peer-reviewed publication following presentation at a national or international meeting. The study objectives were quantitative assessment of the abstracts presented at the American Association of Clinical Anatomists' (AACA) annual meetings with regards to the rate of subsequent full-length publication and comparison to BACA publication rates. All abstracts presented at the AACA annual meetings between 2003 and 2010 were analysed. MEDLINE was searched to identify peer-reviewed publications arising from each presented abstract. In total, 1,120 abstracts were presented with 22.9% (n = 257) subsequently published as full-length research papers. The mean number of abstracts presented each year was 140.0 ± 35.9. The median time to publication was 16 months. Chi-squared analysis showed the publication rate of abstracts presented at AACA (22.9%) was not statistically significantly different to BACA (20.4%) (P = 0.09). A total of 11.3% (n = 29) of the articles were published as full-length research articles before presentation as an abstract at an AACA meeting compared to 5.4% of abstracts presented at a BACA meeting. These rates are lower but comparable to those of surgical specialty meetings. Further work should try to identify any concerning reasons for the reduced rate of abstract publication in anatomical research. Clin. Anat. 30:140-144, 2017. © 2017 Wiley Periodicals, Inc.

Publication fate of abstracts presented at British association of clinical anatomists annual meetings.

Dissemination of research is an integral part of the scientific process. Failure to disseminate research limits the scope for critical appraisal and potentially wastes valuable resources. The gold standard for dissemination of research is peer-reviewed publication following presentation at a national meeting. The primary objective of this study was quantitative assessment of the abstracts presented at British Association of Clinical Anatomists (BACA) summer and winter meetings with regards to the rates of subsequent publication and comparison to other medical specialties. Published abstracts from the summer and winter meetings of BACA between the years of 2000 and 2014 were analyzed. MEDLINE was searched to identify peer-reviewed publications arising from each presented abstract. In total, 1,807 abstracts were presented between the years of 2000 and 2014. The mean number of abstracts presented each year was 60.2, (range 26-157). In total, 20.4% of abstracts were subsequently published in MEDLINE-indexed journals with a median publication time of 19 months. The mean number of cadaveric prosections was 45.2 ± 78.8, (range 1-960). Analysis of abstracts focusing on radiographic imaging found the mean number of scans was 224.4 ± 807.1, (range 1-6,439). Biannual meetings of BACA are a forum for the presentation of high-quality anatomical research. BACA meeting abstracts have generally reduced publication rates compared to some surgical specialty meetings; however, there is no analysis available for an equivalent anatomical meeting. Further work should try to identify reasons that may hinder or limit subsequent publication of the anatomy abstracts presented at BACA. Clin. Anat. 30:133-139, 2017. © 2016 Wiley Periodicals, Inc.