Towards early evaluation of surgical innovations using an integrated approach:SURGE

SURGE aims to establish novel and comprehensive methodology to evaluate the value of surgical innovations throughout all stages of development. Whilst surgical innovations hold strong appeal for professionals and patients, it is currently impossible to predict or establish their role in quality improvement of surgical care. The current surgical innovation pathway is too long, too expensive, not regulated, and lacking an evidence-based evaluation approach. I have developed new approaches evaluating to surgical innovations from as early as their conception. This proposal builds on this development by considering specific challenges in surgical research. I will develop methodologies that enable: 1. a view, shared by all stakeholders, including patients, on where, how and by whom surgical technologies should be developed; 2. early health-economic evaluation of surgical innovations, taking into account learning curve associated morbidity and costs; 3. individual decision making by considering the risks, benefits, needs, preferences and values for individual patients; 4. guidance on how to integrate and apply the new methodologies This project is highly innovative as it adopts a transdisciplinary approach linking different fields and integrating methodological innovations (i.e. interactive evaluations, headroom analyses, comparative effectiveness studies, and an evidence-based approach to decision making in individual patients) with direct application to real-world surgical innovations. I am in a unique position to address these challenges since I have performed visionary and innovative work on the early assessment of surgical innovations, which transverses the boundaries of traditional disciplines, such as surgery, health technology assessment, epidemiology and policy making. My position as an epidemiologist, operating from within the surgical disciplines and my extensive national and international network are exceptional and critical to delivering this work. This proposal will add to the “science of surgical evaluation”, and allow for development of surgical innovations that are affordable, effective, and of value for the patient.