TY - JOUR
T1 - Selecting Image-Guided Surgical Technologies in Oncology
T2 - A Surgeon's Perspective
AU - Lindenberg, Melanie
AU - Retèl, Valesca
AU - van Til, Janine
AU - Kuhlmann, Koert
AU - Ruers, Theo
AU - van Harten, Wim
N1 - Funding Information:
The authors want to thank all the surgeons from the NKI-AVL who participated in the two rounds of interviews. Authors? contributions: The study was designed by W.v.H. V.R. and M.L. The data collection was performed by M.L. in collaboration with K.K. and T.H. All data were analyzed by M.L. and interpreted by and with all authors (J.v.T. V.R. K.K. T.H. and W.v.H.). M.L. drafted the article. All authors listed (J.v.T. V.R. K.K. T.H. W.v.H.), critically reviewed, and approved the article before submission. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For all the interviewees (employees of the eight hospitals involved in our research), the authors asked their permission to record the interviews, and additionally, the authors checked the information retrieved from the interview with each interviewee. No patients or animals were involved in this research. Conflict of interest: All authors declared to have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers? bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or nonfinancial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this article.
Funding Information:
V.P.R. received an unrestricted grant from Agendia BV. W.H.v.H. received grants from Intuitive Surgical, Novartis, Agendia BV. Both did not receive those grants for the work presented in this article.
Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2021/1
Y1 - 2021/1
N2 - Background: To improve surgical performance, image-guided (IG) technologies are increasingly introduced. Yet, it is unknown which oncological procedures yield most value from these technologies. This study aimed to select the most promising IG technology per oncologic indication.Methods: An Analytic Hierarchical Process was used to evaluate three IG technologies: navigation, optical imaging, and augmented reality, in five oncologic indications compared with usual care. Sixteen decision criteria were selected. The relative importance of the criteria and the expected performance of the technologies were evaluated among surgeons. The combination of these scores gives the expected value per technology.Results: On criteria level, sparing critical tissue (9%-18%) and reducing the risk of local recurrence (11%-27%) were most important. Navigation was preferred in three indications—removal of lymph nodes (42%), liver (47%), and rectal tumors (33%). In removing rectal tumors, optical imaging was equally preferred (34%). In removing breast and tongue tumors, no technology was clearly preferred.Conclusions: In selecting IG technologies, especially optical and navigation technologies are expected to add value in addition to usual care. Further development of those technologies for the preferred indications seems valuable. Multi-attribute analysis showed to be useful in prioritization of conducting clinical studies and steer research and development initiatives.
AB - Background: To improve surgical performance, image-guided (IG) technologies are increasingly introduced. Yet, it is unknown which oncological procedures yield most value from these technologies. This study aimed to select the most promising IG technology per oncologic indication.Methods: An Analytic Hierarchical Process was used to evaluate three IG technologies: navigation, optical imaging, and augmented reality, in five oncologic indications compared with usual care. Sixteen decision criteria were selected. The relative importance of the criteria and the expected performance of the technologies were evaluated among surgeons. The combination of these scores gives the expected value per technology.Results: On criteria level, sparing critical tissue (9%-18%) and reducing the risk of local recurrence (11%-27%) were most important. Navigation was preferred in three indications—removal of lymph nodes (42%), liver (47%), and rectal tumors (33%). In removing rectal tumors, optical imaging was equally preferred (34%). In removing breast and tongue tumors, no technology was clearly preferred.Conclusions: In selecting IG technologies, especially optical and navigation technologies are expected to add value in addition to usual care. Further development of those technologies for the preferred indications seems valuable. Multi-attribute analysis showed to be useful in prioritization of conducting clinical studies and steer research and development initiatives.
KW - 2022 OA procedure
KW - Medical devices
KW - Multicriteria decision analysis
KW - Surgical oncology (Mesh)
KW - Technology assessment (Mesh)
KW - Image-guided surgery
UR - http://www.scopus.com/inward/record.url?scp=85090127011&partnerID=8YFLogxK
U2 - 10.1016/j.jss.2020.08.003
DO - 10.1016/j.jss.2020.08.003
M3 - Article
C2 - 32892128
AN - SCOPUS:85090127011
SN - 0022-4804
VL - 257
SP - 333
EP - 343
JO - Journal of Surgical Research
JF - Journal of Surgical Research
ER -
