PDF(Pubmed)
Abstract：
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.
CONCLUSIONS: 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.
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.
CONCLUSIONS: 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.
摘要：
背景：随意采用新的外科技术在实践中有可能对患者造成伤害，并且在采用新的创新背后的决策中存在许多误解。这项研究的目的是综合影响外科医生决定采用新的外科创新进入临床实践的因素。
方法：进行了系统的文献检索，以收集外科医生对将新型外科创新应用于临床实践的观点的所有研究。筛选的数据库是MEDLINE，Embase,科学直接，Scopus,WebofScience,和Cochrane系统评论库（最后于2022年10月访问）。创新涵盖多个专业，包括心脏,一般,泌尿科,和骨科。使用10个问题的批判性评估技能计划（CASP）工具进行定性研究，对论文的质量进行了评估。
结果：共有26项研究（包括1112名参与者，其中694名是外科医生)，来自9个国家，满足纳入和排除标准。研究类型包括半结构化访谈和焦点小组，例如。主题综合后出现的主题和子主题使用五个因果因素(结构，组织，患者级别,提供者级别，以创新为基础)。这些主题进一步分为主持人和障碍。采用创新的主要促进者包括改善临床结果，成本效益，以及内部和外部利益相关者的支持。采用的障碍包括缺乏组织支持和高级外科医生的观点。
结论：有多个复杂因素动态相互作用，影响将新型外科创新应用于临床实践。有必要进一步调查外科医生和其他利益相关者对支持广泛采用外科创新进入临床实践所需的临床证据强度的看法。
方法：进行了系统的文献检索，以收集外科医生对将新型外科创新应用于临床实践的观点的所有研究。筛选的数据库是MEDLINE，Embase,科学直接，Scopus,WebofScience,和Cochrane系统评论库（最后于2022年10月访问）。创新涵盖多个专业，包括心脏,一般,泌尿科,和骨科。使用10个问题的批判性评估技能计划（CASP）工具进行定性研究，对论文的质量进行了评估。
结果：共有26项研究（包括1112名参与者，其中694名是外科医生)，来自9个国家，满足纳入和排除标准。研究类型包括半结构化访谈和焦点小组，例如。主题综合后出现的主题和子主题使用五个因果因素(结构，组织，患者级别,提供者级别，以创新为基础)。这些主题进一步分为主持人和障碍。采用创新的主要促进者包括改善临床结果，成本效益，以及内部和外部利益相关者的支持。采用的障碍包括缺乏组织支持和高级外科医生的观点。
结论：有多个复杂因素动态相互作用，影响将新型外科创新应用于临床实践。有必要进一步调查外科医生和其他利益相关者对支持广泛采用外科创新进入临床实践所需的临床证据强度的看法。
