Evaluation and stages of surgical innovations

Jeffrey S Barkun, Jeffrey K Aronson, Liane S Feldman, Guy J Maddern, Steven M Strasberg, Douglas G Altman, Jeffrey S Barkun, Jane M Blazeby, Isabell C Boutron, Steven Bruce Campbell, Pierre-Alain Clavien, Jonathan A Cook, Patrick L Ergina, David R Flum, Paul Glasziou, John Marshall, Peter McCulloch, Jon Nicholl, Bournaby C Reeves, Christoph M SeilerJonathan L Meakins, Deborah Ashby, Nick Black, John Bunker, Martin Burton, Marion K Campbell, Kalipso Chalkidou, Iain Chalmers, Marc de Leval, Jon Deeks, Adrian M Grant, Muir Gray, Roger Greenhalgh, Milos Jenicek, Sean Kehoe, Richard Lilford, Peter Littlejohns, Yoon Loke, Rajan Madhock, Donald Kirk McPherson, Peter Rothwell, Bill Summerskill, David Taggart, Parris Tekkis, Mandy Thompson, Tom Treasure, Ulrich Trohler, Jan Vandenbroucke, Balliol Collaboration

Research output: Contribution to journalArticlepeer-review

443 Citations (Scopus)


Surgical innovation is an important part of surgical practice. Its assessment is complex because of idiosyncrasies related to surgical practice, but necessary so that introduction and adoption of surgical innovations can derive from evidence-based principles rather than trial and error. A regulatory framework is also desirable to protect patients against the potential harms of any novel procedure. In this first of three Series papers on surgical innovation and evaluation, we propose a five-stage paradigm to describe the development of innovative surgical procedures.
Original languageEnglish
Pages (from-to)1089-1096
Number of pages8
JournalThe Lancet
Issue number9695
Publication statusPublished - 26 Sept 2009


  • biomedical research
  • diffusion of innovation
  • evaluation studies as topic
  • evidence-based medicine
  • humans
  • surgical procedures, operative
  • technology assessment, biomedical

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