When the Evidence Basis Breeds Controversies: Exploring the Value Profile of Robotic Surgery Beyond the Early Introduction Phase

Payam Abrishami*, Albert Boer, Klasien Horstman

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Web of Science)

Abstract

This article investigates qualitatively the value profile of theda Vinci (R) surgical robot after almost two decades of extensive clinical use and research. We aimed to understand whether the swiftly growing body of published studies on robotic prostate surgery can now, that is, beyond an early stage, guide decisions on the acquisition, procurement, and public provision of this innovation. We explored both published studies and the perspectives of diverse stakeholders in the Netherlands. Both arenas represent conflicting, often polarised arguments on the (added) value of da Vinci surgery. What was unclear a decade ago due to lack of evidence is now unclear because of controversies about evidence. The article outlines controversial value issues and indicates the unlikelihood that awaiting more research - amid the mantra "further studies are needed" - will resolve the controversy. The study underscores multi-stakeholder deliberation to resolve controversies regarding the value of advanced medical innovations.

Original languageEnglish
Pages (from-to)596-608
Number of pages13
JournalMedical Care Research and Review
Volume77
Issue number6
DOIs
Publication statusPublished - Dec 2020

Keywords

  • computer-assisted surgery
  • diffusion of innovation
  • evidence-based medicine
  • dissent
  • health technology assessment
  • ASSISTED RADICAL PROSTATECTOMY
  • HEALTH TECHNOLOGY-ASSESSMENT
  • MEDICAL INNOVATIONS
  • WORK DISABILITY
  • CANCER
  • DECISION
  • OUTCOMES
  • INFERIORITY
  • DIFFUSION
  • ADOPTION

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