TY - JOUR
T1 - Teaching Hospitals and the Disconnect between Technology Adoption and Comparative Effectiveness Research
T2 - The Case of the Surgical Robot
AU - Makarov, Danil V.
AU - Li, Huilin
AU - Lepor, Herbert
AU - Gross, Cary P.
AU - Blustein, Jan
N1 - Funding Information:
The Robert Wood Johnson Foundation, the U.S. Department of Veterans Affairs, and the Louis Feil Charitable Lead Trust.
Publisher Copyright:
© SAGE Publications.
PY - 2017/6/1
Y1 - 2017/6/1
N2 - The surgical robot, a costly technology for treatment of prostate cancer with equivocal marginal benefit, rapidly diffused into clinical practice. We sought to evaluate the role of teaching in the early adoption phase of the surgical robot. Teaching hospitals were the primary early adopters: data from the Healthcare Cost and Utilization Project showed that surgical robots were acquired by 45.5% of major teaching, 18.0% of minor teaching and 8.0% of non-teaching hospitals during the early adoption phase. However, teaching hospital faculty produced little comparative effectiveness research: By 2008, only 24 published studies compared robotic prostatectomy outcomes to those of conventional techniques. Just ten of these studies (41.7%) were more than minimally powered, and only six (25%) involved cross-institutional collaborations. In adopting the surgical robot, teaching hospitals fulfilled their mission to innovate, but failed to generate corresponding scientific evidence.
AB - The surgical robot, a costly technology for treatment of prostate cancer with equivocal marginal benefit, rapidly diffused into clinical practice. We sought to evaluate the role of teaching in the early adoption phase of the surgical robot. Teaching hospitals were the primary early adopters: data from the Healthcare Cost and Utilization Project showed that surgical robots were acquired by 45.5% of major teaching, 18.0% of minor teaching and 8.0% of non-teaching hospitals during the early adoption phase. However, teaching hospital faculty produced little comparative effectiveness research: By 2008, only 24 published studies compared robotic prostatectomy outcomes to those of conventional techniques. Just ten of these studies (41.7%) were more than minimally powered, and only six (25%) involved cross-institutional collaborations. In adopting the surgical robot, teaching hospitals fulfilled their mission to innovate, but failed to generate corresponding scientific evidence.
KW - comparative effectiveness research
KW - diffusion of innovation
KW - new technology
KW - prostate cancer
KW - teaching hospitals
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U2 - 10.1177/1077558716642690
DO - 10.1177/1077558716642690
M3 - Article
C2 - 27034439
AN - SCOPUS:85018739530
VL - 74
SP - 369
EP - 376
JO - Medical Care Research and Review
JF - Medical Care Research and Review
SN - 1077-5587
IS - 3
ER -