Teaching Hospitals and the Disconnect between Technology Adoption and Comparative Effectiveness Research: The Case of the Surgical Robot

Danil V. Makarov, Huilin Li, Herbert Lepor, Cary P. Gross, Jan Blustein

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)369-376
Number of pages8
JournalMedical Care Research and Review
Volume74
Issue number3
Early online dateMar 30 2016
DOIs
StatePublished - Jun 1 2017

Keywords

  • comparative effectiveness research
  • diffusion of innovation
  • new technology
  • prostate cancer
  • teaching hospitals

ASJC Scopus subject areas

  • Health Policy

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