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A Delphi consensus statement for digital surgery
npj Digital Medicine ( IF 12.4 ) Pub Date : 2022-07-19 , DOI: 10.1038/s41746-022-00641-6
Kyle Lam 1, 2 , Michael D Abràmoff 3, 4 , José M Balibrea 5, 6 , Steven M Bishop 7 , Richard R Brady 8, 9 , Rachael A Callcut 10 , Manish Chand 11 , Justin W Collins 7, 11 , Markus K Diener 12, 13 , Matthias Eisenmann 14 , Kelly Fermont 15 , Manoel Galvao Neto 16, 17 , Gregory D Hager 18, 19 , Robert J Hinchliffe 20 , Alan Horgan 9 , Pierre Jannin 21 , Alexander Langerman 22, 23 , Kartik Logishetty 1 , Amit Mahadik 24 , Lena Maier-Hein 14, 25, 26, 27 , Esteban Martín Antona 28 , Pietro Mascagni 29, 30, 31 , Ryan K Mathew 32, 33 , Beat P Müller-Stich 34, 35 , Thomas Neumuth 36 , Felix Nickel 34 , Adrian Park 37 , Gianluca Pellino 38, 39 , Frank Rudzicz 40, 41, 42, 43 , Sam Shah 44 , Mark Slack 7, 45, 46 , Myles J Smith 47, 48 , Naeem Soomro 49 , Stefanie Speidel 50, 51 , Danail Stoyanov 52 , Henry S Tilney 1, 53 , Martin Wagner 34, 35 , Ara Darzi 1, 2 , James M Kinross 1 , Sanjay Purkayastha 1
Affiliation  

The use of digital technology is increasing rapidly across surgical specialities, yet there is no consensus for the term ‘digital surgery’. This is critical as digital health technologies present technical, governance, and legal challenges which are unique to the surgeon and surgical patient. We aim to define the term digital surgery and the ethical issues surrounding its clinical application, and to identify barriers and research goals for future practice. 38 international experts, across the fields of surgery, AI, industry, law, ethics and policy, participated in a four-round Delphi exercise. Issues were generated by an expert panel and public panel through a scoping questionnaire around key themes identified from the literature and voted upon in two subsequent questionnaire rounds. Consensus was defined if >70% of the panel deemed the statement important and <30% unimportant. A final online meeting was held to discuss consensus statements. The definition of digital surgery as the use of technology for the enhancement of preoperative planning, surgical performance, therapeutic support, or training, to improve outcomes and reduce harm achieved 100% consensus agreement. We highlight key ethical issues concerning data, privacy, confidentiality and public trust, consent, law, litigation and liability, and commercial partnerships within digital surgery and identify barriers and research goals for future practice. Developers and users of digital surgery must not only have an awareness of the ethical issues surrounding digital applications in healthcare, but also the ethical considerations unique to digital surgery. Future research into these issues must involve all digital surgery stakeholders including patients.



中文翻译:

德尔福数字手术共识声明

数字技术的使用在外科专业中迅速增加,但对“数字手术”一词尚无共识。这一点至关重要,因为数字健康技术提出了外科医生和手术患者独有的技术、治理和法律挑战。我们的目标是定义数字手术这个术语以及围绕其临床应用的伦理问题,并确定未来实践的障碍和研究目标。来自外科、人工智能、工业、法律、伦理和政策等领域的 38 位国际专家参加了四轮德尔菲演习。问题由专家小组和公共小组通过围绕从文献中确定的关键主题的范围界定问卷产生,并在随后的两轮问卷调查中进行投票。如果 > 70% 的小组成员认为该陈述重要,而 <30% 的人认为该陈述不重要。举行了最后一次在线会议,讨论共识声明。数字化手术的定义是使用技术来增强术前计划、手术性能、治疗支持或培训,以改善结果和减少伤害,达成了 100% 的共识。我们强调有关数据、隐私、保密和公众信任、同意、法律、诉讼和责任以及数字手术中的商业伙伴关系的关键伦理问题,并确定未来实践的障碍和研究目标。数字手术的开发者和用户不仅要了解医疗保健中数字应用的伦理问题,还要了解数字手术特有的伦理问题。

更新日期:2022-07-19
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