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Crippa J, Magistro C, Montroni I, Borroni G, Ziccarelli A, Spinelli A, Mari GM. Charting connections: A systematic review of colorectal surgery research networks. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108322. [PMID: 38653161 DOI: 10.1016/j.ejso.2024.108322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/27/2024] [Accepted: 04/03/2024] [Indexed: 04/25/2024]
Abstract
Research in surgery faces intrinsic difficulties such as the lack of reproducibility of surgical operations, self-referring surgeons, decentralized data. Establishing a community of qualified researchers across surgeons is crucial. Clinical networks have been proposed as solutions to many challenges in surgical research, yet their implementation remains uncommon, especially for surgical trialists. The extent of literature produced by networks remains unclear, but fostering such collaborations could enhance the overall quality of surgical research. We conducted review focusing on research networks in colorectal surgery to assess their workload and impact in the literature and identify factors contributing to their durability. Following PRISMA guidelines, we searched for articles published through research networks. Networks were categorized by subspecialty, and specific items were retrieved for further classification. A survey was administered to twenty experts in colorectal surgery or research networking. A total of 2490 manuscripts were screened, and 397 networks identified. Of these, 96 were colorectal networks contributing to 492 publications, with 28 networks having five or more publications. Seventeen networks were affiliated with International or National societies, and only 5 conducted both prospective trials and RCTs. Twenty networks reported national or population-based data, and 26 networks lasted for more than 5 years. Sixteen experts participated in the survey, with an 80 % compliance rate, and 12 of them have been involved in creating a surgical network. The large majority of experts advocate the establishment of guidelines for networks creation in the surgical community.
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Affiliation(s)
- Jacopo Crippa
- Department of General Surgery, ASST Melegnano e Martesana, Via Pandina 1, Vizzolo Predabissi, Milan, 20070, Italy; AIMS Academy Clinical Research Network, Piazza Ospedale Maggiore 3, 20162, Milan, Italy.
| | - Carmelo Magistro
- Department of General Surgery, ASST Melegnano e Martesana, Via Pandina 1, Vizzolo Predabissi, Milan, 20070, Italy; AIMS Academy Clinical Research Network, Piazza Ospedale Maggiore 3, 20162, Milan, Italy
| | - Isacco Montroni
- Division of Colorectal Surgery, Ospedale Santa Maria delle Croci, Viale Randi 5, 48121, Ravenna, Italy
| | - Giacomo Borroni
- AIMS Academy Clinical Research Network, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Chirurgia Generale Varese 1, ASST Settelaghi, Viale Borri 57, 21100, Varese, Italy
| | - Antonio Ziccarelli
- AIMS Academy Clinical Research Network, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; General Surgery Department, ASUFC, Via Pozzuolo n° 330, 33100, Udine, Italy
| | - Antonino Spinelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy
| | - Giulio Maria Mari
- AIMS Academy Clinical Research Network, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Department of Colorectal Surgery, ASST Brianza, 20832, Viale Mazzini 1, Desio, MB, 20832, Italy
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Rendon JS, Swinton M, Bernthal N, Boffano M, Damron T, Evaniew N, Ferguson P, Galli Serra M, Hettwer W, McKay P, Miller B, Nystrom L, Parizzia W, Schneider P, Spiguel A, Vélez R, Weiss K, Zumárraga JP, Ghert M. Barriers and facilitators experienced in collaborative prospective research in orthopaedic oncology: A qualitative study. Bone Joint Res 2017; 6:307-314. [PMID: 28515060 PMCID: PMC5457637 DOI: 10.1302/2046-3758.65.bjr-2016-0192.r1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Objectives As tumours of bone and soft tissue are rare, multicentre prospective collaboration is essential for meaningful research and evidence-based advances in patient care. The aim of this study was to identify barriers and facilitators encountered in large-scale collaborative research by orthopaedic oncological surgeons involved or interested in prospective multicentre collaboration. Methods All surgeons who were involved, or had expressed an interest, in the ongoing Prophylactic Antibiotic Regimens in Tumour Surgery (PARITY) trial were invited to participate in a focus group to discuss their experiences with collaborative research in this area. The discussion was digitally recorded, transcribed and anonymised. The transcript was analysed qualitatively, using an analytic approach which aims to organise the data in the language of the participants with little theoretical interpretation. Results The 13 surgeons who participated in the discussion represented orthopaedic oncology practices from seven countries (Argentina, Brazil, Italy, Spain, Denmark, United States and Canada). Four categories and associated themes emerged from the discussion: the need for collaboration in the field of orthopaedic oncology due to the rarity of the tumours and the need for high level evidence to guide treatment; motivational factors for participating in collaborative research including establishing proof of principle, learning opportunity, answering a relevant research question and being part of a collaborative research community; barriers to participation including funding, personal barriers, institutional barriers, trial barriers, and administrative barriers and facilitators for participation including institutional facilitators, leadership, authorship, trial set-up, and the support of centralised study coordination. Conclusions Orthopaedic surgeons involved in an ongoing international randomised controlled trial (RCT) were motivated by many factors to participate. There were a number of barriers to and facilitators for their participation. There was a collective sense of fatigue experienced in overcoming these barriers, which was mirrored by a strong collective sense of the importance of, and need for, collaborative research in this field. The experiences were described as essential educational first steps to advance collaborative studies in this area. Knowledge gained from this study will inform the development of future large-scale collaborative research projects in orthopaedic oncology. Cite this article: J. S. Rendon, M. Swinton, N. Bernthal, M. Boffano, T. Damron, N. Evaniew, P. Ferguson, M. Galli Serra, W. Hettwer, P. McKay, B. Miller, L. Nystrom, W. Parizzia, P. Schneider, A. Spiguel, R. Vélez, K. Weiss, J. P. Zumárraga, M. Ghert. Barriers and facilitators experienced in collaborative prospective research in orthopaedic oncology: A qualitative study. Bone Joint Res 2017;6:–314. DOI: 10.1302/2046-3758.65.BJR-2016-0192.R1.
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Affiliation(s)
- J S Rendon
- McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada
| | - M Swinton
- McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada
| | - N Bernthal
- Department of Orthopaedic Surgery, University of California Los Angeles, 1250 16 Street, Suite 3142, Santa Monica, Los Angeles, CA, 90404, USA
| | - M Boffano
- Department of Orthopaedics, AO Città della Salute e della Scienza di Torino, Via Zuretti 29, Torino, 10126 Italy
| | - T Damron
- State University of New York (SUNY) Upstate Medical University, 6620 Fly Road, Suite 100, East Syracuse, NY, 13057, USA
| | - N Evaniew
- McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada
| | - P Ferguson
- Division Chair, Division of Orthopaedic Surgery, University of Toronto, 600 University Avenue, Suite 476G, Toronto, ON, Canada
| | - M Galli Serra
- Universidad Austral, Av. Juan Domingo Péron 1500, 4to. Piso, Derqui B1629ODT Pilar, Buenos Aires, Argentina
| | - W Hettwer
- Department of Orthopaedic Surgery, University of Copenhagen, Copenhagen, 2100, Denmark
| | - P McKay
- McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada
| | - B Miller
- Department of Orthopaedics and Rehabilitation, University of Iowa, 200 Hawkins Drive, 01015 JPP, Iowa City, USA
| | - L Nystrom
- Department of Orthopaedic Surgery and Rehabilitation, Loyola University Chicago, 2160 South First Avenue, Maywood, IL, 60153, USA
| | - W Parizzia
- Universidad Austral, Av. Juan Domingo Péron 1500, 4to. Piso, Derqui B1629ODT Pilar, Buenos Aires, Argentina
| | - P Schneider
- McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON, Canada
| | - A Spiguel
- Department of Orthopaedics and Rehabilitation, University of Florida, 3450 Hull Road, Gainesville, FL, 32607, USA
| | - R Vélez
- Department of Orthopaedic Surgery and Traumatology, Hospital Vall d'Hebron, Pg. Vall d'Hebron 119-129, 2a planta, Barcelona, Spain
| | - K Weiss
- Department of Orthopaedic Surgery, University of Pittsburgh, 5200 Centre Avenue, Shadyside Medical Building, Suite 415, Pittsburgh, PA, USA
| | - J P Zumárraga
- Department of Orthopaedics and Traumatology, Universidade de São Paulo, Universidade de São Paulo, Rua Dr. Ovídio Pires de Campos, 333, Cerqueira Cesar, São Paulo, SP, Brazil
| | - M Ghert
- Department of Surgery, McMaster University, 711 Concession Street, Surgical Offices B3 169A
- Hamilton, ON, Canada
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Søreide K, Alderson D, Bergenfelz A, Beynon J, Connor S, Deckelbaum DL, Dejong CH, Earnshaw JJ, Kyamanywa P, Perez RO, Sakai Y, Winter DC. Strategies to improve clinical research in surgery through international collaboration. Lancet 2013; 382:1140-51. [PMID: 24075054 DOI: 10.1016/s0140-6736(13)61455-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
More than 235 million patients undergo surgery every year worldwide, but less than 1% are enrolled in surgical clinical trials--few of which are international collaborations. Several levels of action are needed to improve this situation. International research collaborations in surgery between developed and developing countries could encourage capacity building and quality improvement, and mutually enhance care for patients with surgical disorders. Low-income and middle-income countries increasingly report much the same range of surgical diseases as do high-income countries (eg, cancer, cardiovascular disease, and the surgical sequelae of metabolic syndrome); collaboration is therefore of mutual interest. Large multinational trials that cross cultures and levels of socioeconomic development might have faster results and wider applicability than do single-country trials. Surgeons educated in research methods, and aided by research networks and trial centres, are needed to foster these international collaborations. Barriers to collaboration could be overcome by adoption of global strategies for regulation, health insurance, ethical approval, and indemnity coverage for doctors.
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Affiliation(s)
- Kjetil Søreide
- Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.
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