Global Evidence Gap Assessment for da Vinci Robotic-Assisted Surgery Over a 5-Year Time Horizon
Author(s)
Akshay Chacko, BS1, Ana Yankovsky, MSc2, Usha Kreaden, MSc2;
1Intuitive Surgical Inc., Machine Learning Engineer, Sunnyvale, CA, USA, 2Intuitive Surgical Inc., Sunnyvale, CA, USA
1Intuitive Surgical Inc., Machine Learning Engineer, Sunnyvale, CA, USA, 2Intuitive Surgical Inc., Sunnyvale, CA, USA
Presentation Documents
OBJECTIVES: Scientific publications are crucial to evidence-based evaluation of robotic-assisted surgery with da Vinci surgical systems (dV-RAS) across policymakers, payors, surgeons, and patients. We aim to assess the change in both publication volume and level of evidence (LOE) across country, surgical procedure, and outcome for dV-RAS from 2019 to 2024.
METHODS: Publications on dV-RAS were identified from PubMed, Scopus and Embase. Librarian-assigned metadata and a Python search algorithm were used to select studies across 12 procedures, 9 outcomes, and 13 countries. Tableau visual analysis was conducted to stratify the data by country, procedure, and outcome. An Evidence Quality Index (EQI) score was assigned to each LOE to quantitatively assess evidence growth.
RESULTS: The total EQI score for malignant procedures was 2,198 in 2019 and 2,738 in 2024 (25% growth). For benign, the total EQI grew from 601 to 987 (64% growth). For malignant procedures the largest EQI delta was 75 for EU Lobectomy (93.8% increase), followed by 52 for EU Endometrial Hysterectomy (62.7% increase). For benign, the largest EQI delta was 49 for EU Inguinal Hernia (700% increase), followed by 47 for APAC Benign Hysterectomy (66.2% increase). The smallest malignant EQI delta was 6 for both Americas Endometrial Hysterectomy and APAC Cervical Hysterectomy. For benign procedures, the APAC Gastric Bypass EQI grew by 0. The EQI of numerous benign procedures grew by several hundred percent. In comparison, only two malignant EQIs grew by more than 50%, given the existing mature evidence base.
CONCLUSIONS: This analysis facilitates evidence gap and trend identification, and should be regularly performed to track evidence growth. It also highlights outliers requiring further investigation such as APAC Gastric Bypass, where unseen obstacles may be preventing the evidence from maturing. Next steps include further investigating the impact of external factors (ie. COVID-19) on evidence generation, and also improving the publication selection algorithm.
METHODS: Publications on dV-RAS were identified from PubMed, Scopus and Embase. Librarian-assigned metadata and a Python search algorithm were used to select studies across 12 procedures, 9 outcomes, and 13 countries. Tableau visual analysis was conducted to stratify the data by country, procedure, and outcome. An Evidence Quality Index (EQI) score was assigned to each LOE to quantitatively assess evidence growth.
RESULTS: The total EQI score for malignant procedures was 2,198 in 2019 and 2,738 in 2024 (25% growth). For benign, the total EQI grew from 601 to 987 (64% growth). For malignant procedures the largest EQI delta was 75 for EU Lobectomy (93.8% increase), followed by 52 for EU Endometrial Hysterectomy (62.7% increase). For benign, the largest EQI delta was 49 for EU Inguinal Hernia (700% increase), followed by 47 for APAC Benign Hysterectomy (66.2% increase). The smallest malignant EQI delta was 6 for both Americas Endometrial Hysterectomy and APAC Cervical Hysterectomy. For benign procedures, the APAC Gastric Bypass EQI grew by 0. The EQI of numerous benign procedures grew by several hundred percent. In comparison, only two malignant EQIs grew by more than 50%, given the existing mature evidence base.
CONCLUSIONS: This analysis facilitates evidence gap and trend identification, and should be regularly performed to track evidence growth. It also highlights outliers requiring further investigation such as APAC Gastric Bypass, where unseen obstacles may be preventing the evidence from maturing. Next steps include further investigating the impact of external factors (ie. COVID-19) on evidence generation, and also improving the publication selection algorithm.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
CO163
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
No Additional Disease & Conditions/Specialized Treatment Areas