Search Results

You are looking at 1 - 10 of 909 items for :

  • "innovation" x
  • All content x
Clear All
Full access

Zane Schnurman and Douglas Kondziolka

, including communications of personal experience or historical usage, in addition to clinical studies. Yet recently calls have intensified from payers, regulators, and many in the medical community to limit the definition of efficacy to high-level evidence, chiefly that from randomized controlled trials (RCTs). For better or worse, a major consequence of such adoption will be alterations in the way surgeons investigate new procedures. Effective reform requires critical evaluation of how innovations currently develop from conception to general acceptance. The goal of

Full access

Zane Schnurman and Douglas Kondziolka

, there may be numerous external forces that contribute to an innovation’s pace and process. 8 Pressures from the lay community, regulatory rulings, and funding sources are examples of factors that could play a role in the evolution of a new idea. All are components worthy of study. Considering the wide implications of which treatments become designated as acceptable, further investigation of how a therapy moves from conception to acceptance is warranted. This is particularly important in fields in which treatment development is less standardized. For many new drugs

Full access

Zane Schnurman, Michael L. Smith, and Douglas Kondziolka

significantly impact clinical practice and surgical innovation. To better understand the effect of such regulations and inform any discussion of their implementation, it is essential to understand how off-label therapies develop and how the surgical community comes to embrace new off-label uses. In this study, we analyzed the development of off-label therapies with a model called progressive scholarly acceptance (PSA), which uses publication data and patterns to characterize the process of development from on-label use to off-label innovation. Recombinant bone morphogenetic

Full access

Hani J. Marcus, Archie Hughes-Hallett, Richard M. Kwasnicki, Ara Darzi, Guang-Zhong Yang, and Dipankar Nandi

T echnological innovation within health care may be defined as the introduction of a new technology that initiates a change in clinical practice. 20 , 24 Neurosurgery is a particularly technology-intensive surgical discipline, and new technologies have preceded many of the major advances in operative neurosurgical techniques, including the development of microneurosurgery. 11 , 13 Although the study of innovation is a relatively mature academic field in social science and industry, 19 its application in the health care setting has been largely

Restricted access

Stephen J. Haines

of the types of error they are designed to eliminate. We have seen that this type of evaluation has become accepted in many branches of medicine as the most definitive method of testing innovations in therapy. We may reasonably ask how surgery in general, and neurosurgery in particular, measure up to this standard. Randomized clinical trials have been successfully conducted by surgeons many times in the past. Anderson and Baden 1 have reviewed this subject from the point of view of the gastrointestinal surgeon. Chodak and Plaut 12 cited a number of well

Restricted access

Ralph G. Dacey Jr.

and procedures for the effective classification of what is new in the surgical treatment of a patient and what is part of standard practice. As the authors point out, there is a large “gray area” between a truly new procedure and the innovation and problem solving that contribute to the care of many patients who undergo neurosurgery. The authors have described a set of recommendations for the “surgical innovator” on the appropriate use of the IRB, colleagues, and the neurosurgeon-in-chief for advice and approval when new procedures or components of procedures are

Full access

Frederick A. Boop

the development of global cable communications. This scene from 1966 with New York Harbor and the Statue of Liberty in the background signifies the role of American industry in our World of Innovation. Courtesy of AT&T Archives and History Center. Figure is available in color online only. The Past Cyrus West Field, who some have called “the greatest American of whom you’ve never heard” ( Fig. 2 ), 5 was born in New York City in 1819 and, despite a sickly youth, began his first job working in a dry goods store at the age of 15. Fig. 2. Cyrus West Field, the force

Restricted access

Mark Bernstein and Joseph Bampoe

, 54 What is not so clear, however, is which surgical procedures require an IRB examination or some other form of formal regulation. Furthermore, there is mounting evidence that IRBs are under significant strain, exhibiting inadequate levels of performance, 5 and are in need of significant reform. 46 When the surgical procedure is part of an RCT in which an experimental treatment is tested, such as high-activity brachytherapy for malignant brain tumors, the requirement of IRB approval would seem to be clear. 29, 44 Nevertheless, most surgical innovation does not

Restricted access

Changing our culture

Special topic

Deborah L. Benzil

Brinkley related “Historical Lessons on the Importance of Innovation and Diversity.” As leaders, our impact is incompletely realized if we ignore the potential of diversity. Mixing people with different strengths and backgrounds can help unleash a new font of talent and creativity. Reading this key leadership concept helps us understand some of the greatest successes within the CNS, AANS, and CSNS and unfortunately also some of the projects that fell short despite good ideas and strong leaders. There is this enduring but destructive myth that we must have unanimity to

Full access

S. Harrison Farber, Steven Thomas, Gary Pace, and Shivanand P. Lad

TO THE EDITOR: We would like to comment on the article by Marcus et al. 1 (Marcus HJ, Hughes-Hallett A, Kwasnicki RM, et al: Technological innovation in neurosurgery: a quantitative study. J Neurosurg 123: 174–181, July 2015) that was recently published in the Journal of Neurosurgery. In this study the authors searched a patent database to identify the top-performing patent codes, which were subsequently grouped into “technology clusters.” Concurrently, they queried PubMed to identify peer-reviewed publications. Patents and publications were used as