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New operations and surgical devices spread by enthusiasm before evidence, as robotic prostatectomy, minimally invasive radical hysterectomy and HIPEC did. Every new cancer surgical technique would follow the IDEAL framework, with a prospective registry from first use, defined triggers for a randomised comparison, and payment conditional on registry participation until assessment is complete.
Regulators and payers require that new cancer surgical techniques and devices follow the IDEAL framework (idea, development, exploration, assessment, long-term study), with a prospective registry from first use, defined triggers for moving to a randomised comparison, and reimbursement conditional on registry participation until assessment is complete. Devices already need regulatory clearance but techniques need none, and both diffuse before evidence exists (robotic prostatectomy, minimally invasive radical hysterectomy, cytoreductive surgery with HIPEC). Registries also produce the learning-curve and volume data needed for credentialling.
Shares Intuitive Surgical, Surgery and radiotherapy cure most, get least, Robotic & minimally invasive surgery.
Shares A translation fund for academic surgical devices and radiotherapy technology, A video-based surgical quality registry linking assessed skill to cancer outcomes, Device-agnostic public trials of ablation technologies against surgery, Surgery and radiotherapy cure most, get least.
Shares An independent evaluation unit for surgical robots and AI, paid on evidence, A video-based surgical quality registry linking assessed skill to cancer outcomes, Device-agnostic public trials of ablation technologies against surgery, Surgery and radiotherapy cure most, get least.
Shares An independent evaluation unit for surgical robots and AI, paid on evidence, Weak real-world evidence and registries, Surgery and radiotherapy cure most, get least, Prostate cancer.
Shares A translation fund for academic surgical devices and radiotherapy technology, Surgery and radiotherapy cure most, get least, Prostate cancer.
Shares Device-agnostic public trials of ablation technologies against surgery, Focused ultrasound & histotripsy.
Shares Intuitive Surgical, Prostate cancer.
Shares Publish a per-lesion miss rate for every prostate MRI service before it is allowed to guide focal treatment, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch, Prostate cancer.