SAGES Research Agenda in Gastrointestinal and Endoscopic Surgery: Updated Results of a Delphi Study

Dimitrios Stefanidis, MD, PhD, Paul Montero, MD, David R Urbach, MD, MPH, Aurora Pryor, MD. Carolinas Healtcare System, University of Colorado, University of Toronto, Stony Brook University.

Background: Research in gastrointestinal and endoscopic surgery has witnessed an unprecedented growth since the introduction of minimally invasive techniques in surgery. Coordination and focus of research efforts could further advance the impact of this rapidly expanding field. To guide such endeavors, the Research Committee of SAGES developed and published a research agenda in 2007. That agenda informed the research community of the top 40 research priorities in the field based on input from the SAGES membership. The objectives of this study were to update the SAGES research agenda for gastrointestinal and endoscopic surgery and explore differences in priority ratings between SAGES leadership and general membership.

Methods: The modified Delphi methodology was used to create the research agenda. Using an iterative, anonymous web-based survey, the membership of SAGES was asked for input over three rounds. In Round 1 they were asked to submit up to five important research questions in gastrointestinal and endoscopic surgery. Submitted questions were reviewed by an expert panel, consolidated, and redistributed to the participants for priority ranking using a 5 point Likert scale of importance in Round 2. The top 40 research questions including their ratings from this Round were then redistributed to the participants for a final rating; the results of this final round were used to establish the updated research agenda. Comparisons were made between the ratings of SAGES leadership and general membership using Mann Whitney- U test. P<0.05 was considered significant.

Results: 283 initially submitted research questions were condensed into 89 distinct questions by the expert panel and were then redistributed to the membership for priority ranking. 383 members provided ratings during round 2 and the top 40 questions were rerated by 459 members during round 3 leading to the final ranking of these 40 most important research questions. The top ranked questions involved GI/Biliary, hernia, and bariatric-related topics. The highest rated question was, “How do we best train, assess, and maintain proficiency of surgeons and surgical trainees in flexible endoscopy, laparoscopy, and open surgery?” 28% of responders were leadership and the rest general members. The majority of ratings (73%) were similar between SAGES leadership and general membership with differences mainly noted in questions relating to endoscopy, foregut, and colorectal surgery. SAGES leadership ratings were lower in 89% of questions.

Conclusions: An updated research agenda for gastrointestinal and endoscopic surgery was developed using a systematic methodology. This research agenda will enhance the ability of investigators and funding organizations to focus attention to areas most likely to advance the field and by editors and reviewers to assess the merit and relevance of scientific contributions.

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