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Evidence-based Global Surgery
www.GlobalSurg.org
Dr Edward Fitzgerald
@DrEdFitzgerald
What is GlobalSurg?
Meritocratic group authorship Building global networks
Snap-shot methodology
Align projects to clinical needs Any hospital, any where
High-quality, protocol-led Empowering grass-roots surgeons
Building research capacity
Prospective, bedside-level patient data
Perioperative outcomes by HDI
• https://www.youtube.com/watch?v=STnx6VliTIQ
What it is (and what it isn’t)
EFFICIENT
EFFECTIVE
ECONOMICAL
Protocol-led, core data set, snap-shot methodology
Global penetrance, rapid completion and turn-around
Minimal financial support, own time, low burden
How is it delivered?
Peer reviewed
protocol
disseminated
globally
Collaborator
registration
online
Country leads
coordinate
Complete online
training module
Online central
support and
troubleshooting
14-day snapshot
data collection
within 6-month
window for
participation
Online data
upload and
central analysis
Global ‘Crowd-sourced’ Surgical Outcomes
www.globalsurg.org
HIGH HDI MIDDLE HDI LOW HDI
6538 patients
(60.8%)
2889 patients
(26.9%)
1318 patients
(12.3%)
10,745 patients357 hospitals 58 countries
Primary Outcome: 24-hour postoperative mortality rate (POMR)
Secondary Outcome: 30-day postoperative mortality rate (POMR)
HDI = Human Development Index
Mortality is three times higher in low- compared with high-HDI
countries even when adjusted for prognostic factors
Collaboration Driven High-Impact Results
GlobalSurg Collaborative. BJS 2016; 103: 971–988
www.globalsurg.org
Global feedback in real time
v
Open publication of peer reviews
http://globalsurg.org/read-the-peer-reviews-for-globalsurg-1/
GlobalSurg 2
Determining the worldwide epidemiology of surgical site
infections after abdominal surgery
www.globalsurg.org │ enquiry@globalsurg.org
Database outputs in real time
Establishing a robust validation process
1. Centre-based collaborator questionnaire
2. Independent on-site validation
• Case ascertainment
• Sampled data accuracy
3. Collaborator interview (process vs. system)
Collaboration: Future vision
• Large-scale collaboration normalised
• Methods adopted globally for other clinical areas
• Incorporated into training programmes
• Hands-on research skills training
• All allied-health professional contributing
• Role for all in participating and up-skilling
• Results used as foundation for interventions
• Technology and data/analysis evolves
• Website: www.globalsurg.org
• Email: enquiry@globalsurg.org
www.facebook.com/GlobalSurg
@GlobalSurg
• GlobalSurg is run by the SURG Foundation charity.
• Please donate to support us! https://www.givey.com/surg_foundation
Thank you

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GlobalSurg Bethune global surgery conference presentation

  • 1. Evidence-based Global Surgery www.GlobalSurg.org Dr Edward Fitzgerald @DrEdFitzgerald
  • 2.
  • 3. What is GlobalSurg? Meritocratic group authorship Building global networks Snap-shot methodology Align projects to clinical needs Any hospital, any where High-quality, protocol-led Empowering grass-roots surgeons Building research capacity Prospective, bedside-level patient data Perioperative outcomes by HDI
  • 5. What it is (and what it isn’t) EFFICIENT EFFECTIVE ECONOMICAL Protocol-led, core data set, snap-shot methodology Global penetrance, rapid completion and turn-around Minimal financial support, own time, low burden
  • 6.
  • 7. How is it delivered? Peer reviewed protocol disseminated globally Collaborator registration online Country leads coordinate Complete online training module Online central support and troubleshooting 14-day snapshot data collection within 6-month window for participation Online data upload and central analysis
  • 8.
  • 9.
  • 10. Global ‘Crowd-sourced’ Surgical Outcomes www.globalsurg.org
  • 11. HIGH HDI MIDDLE HDI LOW HDI 6538 patients (60.8%) 2889 patients (26.9%) 1318 patients (12.3%) 10,745 patients357 hospitals 58 countries Primary Outcome: 24-hour postoperative mortality rate (POMR) Secondary Outcome: 30-day postoperative mortality rate (POMR) HDI = Human Development Index
  • 12. Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors Collaboration Driven High-Impact Results GlobalSurg Collaborative. BJS 2016; 103: 971–988
  • 13.
  • 14.
  • 16.
  • 17. Global feedback in real time
  • 18. v
  • 19. Open publication of peer reviews http://globalsurg.org/read-the-peer-reviews-for-globalsurg-1/
  • 20.
  • 21.
  • 22. GlobalSurg 2 Determining the worldwide epidemiology of surgical site infections after abdominal surgery www.globalsurg.org │ enquiry@globalsurg.org
  • 23. Database outputs in real time
  • 24. Establishing a robust validation process 1. Centre-based collaborator questionnaire 2. Independent on-site validation • Case ascertainment • Sampled data accuracy 3. Collaborator interview (process vs. system)
  • 25. Collaboration: Future vision • Large-scale collaboration normalised • Methods adopted globally for other clinical areas • Incorporated into training programmes • Hands-on research skills training • All allied-health professional contributing • Role for all in participating and up-skilling • Results used as foundation for interventions • Technology and data/analysis evolves
  • 26. • Website: www.globalsurg.org • Email: enquiry@globalsurg.org www.facebook.com/GlobalSurg @GlobalSurg • GlobalSurg is run by the SURG Foundation charity. • Please donate to support us! https://www.givey.com/surg_foundation Thank you