An independent jury-based consensus conference model for the development of recommendations in medico-surgical practice

Lesurtel, Mickaël; Perrier, Arnaud; Bossuyt, Patrick M.; Langer, Bernard; Clavien, Pierre‐Alain

doi:10.1016/j.surg.2013.10.003

Cited by 21 publications

(24 citation statements)

References 7 publications

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“…The Morioka Consensus Conference used an independent jury‐based consensus model to achieve its goal through analysis of the available literature and expert presentations to jury panels 117. Because the evidence level for LLR is low for developing strong recommendations, it was reasonable to develop consensus statements by jury decision.…”

Section: The Two Consensus Conferencesmentioning

confidence: 99%

Evolution and revolution of laparoscopic liver resection in Japan

Kaneko

Otsuka

Kubota

et al. 2017

Annals of Gastroent Surgery

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Due to important technological developments and improved endoscopic techniques, laparoscopic liver resection (LLR) is now considered the approach of choice and is increasingly performed worldwide. Recent systematic reviews and meta‐analyses of observational data reported that LLR was associated with less bleeding, fewer complications, and no oncological disadvantage; however, no prospective randomized trials have been conducted. LLR will continue to evolve as a surgical approach that improves patient's quality of life. LLR will not totally supplant open liver surgery, and major LLR remains to be technically challenging procedure. The success of LLR depends on individual learning curves and adherence to surgical indications. A recent study proposed a scoring system for stepwise application of LLR, which was based on experience at high‐volume Japanese centers. A cluster of deaths after major LLR was sensationally reported by the Japanese media in 2014. In response, the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery conducted emergency data collection on operative mortality. The results demonstrated that mortality was not higher than that for open procedures except for hemi‐hepatectomy with biliary reconstruction. An online prospective registry system for LLR was established in 2015 to be transparent for patients who might potentially undergo treatment with this newly developed, technically demanding surgical procedure.

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Section: The Two Consensus Conferencesmentioning

confidence: 99%

Evolution and revolution of laparoscopic liver resection in Japan

Kaneko

Otsuka

Kubota

et al. 2017

Annals of Gastroent Surgery

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“…30 However, acquiring surgical mastery in LLR is difficult and requires specific training. 32 However, the experts provided recommendations on questions 8 to 17, which were related to technical aspects of LLR. Enthusiasm for new surgical technologies such as LLR should not stand in the way of proper comparative evaluation.…”

mentioning

confidence: 99%

A Systematic Review of the Impact of Dedicated Emergency Surgical Services on Patient Outcomes

et al. 2016

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ACS models as well as centralized units and hospitals with dedicated emergency operating rooms, access to radiology and intensive care facilities (ITU) are all factors associated with improved clinical and financial outcomes in the delivery of emergency general surgery. There is, however, no consensus on the elements that constitute an ideal ACS model and how it can be implemented into current surgical practice.

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“…As an answer to this demand, a consensus conference with the title "Chair4 Medicine" was organized in Zurich in 2014. As a basis of this approach, the Zurich-Danish model was applied [9]. In the setting of this model, nine panels of experts, three to six persons per panel, multidisciplinary and international, prepared recommendations on different topics of leadership, e. g., "How to attract the best candidates", "How to assess teaching abilities", etc.…”

Section: Selection Processmentioning

confidence: 99%

Leadership in the 21st century

Kron¹,

Linecker²,

Graf³

et al. 2016

Eur Surg

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Background Leadership is considered important in academic health care systems and the demands on individual leaders are growing. Most often, leadership styles are self-taught by observation and practice. In the past, leadership was primarily defined by the tripod: research, patient care, and education. Beside the three traditional, tasks there is a business-oriented trend in health care, demanding an extreme diversity of abilities, e. g., skills in financial management, communication skills, conflict solving skills, networking, and rewarding skills. Integrating all these aspects to define the profile of a future chairperson has not been possible in the field of academic medicine. Methods A literature search for leadership in academic medicine was performed. In addition, the contributions to the conference "Chair4Medicine" were evaluated. Results Despite growing requirements for a leadership position, one essential property stayed the same over the years: a leader has to educate the next generation of surgeons and be a good motivator and inspiring teacher. Concerning education, surgery is facing a dilemma, displayed by a continuing decrease of applicants in surgical disciplines over the last years. Ten to 15 years ago, the number of applications for a surgical residency position was larger than the positions available. Today, this situation is clearly reversed, as indicated by a noticeable deficit in recruits. The decision to become a surgeon has become more and more unpopular. Reasons for this development are manifold, but often-mentioned causes are a lack of work-life balance, and a chaotic and non-inspiring training process combined with non-attractive leadership styles. Conclusions There is a need for defining objective criteria to identify a future chair in an academic medical center. If the ongoing trend of decreased applications in general surgery continues, we will face a lack of top-motivated surgeons in the close future. More than ever, leadership styles and centers have to rethink their way of teaching and define a new way of being "attractive" for young surgical residents to guarantee the succession of the next generation. Educational opportunities, a clearly structured curriculum, and a productive environment are assumed crucial prerequisites for the next generation. Objective guidelines and instruments for the improvement of education should be developed and implemented.

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An independent jury-based consensus conference model for the development of recommendations in medico-surgical practice

Cited by 21 publications

References 7 publications

Evolution and revolution of laparoscopic liver resection in Japan

Evolution and revolution of laparoscopic liver resection in Japan

A Systematic Review of the Impact of Dedicated Emergency Surgical Services on Patient Outcomes

Leadership in the 21st century

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