Evaluating innovation. Part 1: The concept of progressive scholarly acceptance

Schnurman, Zane; Kondziolka, Douglas

doi:10.3171/2015.1.jns142661

Cited by 19 publications

(27 citation statements)

References 10 publications

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“…The theory behind PSA and techniques for modeling it are explained in more detail in Part 1 of this report. 23 In brief, the idea of PSA stems from the common view of surgical innovators as "tinkerers" who continually refine procedures. 3 This view is historically supported, and surgical innovation can be viewed as a series of broad innovations, followed by periods of refinement.…”

Section: Defining Community Acceptancementioning

confidence: 99%

“…More details on differentiating initial from refining studies are presented in Part 1 of this report. 23 In addition to publication dates and defining the studies as initial or refining, other report characteristics were recorded to investigate development patterns. The number of patients studied (not including control subjects), the authors and main site of investigation, the study design, and whether the study was conducted in the United States or abroad were all noted.…”

Section: Data Collectionmentioning

confidence: 99%

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Evaluating innovation. Part 2: Development in neurosurgery

Schnurman¹,

Kondziolka²

2016

JNS

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______________________________________________________________________________________________________________________________________ -------------------------INDICATIONS AND USAGE-------------------------------G GL LI IA AD DE EL L W Wa af fe er r i is s a an n a al lk ky yl la at ti in ng g d dr ru ug g i in nd di ic ca at te ed d f fo or r t th he e t tr re ea at tm me en nt t o of f: :   n ne ew wl ly y--d di ia ag gn no os se ed d h hi ig gh h--g gr ra ad de e--m ma al li ig gn na an nt t g gl li io om ma a a as s a an n a ad dj ju un nc ct t t to o s su ur rg ge er ry y a an nd d r ra ad di ia at ti io on n ( (1 1) ) a an nd d   r re ec cu ur rr re en nt t g gl li io ob bl la as st to om ma a m mu ul lt ti if fo or rm me e a as s a an n a ad dj ju un nc ct t t to o s su ur rg ge er ry y ( (1 1) )

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Section: Defining Community Acceptancementioning

confidence: 99%

Section: Data Collectionmentioning

confidence: 99%

Evaluating innovation. Part 2: Development in neurosurgery

Schnurman¹,

Kondziolka²

2016

JNS

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“…The transition between these 2 phases has been called progressive scholarly acceptance [21]. Presumably, it is only then that such a therapy would be included in teaching schedules in general at medical schools.…”

Section: Discussionmentioning

confidence: 99%

What Do Medical Students Know about Deep Brain Stimulation

Wloch¹,

Saryyeva²,

Heissler³

et al. 2017

Stereotact Funct Neurosurg

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Background: Deep brain stimulation (DBS) is an established therapy for movement disorders. It is currently under investigation in neuropsychiatric disorders. Neurophobia is a common phenomenon that might have a negative impact in medical education. Little is known about medical students' knowledge about DBS when they enter university and what they learn about it during their medical formation. Methods: A 10-item questionnaire was designed. Questions addressed indications for DBS, costs of DBS, complications, the percentage of Parkinson disease (PD) patients who might profit from DBS, etc. Students at Hannover Medical School were asked to complete the questionnaire in the preclinical study period and in the last year of the study. Results: Comparing the “early group” (204 students) and the “advanced group” (162 students), there was a significant gain of knowledge. More common disorders such as PD and tremor were known to be indications for DBS. Knowledge about the impact of DBS on specific symptoms in PD and about DBS targets was limited in both groups. Conclusions: DBS is partly known among medical students in the preclinical phase with a gain of knowledge during further study. Future studies on this topic addressing general practitioners as neurologists are needed to better understand why knowledge on DBS is still limited.

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“…26 In brief, the goal of a PSA model is to use peer-reviewed publications to identify a standard end point when a procedure can be considered to have been accepted by the relevant scientific community.…”

Section: Progressive Scholarly Acceptancementioning

confidence: 99%

“…Two PSA models were used, an annual model and a cumulative model (referred to as the compounding model in our prior report). 26 In the annual analysis, the number of initial investigations and number of refining studies each year were plotted against time as line graphs. With this model, the annual number of studies can be seen for each year, making it a valuable tool to visualize fluctuations in the number of publications and the immediate impact of different factors.…”

Section: Progressive Scholarly Acceptance Analysismentioning

confidence: 99%

Off-label innovation: characterization through a case study of rhBMP-2 for spinal fusion

Schnurman¹,

Smith²,

Kondziolka³

2016

SPI

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OBJECTIVE Off-label therapies are widely used in clinical practice by spinal surgeons. Some patients and practitioners have advocated for increased regulation of their use, and payers have increasingly questioned reimbursment for off-label therapies. In this study, the authors applied a model that quantifies publication data to analyze the developmental process from initial on-label use to off-label innovation, using as an example recombinant human bone morphogenetic protein 2 (rhBMP-2) because of its wide off-label use. METHODS As a case study of off-label innovation, the developmental patterns of rhBMP-2 from FDA-approved use for anterior lumbar interbody fusion to several of its off-label uses, including posterolateral lumbar fusion, anterior cervical discectomy and fusion, and posterior lumbar interbody fusion/transforaminal lumbar interbody fusion, were evaluated using the “progressive scholarly acceptance” (PSA) model. In this model, PSA is used as an end point indicating acceptance of a therapy or procedure by the relevant scientific community and is reached when the total number of peer-reviewed studies devoted to refinement or improvement of a therapy surpasses the total number assessing initial efficacy. Report characteristics, including the number of patients studied and study design, were assessed in addition to the time to and pattern of community acceptance, and results compared with previous developmental study findings. Disclosures and reported conflicts of interest for all articles were reviewed, and these data were also used in the analysis. RESULTS Publication data indicated that the acceptance of rhBMP-2 off-label therapies occurred more rapidly and with less evidence than previously studied on-label therapies. Additionally, the community appeared to respond more robustly (by rapidly changing publication patterns) to reports of adverse events than to new questions of efficacy. CONCLUSIONS The development of off-label therapies, including the influence of investigative methods, regulation, and changing perspectives, can be characterized on the basis of publication patterns. The approach and findings in this report could inform future off-label development of therapies and procedures as well as attempts to regulate off-label use.

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Evaluating innovation. Part 1: The concept of progressive scholarly acceptance

Cited by 19 publications

References 10 publications

Evaluating innovation. Part 2: Development in neurosurgery

Evaluating innovation. Part 2: Development in neurosurgery

What Do Medical Students Know about Deep Brain Stimulation

Off-label innovation: characterization through a case study of rhBMP-2 for spinal fusion

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