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Adoption of a novel surgical innovation into clinical practice: protocol for a qualitative systematic review examining surgeon views
  1. Thomas L Lewis1,
  2. Hugh N Furness2,
  3. George W Miller3,
  4. Nicholas Parsons4,
  5. Kate Seers5,
  6. Martin Underwood6,
  7. Andrew J Metcalfe1,6
  1. 1 Department of Trauma and Orthopaedic Surgery, University Hospital Coventry & Warwick, Coventry, UK
  2. 2 St George’s University of London, London, UK
  3. 3 Dept. of Surgery, St Thomas’s Hospital, London, UK
  4. 4 Statistics and Epidemiology Unit, Warwick Medical School, University of Warwick, Coventry, UK
  5. 5 Warwick Research in Nursing, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
  6. 6 Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, UK
  1. Correspondence to Thomas L Lewis; tlewis{at}


Introduction Efficient adoption of clinically effective novel surgical innovations has great potential benefits for patients. Factors affecting the adoption of surgical innovation are not well understood and proposed models of adoption do not accurately correlate with historical evidence. This protocol is for a systematic review that aims to identify the qualitative evidence relating to surgeon views regarding the adoption of novel surgical innovation into clinical practice.

Methods and analysis A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance will be performed. Two independent reviewers will search the following databases: MEDLINE, Embase, Science Direct, Scopus, Web of Science and the Cochrane Library of Systematic Reviews. Inclusion criteria are studies which report on the views of surgeons who adopt a novel surgical innovation into clinical practice. Each article will be screened for inclusion and assessed according to a Critical Appraisal Skills Programme tool. Data will be synthesised and analysed according to thematic analysis. Given the anticipated yield of a small heterogeneous body of evidence meeting the eligibility criteria for the review, a narrative-based summary is planned.

Ethics and dissemination This review does not require formal ethical approval as it does not involve direct patient contact or patient-identifiable data. The results of this review will be published in a peer-reviewed journal and presented at relevant conferences. The results will also inform an empirical qualitative study exploring surgeon and other stakeholder views regarding the introduction of novel surgical technology and procedures into clinical practice.

PROSPERO registration number CRD42017076715.

  • surgery
  • qualitative research
  • change management
  • surgical innovation
  • systematic review
  • diffusion of innovation

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors TLL designed the systematic review with inputs from HNF, GWM, NP, KS, MU and AM. TLL drafted the review protocol with inputs from HNF, GWM, NP, KS, MU and AM. All authors approved the final protocol.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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