Abstract
Background:
Surgery is an intrinsic component of healthcare estimated to be involved in treatment of 28-32% of the global burden of disease. Research is crucial to improving quality of surgical care, and thus patient outcomes. We analysed global patterns of public and philanthropic investment in surgical research.
Methods:
Publicly available databases of human surgical research funding awards from 2016-2020 were searched. Awards were categorised by surgical specialty, cross-cutting research theme, and phase of research.
Results:
We identified 8042 awards with total investment $3.48 billion between 2016-2020 (approximately $0.7 billion annually), contrasting with $24.5 billion for cancer research in the same period. Pre-clinical research received most funding ($2.46 billion, 70.7%), clinical trials $0.72 billion (20.6%), and public health research $0.30 billion (8.6%). By cross-cutting theme the largest investment was into intraoperative research, ($1.2 billion, 34.4%), followed by post-operative ($0.85 billion, 25.1%) and pre-operative/neoadjuvant studies (0.46 billion, 12.6%) and interventional radiology ($0.04 billion, 1.3%). Global surgery was least well-funded ($0.03 billion dollars, 0.8%).
Conclusions:
Surgical research remains underfunded in comparison with other specialties, with most investment directed towards preclinical research which does not directly involve patients. Only a small proportion was invested in clinical trials, public health and global surgery. These findings limit the impact of surgical research in improving population health, and contrast starkly with the ubiquity of surgical treatments in the management of the global burden of disease. Urgent prioritisation of surgical research, and evaluation of priorities in research investment is required, to reflect surgery’s pivotal role in global healthcare.
Surgery is an intrinsic component of healthcare estimated to be involved in treatment of 28-32% of the global burden of disease. Research is crucial to improving quality of surgical care, and thus patient outcomes. We analysed global patterns of public and philanthropic investment in surgical research.
Methods:
Publicly available databases of human surgical research funding awards from 2016-2020 were searched. Awards were categorised by surgical specialty, cross-cutting research theme, and phase of research.
Results:
We identified 8042 awards with total investment $3.48 billion between 2016-2020 (approximately $0.7 billion annually), contrasting with $24.5 billion for cancer research in the same period. Pre-clinical research received most funding ($2.46 billion, 70.7%), clinical trials $0.72 billion (20.6%), and public health research $0.30 billion (8.6%). By cross-cutting theme the largest investment was into intraoperative research, ($1.2 billion, 34.4%), followed by post-operative ($0.85 billion, 25.1%) and pre-operative/neoadjuvant studies (0.46 billion, 12.6%) and interventional radiology ($0.04 billion, 1.3%). Global surgery was least well-funded ($0.03 billion dollars, 0.8%).
Conclusions:
Surgical research remains underfunded in comparison with other specialties, with most investment directed towards preclinical research which does not directly involve patients. Only a small proportion was invested in clinical trials, public health and global surgery. These findings limit the impact of surgical research in improving population health, and contrast starkly with the ubiquity of surgical treatments in the management of the global burden of disease. Urgent prioritisation of surgical research, and evaluation of priorities in research investment is required, to reflect surgery’s pivotal role in global healthcare.
| Original language | English |
|---|---|
| Journal | BJS |
| Publication status | Accepted/In press - 1 Apr 2025 |