Reduction in surgical innovation, 1988 to 2006

David E. Rosow, Ilya Likhterov, Michael G. Stewart, Max M. April

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective: We hypothesize that increasing regulation of human subject research has reduced the number of published reports of surgical innovation in otolaryngology. Study Design: A systematic review of a predetermined subset of otolaryngology literature. Methods: We randomly selected half of the articles published in 1988 and 2006 in three prominent journals. After identifying information was concealed, abstracts were classified independently by two authors into three groups: innovation, modification, or neither. Disagreements were resolved by a third author who read the entire article. Proportions were compared with χ2 analysis. Results: The proportion of articles classified as innovation or modification decreased significantly from 67 of 367 (18.3%) in 1988 to 59 of 548 (10.8%) in 2006 (P = 0.001). The elimination of radiology and pathology quiz cases yielded similar results: 11.1 percent vs 18.9 percent, P = 0.001. Innovation or modification in animal model research also decreased (0.9% vs 3.8%, P = 0.003). Overall, only 4 articles were actually classified as true innovation. Conclusions: The frequency of true innovation was low in both years, but articles that described surgical modifications decreased significantly over this 18-year period. One reason may be increased administrative barriers for clinical research approval. Although our analysis cannot determine cause and effect, it is an important finding that deserves further study.

Original languageEnglish (US)
Pages (from-to)657-660
Number of pages4
JournalOtolaryngology - Head and Neck Surgery
Issue number5
StatePublished - May 2009
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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