Assessing technological change in cardiothoracic surgery

Semin Thorac Cardiovasc Surg. Spring 2009;21(1):28-34. doi: 10.1053/j.semtcvs.2009.05.001.


Technological innovation--broadly defined as the development and introduction of new drugs, devices, and procedures--has played a major role in advancing the field of cardiothoracic surgery. It has generated new forms of care for patients and improved treatment options. Innovation, however, comes at a price. Total national health care expenditures now exceed $2 trillion per year in the United States and all current estimates indicate that this number will continue to rise. As we continue to seek the most innovative medical treatments for cardiovascular disease, the spiraling cost of these technologies comes to the forefront. In this article, we address 3 challenges in managing the health and economic impact of new and emerging technologies in cardiothoracic surgery: (1) challenges associated with the dynamics of technological growth itself; (2) challenges associated with methods of analysis; and (3) the ways in which value judgments and political factors shape the translation of evidence into policy. We conclude by discussing changes in the analytical, financial, and institutional realms that can improve evidence-based decision-making in cardiac surgery.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Cardiovascular Surgical Procedures / economics
  • Cardiovascular Surgical Procedures / instrumentation*
  • Cardiovascular Surgical Procedures / legislation & jurisprudence
  • Diffusion of Innovation
  • Equipment Design
  • Evidence-Based Medicine
  • Government Regulation
  • Health Care Costs
  • Health Expenditures
  • Health Planning
  • Health Policy
  • Humans
  • Medical Laboratory Science* / economics
  • Medical Laboratory Science* / legislation & jurisprudence
  • Outcome and Process Assessment, Health Care
  • Public Policy
  • United States