SAGES consensus recommendations on surgical video data use, structure, and exploration (for research in artificial intelligence, clinical quality improvement, and surgical education)

Abstract

Background Surgery generates a vast amount of data from each procedure. Particularly video data provides significant value for surgical research, clinical outcome assessment, quality control, and education. The data lifecycle is influenced by various factors, including data structure, acquisition, storage, and sharing; data use and exploration, and finally data governance, which encompasses all ethical and legal regulations associated with the data. There is a universal need among stakeholders in surgical data science to establish standardized frameworks that address all aspects of this lifecycle to ensure data quality and purpose. Methods Working groups were formed, among 48 representatives from academia and industry, including clinicians, computer scientists and industry representatives. These working groups focused on: Data Use, Data Structure, Data Exploration, and Data Governance. After working group and panel discussions, a modified Delphi process was conducted. Results The resulting Delphi consensus provides conceptualized and structured recommendations for each domain related to surgical video data. We identified the key stakeholders within the data lifecycle and formulated comprehensive, easily understandable, and widely applicable guidelines for data utilization. Standardization of data structure should encompass format and quality, data sources, documentation, metadata, and account for biases within the data. To foster scientific data exploration, datasets should reflect diversity and remain adaptable to future applications. Data governance must be transparent to all stakeholders, addressing legal and ethical considerations surrounding the data. Conclusion This consensus presents essential recommendations around the generation of standardized and diverse surgical video databanks, accounting for multiple stakeholders involved in data generation and use throughout its lifecycle. Following the SAGES annotation framework, we lay the foundation for standardization of data use, structure, and exploration. A detailed exploration of requirements for adequate data governance will follow.

Adoption of routine surgical video recording: a nationwide freedom of information act request across England and Wales

“…The recent SAGES Delphi consensus on surgical video demonstrated support within the surgical community for all surgical procedures to be recorded, relevant cases stored, and surgical video data to be collected holistically with appropriate formatting, quality assurance, and relevant metadata. 6 Our findings of heterogeneous recording practices are concordant with the Delphi findings that there is a broad distribution of surgical procedural recording frequency and that diverse data structures are a barrier to multi-institutional studies involving surgical video. 6 …”

“… 6 Our findings of heterogeneous recording practices are concordant with the Delphi findings that there is a broad distribution of surgical procedural recording frequency and that diverse data structures are a barrier to multi-institutional studies involving surgical video. 6 …”

“… 1 , 2 , 3 , 4 , 5 Moreover, the role of surgical video in improving patient care is expanding into utilisation for quality assurance, education, and research into advanced data-driven tools. 6 Documentation of surgical procedures exclusively with retrospectively written operation notes, which currently remains the clinical standard for the majority of hospitals worldwide, misses these opportunities to capture a wealth of important information that could be used to benefit patients, healthcare providers, and numerous other key stakeholders—especially in camera-dependent procedures such as robotic, laparoscopic, and endoscopic surgery. Recent reviews assessing the current role of video technology in surgery have highlighted the importance of routine surgical video recording, suggesting it would enable standardised, evidence-based surgical care and personalised surgical training through the use of applications such as video-based coaching.…”

“… 9 , 10 , 25 A potential means of addressing these barriers is the modernisation of regulatory structures to address issues such as data ownership and governance. Developments in this area are in their infancy, with the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) recently producing consensus recommendations on surgical video data use, structure, and exploration, 6 and the Department of Health and Social Care releasing policy papers and an independent report highlighting the global importance of NHS data and prioritising its greater application in NHS services. 26 , 27 , 28 The current utilisation of surgical video recording, and its surrounding legal and regulatory structures, are, however, unknown.…”

Surgical Phase Duration in Robot-Assisted Partial Nephrectomy: A Surgical Data Science Exploration for Clinical Relevance

“…Surgical phase assessment allows for consistent and standardized indexing across procedures, which facilitates video review, analysis, and sharing. As video analysis, computer vision, artificial intelligence, and data analytics (so-called 'surgical data science') enter surgical theaters, the importance of correct and uniformly defined surgical phases increases [14]. This is especially true for complex surgeries that require decomposition into simpler phase blocks for objective assessment and review [15].…”