1.
Evidence-Based Global Surgery
www.GlobalSurg.org
Dr Edward Fitzgerald
@DrEdFitzgerald

2.
What is GlobalSurg?
Meritocratic group authorship Building global networks
Snap-shot methodology
Align projects to clinical needs Any hospital, any where
High-quality, protocol-led Empowering grass-roots surgeons
Building research capacity
Prospective, bedside-level patient data
Perioperative outcomes by HDI

3.
A new way of doing research
EFFICIENT
EFFECTIVE
ECONOMICAL
Protocol-led, core data set, snap-shot methodology
Global penetrance, rapid completion and turn-around
Minimal financial support, own time, low burden

4.
How is it delivered?
Peer reviewed
protocol
disseminated
globally
Collaborator
registration
online
Country leads
coordinate
Complete online
training module
Online central
support and
troubleshooting
14-day snapshot
data collection
within 6-month
window for
participation
Online data
upload and
central analysis

5.
Global ‘Crowd-sourced’ Surgical Outcomes
www.globalsurg.org

6.
HIGH HDI MIDDLE HDI LOW HDI
6538 patients
(60.8%)
2889 patients
(26.9%)
1318 patients
(12.3%)
10,745 patients357 hospitals 58 countries
Primary Outcome: 24-hour postoperative mortality rate (POMR)
Secondary Outcome: 30-day postoperative mortality rate (POMR)
HDI = Human Development Index

7.
Mortality is three times higher in low- compared with high-HDI
countries even when adjusted for prognostic factors
Collaboration Driven High-Impact Results
GlobalSurg Collaborative. BJS 2016; 103: 971–988

8.
www.globalsurg.org

9.
Global feedback in real time

10.
v

11.
Open publication of peer reviews
http://globalsurg.org/read-the-peer-reviews-for-globalsurg-1/

12.
Adjusted mortality in children up to 7 times greater in low-HDI and
middle-HDI countries compared with high-HDI

13.
GlobalSurg 2
Determining the worldwide epidemiology of surgical site
infections after abdominal surgery
www.globalsurg.org │ enquiry@globalsurg.org

14.
Establishing a robust validation process
1. Centre-based collaborator questionnaire
2. Independent on-site validation
• Case ascertainment
• Sampled data accuracy
3. Collaborator interview (process vs. system)

15.
GlobalSurg 2

16.
1. LMICs more likely to use postop antibiotics
2. Antibiotic course likely to be longer
3. Organisms twice as likely to be resistant in LIMCs
Between 1-in-5 and 1-in-3 infections are resistant to the antibiotic prescribed

17.
Significant Global Impact

18.
GlobalSurg Combined

19.
GlobalSurg Combined

20.
GlobalSurg 3
www.globalsurg.org │ enquiry@globalsurg.org

21.
GlobalSurg 3: Your opportunity
Determine variation in quality of cancer surgery worldwide
• Breast, gastric & colon cancer
• Any hospital, any where
• 4-week periods between April 1st & October 31st 2018
Quality measures include
• Infrastructure
• Care processes
• Outcomes
Primary outcome measure
• 30-day mortality/complication rates

22.
Collaboration: Future vision
• Large-scale collaboration normalised
• Methods adopted globally for other clinical areas
• Incorporated into training programmes
• Hands-on research skills training
• All allied-health professional contributing
• Role for all in participating and up-skilling
• Results used as foundation for interventions
• Technology and live data/analysis evolves

23.
https://www.youtube.com/watch?v=STnx6VliTIQ

24.
• Website: www.globalsurg.org
• Email: enquiry@globalsurg.org
www.facebook.com/GlobalSurg
@GlobalSurg
• GlobalSurg is run by the SURG Foundation charity.
• Please donate to support us! https://www.givey.com/surg_foundation
Thank you

25.
Please make a donation to support!
https://mydonate.bt.com/fundraisers/kiliforlifebox#donationSummary
Fundraising for the Lifebox Foundation
We’ve climbed Mount Kilimanjaro to raise funds for Lifebox!
5895 metres