Surgeon evaluation of suture and endo-mechanical products
Lawton R Burns1, J Andrew Lee, Eric T Bradlow
1Department of Health Care Systems, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. burnsl@wharton.upenn.edu
Background:
Surgeons select medical instruments without comparative performance data. This analysis seeks to determine if suture and endo-mechanical products made by different vendors have equivalent performance profiles or are clearly distinguished by physicians on different dimensions.
Materials And Methods:
A sample of 45 surgeons evaluated eight vendors of five categories of suture and endo-mechanical products: clip appliers, staplers, trocars, needles and sutures, and endoscopic specimen retrieval devices. Surgeons rated each vendor's products in each category on multiple performance dimensions at six animal laboratories at academic medical centers around the U.S. between April and September 2005. Performance dimensions included the product's clinical acceptability, ergonomics, functionality, overall performance, and relative rank-order preference.
Results:
Physician evaluations of vendor performance vary widely. Vendors rated as clinically equivalent on a given product received different performance ratings by physicians. Ethicon's products (Somerville, NJ) were rated consistently high by physicians across product categories. This suggests the presence of some superior brand performance. Nevertheless, within some categories, there were alternative vendors (U.S. Surgical [Mansfield, MA], Applied Medical [Rancho Margarita, CA]) whose products are rated similar to the brand leader. This suggests there are often multiple vendors from which to choose. There was also evidence of idiosyncratic physician preference, especially due to the physician's gender, height, and glove size.
Conclusions:
Suture and endo-mechanical products made by different vendors do not have equivalent performance profiles. Specific brand seems to be the most important determinant of physician evaluations of the different vendors' products. These results suggest the value and importance of conducting head-to-head comparisons of multiple vendors of the same product.