Evaluation and stages of surgical innovations

Surgical innovation is an important part of surgical practice. Its assessment is complex because of idiosyncrasies related to surgical practice, but necessary so that introduction and adoption of surgical innovations can derive from evidence-based principles rather than trial and error. A regulatory framework is also desirable to protect patients against the potential harms of any novel procedure. In this first of three Series papers on surgical innovation and evaluation, we propose a five-stage paradigm to describe the development of innovative surgical procedures.

CompAS: A new approach to commonality and variability analysis with applications in computer assisted orthopaedic surgery

In rapidly evolving domains such as Computer Assisted Orthopaedic Surgery (CAOS) emphasis is often put first on innovation and new functionality, rather than in developing the common infrastructure needed to support integration and reuse of these innovations. In fact, developing such an infrastructure is often considered to be a high-risk venture given the volatility of such a domain. We present CompAS, a method that exploits the very evolution of innovations in the domain to carry out the necessary quantitative and qualitative commonality and variability analysis, especially in the case of scarce system documentation. We show how our technique applies to the CAOS domain by using conference proceedings as a key source of information about the evolution of features in CAOS systems over a period of several years. We detect and classify evolution patterns to determine functional commonality and variability. We also identify non-functional requirements to help capture domain variability. We have validated our approach by evaluating the degree to which representative test systems can be covered by the common and variable features produced by our analysis.

What Makes a Family Firm Innovative? CEO Risk-Taking Propensity and the Organizational Context of Family Firms

Investigating the new product portfolio innovativeness of family firms connects two important topics that have recently received considerable attention in innovation and family firm research. First, new product portfolio innovativeness has been identified as a critical determinant of firm performance. Second, research on family firms has focused on the questions of if and why family firms are more or less innovative than other organizational forms. Research investigating the innovativeness of family firms has often applied a risk-oriented perspective by identifying socioemotional wealth (SEW) as the main reference that determines firm behavior. Thus, prior research has mainly focused on the organizational context to predict innovation-related family firm behavior and neglected the impact of preferences and the behavior of the chief executive officer (CEO), which have both been shown to affect firm outcomes. Hence, this study aims to extend the previous research by introducing the CEO's disposition to organizational context variables to explain the new product portfolio innovativeness of small and medium-sized family firms. Specifically, this study explores how the organizational context (i.e., ownership by top management team [TMT] family members and generation in charge of the family firm) of family firms interacts with CEO risk-taking propensity to affect new product portfolio innovativeness. Using a sample of 114 German CEOs of small and medium-sized family firms operating in manufacturing industries, the results show that CEO risk-taking propensity has a positive effect on new product portfolio innovativeness. Moreover, the analyses show that the organizational context of family firms impacts the relationship between CEO risk-taking propensity and new product portfolio innovativeness. Specifically, the relationship between CEO risk-taking propensity and new product portfolio innovativeness is weaker if levels of ownership by TMT family members are high (high SEW). Additionally, the effect of CEO risk-taking propensity on new product portfolio innovativeness is stronger in family firms at earlier generational stages (high SEW). This result suggests that if SEW is a strong reference, family firm-specific characteristics can affect individual dispositions and, in turn, the behaviors of executives. Therefore, this study helps extend the knowledge on the determinants of new product portfolio innovativeness of family firms by considering an individual CEO preference and the organizational context variables of family firms simultaneously.

Socio-technical transitions and policy change - Advocacy coalitions in Swiss energy policy

Policies and politics are an integral part of socio-technical transitions but have not received much attention in the transitions literature so far. Drawing on the advocacy coalition framework, our paper addresses this gap with a study on actors and coalitions in Swiss energy policy. Our results show that advocacy coalitions in Switzerland have largely remained stable despite the Fukushima shock. However, heterogeneity of beliefs has increased and in 2013, even a majority of actors expressed their support for the energy transition – an indication that major policy change might be ahead. It seems that in socio-technical transitions, changes in the policy issue and in the actor base also work toward policy change, next to changes in core beliefs. We make suggestions how the advocacy coalition framework can inform analysis and theory building in transition studies. We also present first ideas about the interplay of socio-technical systems and policy systems.

Challenges in evaluating surgical innovation

Research on surgical interventions is associated with several methodological and practical challenges of which few, if any, apply only to surgery. However, surgical evaluation is especially demanding because many of these challenges coincide. In this report, the second of three on surgical innovation and evaluation, we discuss obstacles related to the study design of randomised controlled trials and non-randomised studies assessing surgical interventions. We also describe the issues related to the nature of surgical procedures-for example, their complexity, surgeon-related factors, and the range of outcomes. Although difficult, surgical evaluation is achievable and necessary. Solutions tailored to surgical research and a framework for generating evidence on which to base surgical practice are essential.

The Software Prototype as Digital Boundary Object – A Revelatory Longitudinal Innovation Case

With the availability of lower cost but highly skilled software development labor from offshore regions, entrepreneurs from developed countries who do not have software development experience can utilize this workforce to develop innovative software products. In order to succeed in offshored innovation projects, the often extreme knowledge boundaries between the onsite entrepreneur and the offshore software development team have to be overcome. Prior research has proposed that boundary objects are critical for bridging such boundaries – if they are appropriately used. Our longitudinal, revelatory case study of a software innovation project is one of the first to explore the role of the software prototype as a digital boundary object. Our study empirically unpacks five use practices that transform the software prototype into a boundary object such that knowledge boundaries are bridged. Our findings provide new theoretical insights for literature on software innovation and boundary objects, and have implications for practice.

Latin Americaʹs emergence in global services: a new driver of structural change in the region?

Studies of international production acknowledge that the ability of firms to learn, upgrade and innovate in global value chains (GVCs) is influenced by knowledge flows within these global networks and by the national institutional systems in which the firms are embedded. Little is known, however, about how differences in national innovation and business systems shape the way firms and national economies insert themselves in global value chains and how this influences their upgrading trajectories. Based on a review of the existing academic literature, the chapter examines the impact of national innovation and business systems from middle-income and developing countries on learning and innovation processes in services GVCs.