Evidence map›Paper›PMID 32592513›Full record

ArticleThe British journal of surgery2020

The Lifebox Surgical Headlight Project: engineering, testing, and field assessment in a resource-constrained setting.

N Starr, N Panda, E W Johansen, J A Forrester, E Wayessa, D Rebollo, A August, K Fernandez, S Bitew, T Negussie Mammo and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

N StarrDepartments of Surgery, University of California, San Francisco, San Francisco, USA.ORCID 0000-0003-0714-5512
N PandaAriadne Labs, Brigham and Women's Hospital, Harvard T. H. School of Public Health, Boston, USA.
E W JohansenSpark Health Design, Hanover, Massachusetts, USA.
J A ForresterStanford University, Stanford, California, USA.
E WayessaDepartments of Surgery, Wollega University, Nekempte, Ethiopia.
D RebolloSchool of Medicine, New York University, New York, USA.
A AugustStanford University, Stanford, California, USA.
K FernandezLifebox Foundation, London, UK.
S BitewLifebox Foundation, London, UK.
T Negussie MammoLifebox Foundation, London, UK.
T G WeiserStanford University, Stanford, California, USA.ORCID 0000-0002-3118-3888

Funding

RESEARCH TRAINING IN ALIMENTARY TRACT SURGERYT32DK007754 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI HODIN, RICHARD A. · 1997 to 2025
$6.5M
RESEARCH TRAINING IN GASTROINTESTINAL SURGERYT32DK007573 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HARRIS, HOBART WHITAKER · 1988 to 2019
$3.0M
Foundation for the National Institutes of Health T32 DK7573-29NIDDK NIH HHS T32 DK007573NIDDK NIH HHS T32 DK007754UBS Foundation 11698
6 · The paper itself

Abstract

backgroundPoor surgical lighting represents a major patient safety issue in low-income countries. This study evaluated device performance and undertook field assessment of high-quality headlights in Ethiopia to identify critical attributes that might improve safety and encourage local use.

methodsFollowing an open call for submissions (December 2018 to January 2019), medical and technical (non-medical) headlights were identified for controlled specification testing on 14 prespecified parameters related to light quality/intensity, mounting and battery performance, including standardized illuminance measurements over time. The five highest-performing devices (differential illumination, colour rendering, spot size, mounting and battery duration) were distributed to eight Ethiopian surgeons working in resource-constrained facilities. Surgeons evaluated the devices in operating rooms, and in a comparative session rated each headlight in terms of performance and willingness to purchase.

resultsOf 25 submissions, eight headlights (6 surgical and 2 technical) met the criteria for full specification testing. Scores ranged from 8 to 12 (of 14), with differential performance in lighting, mounting and battery domains. Only two headlights met the illuminance parameters of more than 35 000 lux during initial testing, and no headlight satisfied all minimum specifications. Of the five headlights evaluated in Ethiopia, daily operation logbooks noted variability in surgeons' opinions of lighting quality (6-92 per cent) and spot size (0-92 per cent). Qualitative interviews also yielded important feedback, including preference for easy transport. Surgeons sought high quality with price sensitivity (using out-of-pocket funds) and identified the least expensive but high-functioning device as their first choice.

conclusionNo device satisfied all the predetermined specifications, and large price discrepancies were critical factors leading surgeons' choices. The favoured device is undergoing modification by the manufacturer based on design feedback so an affordable, high-quality surgical headlight crafted specifically for the needs of resource-constrained settings can be used to improve surgical safety.

Indexed as

Equipment DesignPatient SafetySurgical InstrumentsAttitude of Health PersonnelDeveloping CountriesEthiopiaHumansInterviews as TopicLightingOperating RoomsQualitative ResearchQuality of Health CareSurgeons

Identifiers

PMID32592513
PMCPMC7938832

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.