A video-based surgical quality registry linking assessed skill to cancer outcomes
Surgeons' skill affects whether cancer comes back, but nobody measures it. Recording operations and rating them, increasingly with AI, then linking ratings to outcomes, would make surgical quality visible and improvable.
A registry in which cancer operations are routinely video-recorded, rated for technical skill by blinded peers and validated computer-vision tools, and linked to pathological (margins, lymph node yield) and oncological outcomes. Michigan's bariatric surgery collaborative showed that peer-rated skill predicts complications; oncology studies have linked skill ratings to margin status and survival. The registry supports credentialling for trials, targeted coaching, learning-curve monitoring for new techniques, and eventually AI feedback during surgery. Consent, data protection and non-punitive governance are the hard parts and must be designed with surgeons.
- Surgery and radiotherapy cure most, get least · Surgery and radiotherapy cure more people than drugs do, but attract a fraction of the research investment.
- Weak real-world evidence and registries · We do not reliably know what happens to patients after approval, so we cannot tell which drugs deliver in practice.