On October 22, 2024, the Peking University Institute for Global Health and Development (GHD) officially launched the researcher mobilization meeting for The Survey of Medical Assessment for Robotic Technology (SMART) project. At the beginning of the meeting, the Principal Investigator (PI) of the SMART project and Dean of GHD, Professor Gordon G. Liu, along with the PI for the clinical research of the SMART project and Dean of the Sixth Affiliated Hospital of Sun Yat-sen University, Professor WU Xiaojian, delivered opening speeches.
Dean Liu emphasized that the SMART project represents an unprecedented effort to conduct a large-scale health technology assessment cohort study comparing robotic, laparoscopic, and open surgeries for rectal cancer. This study is groundbreaking in scale and complexity within the field, both domestically and internationally, holding immense practical and historical significance. The clinical research of the SMART project involves 16 major hospitals nationwide, showcasing a multi-center and multi-dimensional collaborative model. The GHD research team initiated and is responsible for the overall coordination, research design, data analysis, and report writing of the SMART project. The team also provides comprehensive support and oversight throughout the implementation process to ensure scientific rigor and data accuracy.
Dean WU noted that the SMART project comprises 16 research centers nationwide, six of which have completed project approval and ethical reviews, laying a solid foundation for further progress. This mobilization meeting marks the transition to the substantive phase of the research, with plans to organize an in-person exchange in mid-December to discuss implementation details, research procedures, and data management, ensuring smooth data collection in the subsequent stages. The SMART project will not only have a profound impact on the clinical application of medical technology in China but also provide robust data support for health economics, particularly in shaping and refining medical insurance policies.
Subsequently, the three co-leaders responsible for the clinical research of the SMART project - Professor WANG Jianping, Honorary Dean of the Sixth Affiliated Hospital of Sun Yat-sen University and former Executive Vice President of Sun Yat-sen University; Professor XU Jianmin, Director of the Colorectal Cancer Center and Colorectal Surgery Department at Zhongshan Hospital, Fudan University; and Professor CAI Sanjun, Director of the Colorectal Cancer Diagnosis and Treatment Center at Fudan University Shanghai Cancer Center—delivered speeches.
Professor WANG Jianping highlighted that one of the key objectives of the SMART project is to provide evidence-based and data-driven materials for the formulation of national medical insurance policies through comprehensive health economic evaluations. In the current medical environment, while many healthcare institutions have actively adopted robotic-assisted surgery, this technology is still in its early stages and has not yet been incorporated into medical insurance reimbursement systems. This undoubtedly increases the financial burden on patients and limits the widespread adoption of the technology. Through this multi-center, prospective, observational study, the SMART project aims to generate extensive comparative data on the clinical outcomes and cost-effectiveness of robotic-assisted surgery versus traditional laparoscopic and open surgeries, thereby providing high-quality evidence to support the formulation of national medical insurance policies.
Professor XU Jianmin stated that the SMART project has undergone extensive preparation, during which the research team repeatedly revised and refined the study protocol to ensure that the design accurately and reliably reflects both clinical and economic data. Professor XU’s team has accumulated significant experience in the field of robotic-assisted surgery, with research findings already published in leading international journals. These efforts have laid a solid foundation for the subsequent implementation of the SMART project.
Professor CAI Sanjun emphasized that to ensure the SMART project showcases China’s standards in both international and domestic clinical practices, the project team must strictly adhere to the protocol’s design requirements. During implementation, the project will focus on standardizing patient selection, surgical procedures, and data processing to ensure that every step is executed at a high standard.
Additionally, Professor CAI highlighted that modern medicine not only requires physicians to possess clinical skills but also demands their understanding of health economics. This knowledge is essential for better assessing and evaluating the utilization of medical resources and their economic efficiency. This aspect aligns with one of the core missions of the SMART project: combining clinical outcomes with economic analyses to provide more comprehensive and precise evidence for future medical decision-making and healthcare policy development.
Subsequently, Professor Cai Zerong, a core member of the SMART project from the Sixth Affiliated Hospital of Sun Yat-sen University, provided a detailed overview of the SMART project’s research background, objectives, design, preparation, and implementation process. Additionally, representatives from Digital Health China Technologies, responsible for the application and quality control of the SMART project’s data system, introduced the research platform and follow-up system.
At the end of the meeting, Dean Gordon G. Liu reiterated the innovative significance of the project in evaluating the health economics of surgical robots. He specifically emphasized that the SMART project is not only committed to conducting real-world comparative studies on the clinical outcomes of different surgical approaches but also aims to provide valuable health economic evaluation data. This data will serve as scientific evidence to support decision-making in optimizing the allocation of medical resources and enhancing the accessibility and affordability of medical technologies.
