{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:29:26Z","timestamp":1777944566803,"version":"3.51.4"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T00:00:00Z","timestamp":1748908800000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Surgery is an intrinsic component of healthcare, estimated to be involved in the treatment of 28\u201332% of the global burden of disease. Research is crucial to improving the quality of surgical care and thus patient outcomes. The aim of this study was to analyse global patterns of public and philanthropic investment in surgical research.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Publicly available databases of human surgical research funding awards between 2016 and 2020 were searched. Awards were categorized by surgical specialty, cross-cutting research theme, and phase of research.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 8042 awards were identified, with a total investment of $3.48 billion between 2016 and 2020 (approximately $0.7 billion annually), contrasting with $24.5 billion for cancer research in the same interval. Preclinical research received most of the funding ($2.46 billion (70.7%)), clinical trials received $0.72 billion (20.6%), and public health research received $0.30 billion (8.6%). By cross-cutting research theme, the largest investment was into intraoperative research ($1.4 billion (40.94%)), followed by postoperative research ($0.76 billion (21.9%)), preoperative\/neoadjuvant studies ($0.43 billion (12.3%)), and interventional radiology ($0.04 billion (1.2%)). Global surgery was the least well-funded area of research ($0.03 billion (0.8%)).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Surgical research remains underfunded in comparison with other specialties, with most investment directed towards preclinical research, not directly involving patients. Only a small proportion was invested in clinical trials, public health, and global surgery. These findings limit the impact of surgical research on improving population health and contrast starkly with the ubiquity of surgical treatments in the management of the global burden of disease. Urgent prioritization of surgical research and evaluation of priorities in research investment are required, to reflect surgery\u2019s pivotal role in global healthcare.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjs\/znaf089","type":"journal-article","created":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T09:11:31Z","timestamp":1748941891000},"source":"Crossref","is-referenced-by-count":4,"title":["Global funding for surgical research between 2016 and 2020: content analysis of public and philanthropic investments"],"prefix":"10.1093","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4123-9611","authenticated-orcid":false,"given":"Stuart A","family":"McIntosh","sequence":"first","affiliation":[{"name":"Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry, and Biomedical Sciences, Queen\u2019s University Belfast , Belfast ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2506-6965","authenticated-orcid":false,"given":"George","family":"Hudson","sequence":"additional","affiliation":[{"name":"Bristol Medical School , University of Bristol, Bristol ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9650-3766","authenticated-orcid":false,"given":"Michael","family":"Jiang","sequence":"additional","affiliation":[{"name":"Bristol Medical School , University of Bristol, Bristol ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben","family":"Palmer","sequence":"additional","affiliation":[{"name":"Patrick G Johnston Centre for Cancer Research, School of Medicine, Dentistry, and Biomedical Sciences, Queen\u2019s University Belfast , Belfast ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6977-312X","authenticated-orcid":false,"given":"Shelley","family":"Potter","sequence":"additional","affiliation":[{"name":"Bristol Medical School , University of Bristol, Bristol ,","place":["UK"]},{"name":"Bristol Breast Care Centre, North Bristol NHS Trust , Bristol ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1189-0531","authenticated-orcid":false,"given":"Michael G","family":"Head","sequence":"additional","affiliation":[{"name":"Clinical Informatics Research Unit, Faculty of Medicine, University of Southampton , Southampton ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramsey I","family":"Cutress","sequence":"additional","affiliation":[{"name":"Southampton Breast Surgical Unit, University Hospital Southampton , Southampton ,","place":["UK"]},{"name":"Cancer Sciences, Southampton General Hospital , Southampton ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,6,3]]},"reference":[{"key":"2025060305112600600_znaf089-B1","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/S0140-6736(15)60160-X","article-title":"Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development","volume":"386","author":"Meara","year":"2015","journal-title":"Lancet"},{"issue":"Suppl 2","key":"2025060305112600600_znaf089-B2","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1016\/S2214-109X(14)70384-5","article-title":"Global burden of surgical disease: an estimation from the provider perspective","volume":"3","author":"Shrime","year":"2015","journal-title":"Lancet Glob Health"},{"key":"2025060305112600600_znaf089-B3","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1016\/S0140-6736(96)90137-3","article-title":"Surgical research or comic opera: questions, but few answers","volume":"347","author":"Horton","year":"1996","journal-title":"Lancet"},{"key":"2025060305112600600_znaf089-B4","doi-asserted-by":"crossref","first-page":"znad412","DOI":"10.1093\/bjs\/znad412","article-title":"From opera buffa to opera seria: anniversaries of Royal College of Surgeons of England research initiatives","volume":"111","author":"Hutchinson","year":"2024","journal-title":"Br J Surg"},{"key":"2025060305112600600_znaf089-B5","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/S0140-6736(23)00856-5","article-title":"Surgical research-comic opera no more","volume":"402","author":"Bagenal","year":"2023","journal-title":"Lancet"},{"key":"2025060305112600600_znaf089-B6","doi-asserted-by":"crossref","first-page":"e1295","DOI":"10.1016\/S2214-109X(20)30357-0","article-title":"The allocation of US$105 billion in global funding from G20 countries for infectious disease research between 2000 and 2017: a content analysis of investments","volume":"8","author":"Head","year":"2020","journal-title":"Lancet Glob Health"},{"key":"2025060305112600600_znaf089-B7","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1016\/S1470-2045(23)00182-1","article-title":"Global funding for cancer research between 2016 and 2020: a content analysis of public and philanthropic investments","volume":"24","author":"McIntosh","year":"2023","journal-title":"Lancet Oncol"},{"key":"2025060305112600600_znaf089-B8","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/S1473-3099(12)70261-X","article-title":"UK investments in global infectious disease research 1997\u20132010: a case study","volume":"13","author":"Head","year":"2013","journal-title":"Lancet Infect Dis"},{"key":"2025060305112600600_znaf089-B9","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1097\/SLA.0000000000001532","article-title":"Making the leap: the translation of innovative surgical devices from the laboratory to the operating room","volume":"263","author":"Marcus","year":"2016","journal-title":"Ann Surg"},{"key":"2025060305112600600_znaf089-B10","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1097\/SLA.0000000000004907","article-title":"IDEAL-D framework for device innovation: a consensus statement on the preclinical stage","volume":"275","author":"Marcus","year":"2022","journal-title":"Ann Surg"},{"key":"2025060305112600600_znaf089-B11","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1016\/S1470-2045(15)00223-5","article-title":"Global cancer surgery: delivering safe, affordable, and timely cancer surgery","volume":"16","author":"Sullivan","year":"2015","journal-title":"Lancet Oncol"},{"key":"2025060305112600600_znaf089-B12","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1097\/SLA.0b013e318246591f","article-title":"The state of research and development in global cancer surgery","volume":"255","author":"Purushotham","year":"2012","journal-title":"Ann Surg"},{"key":"2025060305112600600_znaf089-B13","doi-asserted-by":"crossref","first-page":"e018625","DOI":"10.1136\/bmjopen-2017-018625","article-title":"A systematic analysis of UK cancer research funding by gender of primary investigator","volume":"8","author":"Zhou","year":"2018","journal-title":"BMJ open"},{"key":"2025060305112600600_znaf089-B14","author":"WHO"},{"issue":"Suppl 2","key":"2025060305112600600_znaf089-B15","doi-asserted-by":"crossref","first-page":"S51","DOI":"10.1016\/S0140-6736(15)60846-7","article-title":"Funding flows to global surgery: an analysis of contributions from the USA","volume":"385","author":"Gutnik","year":"2015","journal-title":"Lancet"},{"key":"2025060305112600600_znaf089-B16","doi-asserted-by":"crossref","first-page":"e1391","DOI":"10.1016\/S2214-109X(21)00291-6","article-title":"Enhanced postoperative surveillance versus standard of care to reduce mortality among adult surgical patients in Africa (ASOS-2): a cluster-randomised controlled trial","volume":"9","author":"Biccard","year":"2021","journal-title":"Lancet Glob Health"},{"key":"2025060305112600600_znaf089-B17","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1016\/S0140-6736(21)00767-4","article-title":"Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study","volume":"398","author":"Wright","year":"2021","journal-title":"Lancet"},{"key":"2025060305112600600_znaf089-B18","doi-asserted-by":"publisher","DOI":"10.1038\/d41586-025-00231-y","article-title":"\u2018Never seen anything like this\u2019: Trump\u2019s team halts NIH meetings and travel","author":"Kozlov","year":"2025","journal-title":"Nature"},{"key":"2025060305112600600_znaf089-B19","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1093\/bjs\/znad160","article-title":"Two decades of surgical randomized controlled trials: worldwide trends in volume and methodological quality","volume":"110","author":"Pronk","year":"2023","journal-title":"Br J Surg"},{"key":"2025060305112600600_znaf089-B20","doi-asserted-by":"crossref","first-page":"e004600","DOI":"10.1136\/bmjopen-2013-004600","article-title":"Investments in respiratory infectious disease research 1997\u20132010: a systematic analysis of UK funding","volume":"4","author":"Head","year":"2014","journal-title":"BMJ Open"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/112\/6\/znaf089\/63422369\/znaf089.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/112\/6\/znaf089\/63422369\/znaf089.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,3]],"date-time":"2025-06-03T09:11:34Z","timestamp":1748941894000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/doi\/10.1093\/bjs\/znaf089\/8155675"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,31]]},"references-count":20,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6,3]]},"published-print":{"date-parts":[[2025,5,31]]}},"URL":"https:\/\/doi.org\/10.1093\/bjs\/znaf089","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,6]]},"published":{"date-parts":[[2025,5,31]]},"article-number":"znaf089"}}