Frontiers in Health Services · Published 2026-07-24 · DOI 10.3389/frhs.2026.1836470
Min-Che Tung, Lihua Huang, Yi-Sheng Lin, Chao-Yu Hsu, Wei-Chun Weng, Lonfye Lye, Yen-Chuan Ou
High-cost medical technologies are usually evaluated by clinical outcomes and cost-effectiveness, while their organizational effects are less often examined. We conducted a 10-year longitudinal institutional case study (2012–2022) of 395 prostate cancer procedures, combining process tracing, descriptive quantitative trends, implementation records, and workflow documentation. Three quantitative indicators were examined across four adoption stages: procedural volume, biopsy-free surgery, and final pathological confirmation. Biopsy-free surgery increased from 13 of 55 procedures (23.6%) during experimentation to 96 of 125 (76.8%) during maturity, and final pathological confirmation increased from 22 of 55 (40.0%) to 96 of 125 (76.8%). Cochran–Armitage tests showed significant increasing trends for both indicators (Z = 6.48 and 5.25, respectively; both p < 0.001). Institutional records documented concurrent introduction of training, standardized protocols, structured assessment, multidisciplinary processes, and follow-up pathways. These findings demonstrate temporal changes in clinical practice and suggest, without quantitatively establishing, a broader evolution toward more coordinated prostate cancer care. Evaluation of high-cost technologies should therefore distinguish measured clinical changes from organizational interpretations based on implementation evidence.
Abstract from DOAJ. Public domain (CC0 1.0).
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Tung, M., Huang, L., Lin, Y., et al. (2026). Longitudinal adoption of robotic surgery and changes in prostate cancer care delivery: a 10-year institutional case study. Frontiers in Health Services. https://doi.org/10.3389/frhs.2026.1836470