AI-CARE - Artificial Intelligence for CAtaract surgery Risk Estimation and reduction

"Over 300M surgical operations are performed annually worldwide to meet the global burden of disease. Despite the high volume, surgery is non-standardised and variations can occur in performance that can result in preventable errors and avoidable complications.

Analyses of the reasons for adverse events in surgery have revealed that many causes originate from behavioural or non-technical aspects of performance (e.g. poor communication among members of the surgical team) rather than from a lack of surgical (i.e. technical) skills. Therefore, technical skills appear to be necessary but not sufficient to ensure patient safety. Focus on non-technical skills, such as team working, situation awareness, decision making, and communication will increase the likelihood of maintaining high levels of error-free performance. This is also particularly important for low- and middle-income countries where there is a significant workforce shortage and lack of non-technical skills dissemination.

Innovations in effective and efficient surgical team performance are required to meet the growing demand in both case volume and training; advances in digital technologies provide increased potential towards improved healthcare delivery and patient outcomes. This proposal focuses on cataract surgery, the most common procedure performed in the UK with approximately 400,000 cataract operations per year in England, to demonstrate the potential of digital technologies in surgery. Using Artificial Intelligence (AI), emerging visualisation technologies and mobile computing, this project will develop a ubiquitous central digital architecture for the operating room (OR) during cataract surgery. With AI-enhanced surgical workflows, smart ORs and improved training resources, which lead to better efficiency and safety, global surgery can scale more effectively to meet the perpetual demand in both developed and developing countries.

The project will develop an AI framework with supporting hardware that will be used to automatically analyse cataract surgical procedures. These, in turn, will be used to develop best practice surgical workflows to train the entire OR team, optimise surgical performance and monitor and assess surgical competence that will ultimately improve patient care and outcomes. We believe that this project will promote best practices and provide an enhanced educational platform for cataract surgery. This platform will build on our clinically validated training software of instructional simulations, Touch Surgery, to promote surgical standardisation and offer a unique digital tool for everybody in the operating theatre."