Open Source Research Collaboration: innovation in surgical research

Interview with Alaa El-Hussuna, surgeon and coordinator of the initiative #OpenSourceResearch collaboration. Edited by Luca Gordini

Alaa El-Hussuna is associate professor of surgery and the coordinator of #OpenSourceResearch collaboration. He has a master degree in information technology and PhD in surgery. A Danish colorectal surgeon and a member of European Society of Colo-Proctology (ESCP) research committee. He is a founding member and currently the chairperson of cohort study committee in The ESCP.

When was #OpenSourceResearch collaboration born? How and why did it happen?

The #OpenSourceResearch collaboration started as a research network in September 2018. The initiative used #SoMe4Surgery network that was constructed by professor Julio Mayol to connect surgeons.

We experimented with a review about biological treatment and post-operative outcome in patients with inflammatory bowel disease. It was first #OpenSourceResearch collaboration and first online peer reviewed publication (published in Crohn Colitis 360). We used Twitter as a platform for discussions and Google shared document as platform to write the article.

Then we took the collaboration a step further, we involved patients in our online discussions. The second project was about patient-reported outcome in colorectal surgery. It was also a new experiment. The study is recently published in Surgical Innovation Journal.

We decided then to transform this network to a registered organization so that we can expand and raise funds to our activities. The organization was born in September 2020 and in a couple of months we had members from all over the world.

What is #OpenSourceResearch’s mission?

The #OpenSourceResearch collaboration aims to:

Close the gap between the rapidly evolving information technology sector and the slowly moving healthcare sector by implementing IT in medical research. Through creating multidisciplinary teams (across scientific disciplines) the organization aims to conduct research, improve data use/re-use and help with data mining.
Support researchers from low-and-middle income countries (LMIC) to develop their research skills

What projects are Open Source Research running?

We have 12 different research projects at different stages of production. These projects can be found on our website. To take an example of the diversity of our research we can mention few of them. Research project number 2 about patient-reported outcome in colorectal surgery comprises a review (published), a workshop with wide involvement of patients and then a large population-based survey. In project number 3 (de-identification of health care data) we want to encourage data sharing by ensuring data de-identification. The project was launched in November 2020 and the project team is working on literature review. In project number 11 we want to use artificial intelligence to crunch CT images and detect the risk of anastomotic leak in colorectal surgery. This project is at the conception phase.

Do you think that COVID-19 pandemic influenced/has affected medical publishing and peer-review process?

Certainly, it did. The peer review process is taking longer time now. The publications are more focused on the outbreak and its effect on different activities. But in #OpenSourceResearch we believe that the best response to the outbreak is “more research”. We shall continue our mission of conducting research and helping the other to do research. You know we have huge amount of data but these resources are untapped. If we use these data in a wise way, we can advance science at a faster rhythm and fight this outbreak or other emergent health care issues.

There is a lot of interest around #OpenSourceResearch. Could you talk about your future projects?

The increasing interest in #OpenSourceResearch collaboration reflects the increasing need for such collaboration. Our collaborators are intellectual contributors and not merely data collector. Being an intellectual contributor enriches our collaborators minds and stimulate their knowledge seeking endeavour.

Medicine will evolve from “a clinical science supported by data to a data science supported by clinicians”. Here, comes our role. We are the bridge between clinician and data scientists. We speak both languages fluently. We have a culture of working in teams yet still as a big family.

In future, we shall focus even more on engaging people from different scientific disciplines in our research.

We would like to invest in researchers in low-and-middle income countries to increase their research skills. They can also join us to solve problems in the high-income countries because they can see these problems form different angles. The world is a small village and we need to work together to make this village greener, more peaceful and more prosperous.

What international collaboration means to #OpenSourceResearch team?

In #OpenSourceResearch collaboration we support international collaboration. We took part in other collaborative projects like #CovidSurg, #REACCT, #EuroPower, #SoMe4Surgery and more. “It is not the strongest of the species that survives, but rather, that which is most adaptable to change”. Adaptation means more collaboration. The more we collaborate the fitter we shall be to survive on this planet.

What global reach means to #OpenSourceResearch team?

It means that we reach our colleagues in low-and-middle income countries as well as our colleagues in the rest of the world. The history of human beings is filled with milestones. Most, if not all of these milestones were the fruit of global collaboration. Think of Arabic numbers and the invention of zero.

We offer help for design, conduct and report studies done by researchers from LMIC studies. On our website, you can see many LMICs’ research projects that were supported by #OpenSourceResearch collaboration. In #OpenSourceResearch collaboration we build the intangible assets of our members. We “do not give a fish. We teach them fishing”. They teach us how can we be better.

How are you going to finance the administrative costs of #OpenSourceResearch as an organization?

Like other organizations, the members pay a membership fee ranging from 10-40 USD per year. However, if a member cannot pay this fee, he/she can apply for a free membership. This fee will not cover the administrative costs let alone the costs of planned activities for instance workshops but it is a symbolic gesture from our members to support the organization. We are planning to apply for national and international funding agencies.

Do you think that international collaboration differs from Surgery to other medical specialties?

I am sorry to say yes. The #OpenSourceResearch collaboration has submitted a paper about collaborative authorship in surgery. This paper showed that more than one third of the established surgical collaborations use their data once only. Data sharing in surgery is not comparable to other medical disciplines. Take genetics for example.

Another problem is that innovation in surgery has meant new instruments to do the same surgery. Why not new surgical solutions? New ideas are difficult to publish and present in surgical conferences. We need to give innovation a chance if we want surgery to continue as a science.

What is the next step for #OpenSourceResearch as an organization?

The foundation of research committee. This will be “the jewel in the crown” because it will create and lead innovative, multi-disciplinary, cutting edge clinical researches. We are recruiting scientists for this committee. All are invited. All are welcome.

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