A shift in global surgery is needed to address current challenges in evidence generation and care delivery.

• Traditional research methods are inadequate for sustainability and equity in surgical practices.
• Emphasizing context-sensitive and systems-oriented approaches is critical.

Strengthening foundational evidence will enhance credibility and guide effective policy and surgical decisions.

• Future success depends on both expanding access and recalibrating research methodologies.

A new prediction model helps surgeons estimate patient recovery time after gastrointestinal cancer surgery, improving preoperative counseling.

• Among 91,270 patients, the median days at home within 90 days post-surgery was 82 (IQR 77-85).
• The model achieved strong accuracy (mean absolute error 8.67) and good calibration.

This tool enhances shared decision-making by providing tailored recovery expectations based on preoperative factors.

Over one-quarter of elective surgery patients exhibit high-risk substance use, signaling potential complications.

• 27.6% of patients reported high-risk substance use; 6.6% reported polysubstance use.
• Most common substances: cannabis (15.0%), alcohol (11.1%), and nicotine (8.5%).

Routine preoperative screening is essential to identify these risks and optimize patient outcomes.

• Highest rates of high-risk use were seen in neurosurgery (27.1%), lowest in endocrine surgery (15.1%).

ACS verification enhances safety and effectiveness across multiple surgical outcomes.

• 61% of outcomes improved with ACS verification; 34% showed no difference.
• Significant gains in safety (p=0.0024), effectiveness (p<0.0001), equity (p=0.001), and patient-centeredness (p<0.0001).

Consider ACS verification as a pivotal strategy for quality improvement, particularly in safety-focused practices.

• Efficiency and timeliness outcomes were less consistent and warrant further investigation.