{"id":"https://openalex.org/W7164367367","doi":"https://doi.org/10.1016/j.imed.2026.06.001","title":"Toward clinical-grade surgical intelligence for safer operative care: The role of generalist surgical foundation models","display_name":"Toward clinical-grade surgical intelligence for safer operative care: The role of generalist surgical foundation models","publication_year":2026,"publication_date":"2026-06-11","ids":{"openalex":"https://openalex.org/W7164367367","doi":"https://doi.org/10.1016/j.imed.2026.06.001"},"language":"en","primary_location":{"id":"doi:10.1016/j.imed.2026.06.001","doi":"https://doi.org/10.1016/j.imed.2026.06.001","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.imed.2026.06.001","pdf_url":null,"source":{"id":"https://openalex.org/S4210178142","display_name":"Intelligent Medicine","issn_l":"2096-9376","issn":["2096-9376","2667-1026"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","oarl","poland-20"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Intelligent Medicine","raw_type":"journal-article"},"volume":null,"type":"editorial","indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1016/j.imed.2026.06.001","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5101915199","display_name":"Kai Sun","orcid":"https://orcid.org/0000-0002-2301-7257","observed_orcids":["https://orcid.org/0000-0002-2301-7257"]},"institutions":[{"id":"https://openalex.org/I99065089","display_name":"Tsinghua University","ror":"https://ror.org/03cve4549","country_code":"CN","type":"education","lineage":["https://openalex.org/I99065089"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Kai Sun","raw_affiliation_strings":["School of Biomedical Engineering, Tsinghua University, Beijing 10084, China"],"raw_orcid":"https://orcid.org/0000-0002-2301-7257","affiliations":[{"raw_affiliation_string":"School of Biomedical Engineering, Tsinghua University, Beijing 10084, China","institution_ids":["https://openalex.org/I99065089"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5005660159","display_name":"Tianyu Liu","orcid":"https://orcid.org/0000-0001-9121-9021","observed_orcids":["https://orcid.org/0000-0001-9121-9021"]},"institutions":[{"id":"https://openalex.org/I99065089","display_name":"Tsinghua University","ror":"https://ror.org/03cve4549","country_code":"CN","type":"education","lineage":["https://openalex.org/I99065089"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Tianyu Liu","raw_affiliation_strings":["Department of Computer Science and Technology, Tsinghua University, Beijing 10084, China"],"raw_orcid":"https://orcid.org/0000-0001-9121-9021","affiliations":[{"raw_affiliation_string":"Department of Computer Science and Technology, Tsinghua University, Beijing 10084, China","institution_ids":["https://openalex.org/I99065089"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5028264743","display_name":"Xing\u2010Tian Wang","orcid":"https://orcid.org/0009-0009-5332-0853","observed_orcids":["https://orcid.org/0009-0009-5332-0853"]},"institutions":[{"id":"https://openalex.org/I99065089","display_name":"Tsinghua University","ror":"https://ror.org/03cve4549","country_code":"CN","type":"education","lineage":["https://openalex.org/I99065089"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Xinzhou Wang","raw_affiliation_strings":["Department of Computer Science and Technology, Tsinghua University, Beijing 10084, China"],"raw_orcid":"https://orcid.org/0009-0009-5332-0853","affiliations":[{"raw_affiliation_string":"Department of Computer Science and Technology, Tsinghua University, Beijing 10084, China","institution_ids":["https://openalex.org/I99065089"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5138448053","display_name":"Ling Wang","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ling Wang","raw_affiliation_strings":["Xi\u2019an Research Institute of High Technology, Xi\u2019an, Shaanxi 710025, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Xi\u2019an Research Institute of High Technology, Xi\u2019an, Shaanxi 710025, China","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5138420852","display_name":"Fuchun Sun","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I99065089","display_name":"Tsinghua University","ror":"https://ror.org/03cve4549","country_code":"CN","type":"education","lineage":["https://openalex.org/I99065089"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Fuchun Sun","raw_affiliation_strings":["Department of Computer Science and Technology, Tsinghua University, Beijing 10084, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Computer Science and Technology, Tsinghua University, Beijing 10084, China","institution_ids":["https://openalex.org/I99065089"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5138438264","display_name":"Jiahong Dong","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210153550","display_name":"Beijing Tsinghua Chang Gung Hospital","ror":"https://ror.org/050nfgr37","country_code":"CN","type":"healthcare","lineage":["https://openalex.org/I4210153550"]},{"id":"https://openalex.org/I99065089","display_name":"Tsinghua University","ror":"https://ror.org/03cve4549","country_code":"CN","type":"education","lineage":["https://openalex.org/I99065089"]}],"countries":["CN"],"is_corresponding":true,"raw_author_name":"Jiahong Dong","raw_affiliation_strings":["Hepato-Pancreato-Biliary Center, Beijing Tsinghua Changgung Hospital, Beijing 102218, China","School of Biomedical Engineering, Tsinghua University, Beijing 10084, China","School of Clinical Medicine, Tsinghua University, Beijing 10084, China"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Hepato-Pancreato-Biliary Center, Beijing Tsinghua Changgung Hospital, Beijing 102218, China","institution_ids":["https://openalex.org/I4210153550"]},{"raw_affiliation_string":"School of Biomedical Engineering, Tsinghua University, Beijing 10084, China","institution_ids":["https://openalex.org/I99065089"]},{"raw_affiliation_string":"School of Clinical Medicine, Tsinghua University, Beijing 10084, China","institution_ids":["https://openalex.org/I99065089"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5028264743","https://openalex.org/A5101915199","https://openalex.org/A5138420852","https://openalex.org/A5138438264"],"corresponding_institution_ids":["https://openalex.org/I4210153550","https://openalex.org/I99065089"],"apc_list":{"value":1100,"currency":"USD","value_usd":1100},"apc_paid":{"value":1100,"currency":"USD","value_usd":1100},"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":"6","issue":"4","first_page":"367","last_page":"373"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.9340999722480774,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.9340999722480774,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10916","display_name":"Surgical Simulation and Training","score":0.06030000001192093,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.0006000000284984708,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/surgical-safety","display_name":"surgical safety","score":0.7889999747276306},{"id":"https://openalex.org/keywords/surgical-decision-support","display_name":"surgical decision support","score":0.5189999938011169},{"id":"https://openalex.org/keywords/procedural-understanding","display_name":"procedural understanding","score":0.5740000009536743},{"id":"https://openalex.org/keywords/model-validation","display_name":"model validation","score":0.3580000102519989}],"concepts":[{"id":"https://openalex.org/C2776654903","wikidata":"https://www.wikidata.org/wiki/Q2601463","display_name":"SAFER","level":2,"score":0.8525000214576721},{"id":"https://openalex.org/C2780966255","wikidata":"https://www.wikidata.org/wiki/Q5474306","display_name":"Foundation (evidence)","level":2,"score":0.6984999775886536},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.5633999705314636},{"id":"https://openalex.org/C45371612","wikidata":"https://www.wikidata.org/wiki/Q3058587","display_name":"Generalist and specialist species","level":3,"score":0.4325000047683716},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.3610000014305115},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.3156999945640564},{"id":"https://openalex.org/C3019611579","wikidata":"https://www.wikidata.org/wiki/Q6641956","display_name":"Surgical procedures","level":2,"score":0.313400000333786},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.30880001187324524},{"id":"https://openalex.org/C55587333","wikidata":"https://www.wikidata.org/wiki/Q1133029","display_name":"Engineering ethics","level":1,"score":0.30630001425743103},{"id":"https://openalex.org/C509550671","wikidata":"https://www.wikidata.org/wiki/Q126945","display_name":"Medical education","level":1,"score":0.3052999973297119},{"id":"https://openalex.org/C116834253","wikidata":"https://www.wikidata.org/wiki/Q2039217","display_name":"Identification (biology)","level":2,"score":0.30219998955726624},{"id":"https://openalex.org/C3017684034","wikidata":"https://www.wikidata.org/wiki/Q942348","display_name":"Surgical robot","level":3,"score":0.26750001311302185},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.266400009393692},{"id":"https://openalex.org/C2989236134","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Patient care","level":2,"score":0.2572000026702881},{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.2547000050544739}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1016/j.imed.2026.06.001","doi":"https://doi.org/10.1016/j.imed.2026.06.001","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.imed.2026.06.001","pdf_url":null,"source":{"id":"https://openalex.org/S4210178142","display_name":"Intelligent Medicine","issn_l":"2096-9376","issn":["2096-9376","2667-1026"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","oarl","poland-20"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Intelligent Medicine","raw_type":"journal-article"},{"id":"pmh:oai:doaj.org/article:1d87a6be3b434524a463f2c17ae2cc0d","doi":null,"is_oa":false,"landing_page_url":"https://doaj.org/article/1d87a6be3b434524a463f2c17ae2cc0d","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Intelligent Medicine, Vol 6, Iss 4, Pp 367-373 (2026)","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1016/j.imed.2026.06.001","doi":"https://doi.org/10.1016/j.imed.2026.06.001","is_oa":true,"landing_page_url":"https://doi.org/10.1016/j.imed.2026.06.001","pdf_url":null,"source":{"id":"https://openalex.org/S4210178142","display_name":"Intelligent Medicine","issn_l":"2096-9376","issn":["2096-9376","2667-1026"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","oarl","poland-20"],"host_organization":"https://openalex.org/P4310320990","host_organization_name":"Elsevier BV","host_organization_lineage":["https://openalex.org/P4310320990"],"host_organization_lineage_names":["Elsevier BV"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Intelligent Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9391000270843506,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[{"id":"https://openalex.org/G1830143667","display_name":null,"funder_award_id":"82090050","funder_id":"https://openalex.org/F4320321001","funder_display_name":"National Natural Science Foundation of China"},{"id":"https://openalex.org/G5602664946","display_name":null,"funder_award_id":"82090053","funder_id":"https://openalex.org/F4320321001","funder_display_name":"National Natural Science Foundation of China"},{"id":"https://openalex.org/G6033659780","display_name":null,"funder_award_id":"U22A2057","funder_id":"https://openalex.org/F4320321001","funder_display_name":"National Natural Science Foundation of China"}],"funders":[{"id":"https://openalex.org/F4320321001","display_name":"National Natural Science Foundation of China","ror":"https://ror.org/01h0zpd94"}],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":33,"referenced_works":["https://openalex.org/W2023276160","https://openalex.org/W2043861297","https://openalex.org/W2266464013","https://openalex.org/W3022539379","https://openalex.org/W3061235327","https://openalex.org/W3096597946","https://openalex.org/W3101712992","https://openalex.org/W3136907493","https://openalex.org/W3198379050","https://openalex.org/W3203457317","https://openalex.org/W3212407416","https://openalex.org/W4210656949","https://openalex.org/W4280488363","https://openalex.org/W4362458937","https://openalex.org/W4365143687","https://openalex.org/W4391109864","https://openalex.org/W4392044798","https://openalex.org/W4393860447","https://openalex.org/W4395668991","https://openalex.org/W4396862413","https://openalex.org/W4403150635","https://openalex.org/W4404562731","https://openalex.org/W4406548642","https://openalex.org/W4407450062","https://openalex.org/W4409091111","https://openalex.org/W4411040306","https://openalex.org/W4413050074","https://openalex.org/W4415343185","https://openalex.org/W4417432376","https://openalex.org/W7126395632","https://openalex.org/W7127584095","https://openalex.org/W7128534154","https://openalex.org/W7133347176"],"related_works":["https://openalex.org/W4415343185","https://openalex.org/W4415442205","https://openalex.org/W7211958703","https://openalex.org/W7214999841","https://openalex.org/W7172149148","https://openalex.org/W7203678805","https://openalex.org/W4395053885","https://openalex.org/W7129216706","https://openalex.org/W7138871742","https://openalex.org/W4416058538"],"abstract_inverted_index":{"Surgery":[0],"is":[1,63,88,129],"a":[2,90,95,108,119,147,151,166,251],"real-time,":[3],"embodied":[4],"and":[5,16,35,56,80,100,136,175,197,216,228,274],"safety-critical":[6],"form":[7],"of":[8,29,97,250,263],"care":[9,73],"in":[10,131],"which":[11],"decisions,":[12],"anatomy,":[13,31],"physical":[14],"action":[15,199],"patient":[17,81],"outcomes":[18],"are":[19],"tightly":[20],"coupled.":[21],"Artificial":[22],"intelligence":[23,141,196,254],"(AI)":[24],"has":[25],"improved":[26],"the":[27],"recognition":[28],"instruments,":[30],"workflow,":[32],"technical":[33],"performance":[34],"multimodal":[36,195],"surgical":[37,67,85,103,114,140,235],"context,":[38],"but":[39,94,116,247],"these":[40,264],"capabilities":[41],"have":[42],"limited":[43],"clinical":[44,177,261],"value":[45,262],"if":[46],"they":[47],"remain":[48],"confined":[49],"to":[50,64,157,187,214],"retrospective":[51],"benchmarks,":[52],"narrow":[53],"procedural":[54,190],"settings":[55],"isolated":[57],"perception":[58,186],"tasks.":[59],"The":[60,260],"central":[61],"challenge":[62],"determine":[65],"whether":[66,269],"models":[68,105,155,237,265],"can":[69],"support":[70],"safer":[71,257],"operative":[72,132,258],"under":[74,221],"uncertainty,":[75,223],"across":[76,169],"procedures,":[77],"institutions,":[78],"devices":[79],"contexts,":[82],"without":[83],"obscuring":[84],"responsibility.":[86],"This":[87],"not":[89,150,238],"scaling":[91],"problem":[92,96,168],"alone,":[93],"representation,":[98],"evidence":[99,208,273],"accountability.":[101],"Generalist":[102],"foundation":[104,236],"may":[106],"provide":[107],"shared":[109],"basis":[110],"for":[111,154,256],"clinically":[112,252],"useful":[113],"understanding,":[115,191],"surgery":[117,161],"demands":[118],"more":[120],"constrained":[121],"formulation":[122],"than":[123],"general":[124],"biomedical":[125],"AI,":[126],"one":[127],"that":[128,209],"anchored":[130,189],"accountability,":[133],"real-time":[134,219],"decision-making":[135],"patient-level":[137,226],"consequences.":[138],"Clinical-grade":[139],"should":[142,162,182,204],"accordingly":[143],"be":[144,163,205],"defined":[145],"as":[146,165,239,248],"qualification":[148],"standard,":[149],"capability":[152],"threshold,":[153],"intended":[156],"assist":[158],"surgeons.":[159],"First,":[160],"treated":[164],"generalization":[167],"sensory-action":[170],"regimes,":[171],"longitudinal":[172],"perioperative":[173],"episodes":[174],"heterogeneous":[176],"environments.":[178],"Second,":[179],"model":[180],"development":[181],"progress":[183],"from":[184],"machine-readable":[185],"temporally":[188],"evidence-grounded":[192],"reasoning,":[193],"operating-room":[194],"surgeon-supervised":[198],"support.":[200],"Third,":[201],"clinical-grade":[202],"claims":[203],"earned":[206],"through":[207],"extends":[210],"beyond":[211],"benchmark":[212],"accuracy":[213],"external":[215],"cross-regime":[217],"validity,":[218],"reliability":[220],"intraoperative":[222],"human-facing":[224],"utility,":[225],"relevance":[227],"lifecycle":[229],"governance.":[230],"We":[231],"therefore":[232],"reframe":[233],"generalist":[234],"autonomous":[240],"substitutes":[241],"or":[242],"increasingly":[243],"capable":[244],"pretraining":[245],"assets,":[246],"components":[249],"accountable":[253],"layer":[255],"care.":[259],"will":[266],"depend":[267],"on":[268],"broader":[270],"representations,":[271],"stronger":[272],"explicit":[275],"accountability":[276],"mature":[277],"together.":[278]},"counts_by_year":[],"updated_date":"2026-10-14T16:39:01.820549","created_date":"2026-06-12T00:00:00"}