Davos Alliance for Patient-Centered Surgical Intelligence (DAPSI)

An Open Invitation by ERMOS Foundation and MAIVAN.ai

ERMOS Foundation – The European Research Foundation for Mobility and Orthopaedic Surgery in Davos – and MAIVAN.ai – The Medical AI Validation Network – are pleased to invite the following eminent institutions to join a new international initiative:

  • EFORT – The European Federation of National Associations of Orthopaedics and Traumatology / EFORT Foundation
  • EFORT NORE – The Network of Orthopaedic Registries of Europe
  • AO Foundation / AO Innovation Translation Center 
  • ICHOM – The International Consortium for Health Outcomes Measurement

We propose the creation of the Davos Alliance for Patient-Centered Surgical Intelligence (DAPSI) and the adoption of a shared manifesto for the next era of healthcare.

The purpose of DAPSI is simple but ambitious:

To move healthcare from measuring procedures to measuring lives.

We believe that the future of orthopaedics — and ultimately all of healthcare — will be built on patient-centered outcomes, real-world evidence, responsible artificial intelligence, and continuously learning clinical systems.

To initiate this conversation, we propose the following

MANIFESTO

PREAMBLE

Orthopaedic and musculoskeletal care has achieved extraordinary advances over recent decades.

Innovations in surgical techniques, implants, biomaterials, imaging technologies, navigation systems, and digital health have improved the treatment of millions of patients worldwide.

Yet a fundamental question remains:

How should success in healthcare be measured?

Historically, medicine has often focused on biological and technical endpoints:

  • Was the fracture healed?
  • Was the implant positioned correctly?
  • Was the operation completed successfully?
  • Did the imaging findings improve?

These measures remain important.

However, they are not sufficient.

For patients, the ultimate outcomes are different:

  • Can I walk again?
  • Can I work again?
  • Can I live independently?
  • Can I participate in family and society?
  • Has my quality of life improved?

The future of healthcare must therefore move beyond measuring interventions toward measuring lives restored.

This shift reflects the evolution from:

Volume-Based Care → Value-Based Care
Clinical Activity → Patient Outcomes
Evidence Generation → Continuous Learning Systems
Data Collection → Real-World Intelligence

We believe orthopaedics is uniquely positioned to lead this transformation.

OUR SHARED VISION

By transforming routine clinical care into structured, interoperable, and outcome-linked intelligence, DAPSI seeks to establish a continuous learning system for musculoskeletal care, research, education, innovation, and evidence generation.

The Davos Alliance for Patient-Centered Surgical Intelligence (DAPSI) aims to

  • create the world’s first surgeon-governed, patient-centered Evidence Network and Data Commons,
  • connecting orthopaedic knowledge, patient outcomes, registry data, and post-market clinical follow-up (PMCF) evidence
  • through AI-enabled clinical workflows.

We envision a future in which every orthopaedic patient journey contributes to a continuously learning global evidence ecosystem.

In this future:

  • Clinical decisions are informed by high-quality real-world evidence.
  • Outcomes are measured using internationally accepted patient-centered standards.
  • Post-market surveillance becomes an integral part of routine care.
  • Surgical knowledge is continuously validated and improved.
  • Artificial intelligence operates under transparent human governance.
  • Patients, clinicians, researchers, regulators and innovators benefit from trusted evidence generated from real clinical practice.

The goal is not merely better technology.

The goal is better outcomes for patients.

THE FIVE PRINCIPLES OF PATIENT-CENTERED SURGICAL INTELLIGENCE

Principle 1

Outcomes Matter More Than Procedures

The ultimate purpose of healthcare is not the delivery of interventions but the improvement of human lives.

Success should increasingly be assessed through:

  • Function
  • Pain reduction
  • Quality of life
  • Return to work
  • Participation in society
  • Long-term patient well-being

Principle 2

Every Patient Journey Is a Source of Evidence

Clinical evidence should not be generated solely through isolated studies.

Every appropriately governed patient journey has the potential to contribute to:

  • Clinical learning
  • Quality improvement
  • Safety monitoring
  • Device evaluation
  • Scientific discovery

Routine care and evidence generation should become increasingly integrated.

Principle 3

Real-World Evidence Must Be Trustworthy

Real-world evidence must be:

  • Scientifically rigorous
  • Transparent
  • Auditable
  • Reproducible
  • Privacy-preserving
  • Clinically meaningful

Trustworthy evidence requires clear governance, quality standards, and professional stewardship.

Principle 4

Artificial Intelligence Must Remain Human-Governed

AI can augment healthcare.

It cannot replace professional accountability.

Clinical judgment remains the responsibility of qualified healthcare professionals.

AI systems should be:

  • Explainable where possible
  • Continuously validated
  • Independently monitored
  • Ethically governed
  • Aligned with patient interests

Surgeons, clinicians, patients, and professional societies must remain at the center of decision-making.

Principle 5

Knowledge Should Improve Collectively

Healthcare knowledge should become a shared societal asset.

The benefits of data, evidence, and intelligence should be distributed fairly among:

  • Patients
  • Healthcare professionals
  • Hospitals
  • Researchers
  • Professional societies
  • Industry innovators

Collaborative evidence ecosystems create greater value than isolated data silos.

COLLABORATIVE COMMITMENTS

The signatories commit to exploring and advancing:

Outcome Measurement

Promoting internationally harmonized patient-centered outcome standards and methodologies.

Real-World Evidence

Supporting the generation of high-quality clinical evidence throughout the lifecycle of medical technologies and healthcare interventions.

Post-Market Clinical Follow-Up

Advancing practical and scalable approaches to PMCF and long-term outcome monitoring.

Education and Training

Developing educational initiatives that strengthen evidence literacy, outcome measurement, AI literacy, and responsible innovation.

Responsible Surgical Intelligence

Supporting the development of surgeon-governed and patient-centered AI systems that enhance clinical care, education, and research.

Global Collaboration

Building bridges among professional societies, healthcare providers, patients, academia, regulators, industry, and technology innovators.

A CALL TO ACTION

The next era of healthcare will not be defined by data alone.

It will be defined by our ability to transform data into trustworthy knowledge, knowledge into better decisions, and decisions into better lives.

Orthopaedics has long been a pioneer in education, registries, evidence generation, and international collaboration.

We believe it can now become a pioneer in patient-centered surgical intelligence.

Together, we invite clinicians, patients, healthcare organizations, professional societies, researchers, regulators, and innovators worldwide to join us in building a future where every patient journey contributes to better care, better evidence, and better outcomes.

The DAPSI DECLARATION 2026

The Davos Alliance for Patient-Centered Surgical Intelligence believes that the future of healthcare must be grounded in patient-centered outcomes, trustworthy real-world evidence, responsible surgical intelligence, and continuously learning health systems.

From Measuring Procedures to Measuring Lives.

From Data Collection to Surgical Intelligence.

From Isolated Evidence to Learning Health Systems.

From Technology-Centered Innovation to Patient-Centered Outcomes.

The Davos Alliance for Patient-Centered Surgical Intelligence — DAPSI
Better Data. Better Evidence. Better Care.