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Considering Surgeon Skill in Randomized Clinical Trials.

Published on May 6, 2020in JAMA Surgery10.668
· DOI :10.1001/JAMASURG.2020.1039
Amir A. Ghaferi26
Estimated H-index: 26
(UM: University of Michigan),
Justin B. Dimick67
Estimated H-index: 67
(UM: University of Michigan)
Abstract
  • References (5)
  • Citations (0)
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References5
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#1Nathan J. Curtis (Imperial College London)H-Index: 1
#2Jake D. Foster (Imperial College London)H-Index: 1
Last. Nader K. Francis (UCL: University College London)H-Index: 22
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Importance Complex surgical interventions are inherently prone to variation yet they are not objectively measured. The reasons for outcome differences following cancer surgery are unclear. Objective To quantify surgical skill within advanced laparoscopic procedures and its association with histopathological and clinical outcomes. Design, Setting, and Participants This analysis of data and video from the Australasian Laparoscopic Cancer of Rectum (ALaCaRT) and 2-dimensional/3-dimensional (2D3D) m...
1 CitationsSource
#1Oliver A. VarbanH-Index: 12
#2Jyothi R. ThummaH-Index: 12
Last. Justin B. DimickH-Index: 67
view all 6 authors...
BACKGROUND: Prior studies have demonstrated a correlation between surgical skill and complication rates after laparoscopic Roux-en-Y gastric bypass. However, the impact of surgical skill on a similar but less technically challenging procedure such as sleeve gastrectomy (SG) is unknown. METHODS: Practicing bariatric surgeons (n = 25) participating in a statewide quality improvement collaborative submitted an unedited deidentified video of a representative laparoscopic SG. Videos were obtained bet...
2 CitationsSource
#1Oliver A. VarbanH-Index: 12
#2Jyothi R. Thumma (UM: University of Michigan)H-Index: 12
Last. Justin B. Dimick (UM: University of Michigan)H-Index: 67
view all 7 authors...
Background Considerable technical variation exists when performing laparoscopic sleeve gastrectomy (LSG). However, little is known about which techniques are associated with optimal outcomes.
1 CitationsSource
#1John D. Birkmeyer (UM: University of Michigan)H-Index: 78
#2Jonathan F. FinksH-Index: 18
Last. Mousumi BanerjeeH-Index: 43
view all 7 authors...
Background Clinical outcomes after many complex surgical procedures vary widely across hospitals and surgeons. Although it has been assumed that the proficiency of the operating surgeon is an important factor underlying such variation, empirical data are lacking on the relationships between technical skill and postoperative outcomes. Methods We conducted a study involving 20 bariatric surgeons in Michigan who participated in a statewide collaborative improvement program. Each surgeon submitted a...
532 CitationsSource
#1Leigh A Neumayer (UofU: University of Utah)H-Index: 42
Last. William G. Henderson Mph (University of Colorado Denver)H-Index: 106
view all 8 authors...
Background Repair of inguinal hernias in men is a common surgical procedure, but the most effective surgical technique is unknown. Methods We randomly assigned men with inguinal hernias at 14 Veterans Affairs (VA) medical centers to either open mesh or laparoscopic mesh repair. The primary outcome was recurrence of hernias at two years. Secondary outcomes included complications and patient-centered outcomes. Results Of the 2164 patients who were randomly assigned to one of the two procedures, 19...
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