Abstract:
BACKGROUND:A low prevalence of high-level clinical studies in the surgical literature has been reported previously. We reviewed a recent sample of surgical publications to assess the current status of clinical research. STUDY DESIGN:A 3-month sample of journal articles in Archives of Surgery, Surgery, and Annals of Surgery in 2005 was evaluated by two independent reviewers to determine the distribution of articles in established evidence classes. RESULTS:A total of 133 publications were identified in the three journals during the time periods reviewed, including 101 clinical articles and 30 basic science articles. Among the clinical papers, there were 8 class I studies (7.9%), 34 class II studies (33.7%), and more than half were class III studies (59 of 101, or 58.4%). CONCLUSIONS:The low prevalence of high-level evidence to guide surgical management of patients persists in major general surgery journals. We believe that education about proper research methodology is not only important for researchers, but is also important for practicing surgeons, and can have important health policy implications as well.
journal_name
J Am Coll Surgjournal_title
Journal of the American College of Surgeonsauthors
Chang DC,Matsen SL,Simpkins CEdoi
10.1016/j.jamcollsurg.2006.08.013subject
Has Abstractpub_date
2006-12-01 00:00:00pages
827-30issue
6eissn
1072-7515issn
1879-1190pii
S1072-7515(06)01242-7journal_volume
203pub_type
杂志文章abstract:BACKGROUND:Uninsured patients have poor access to screening colonoscopy and subsequently present with advanced stages of colorectal cancer (CRC) that beget worse outcomes and higher total costs. Providing pro bono colonoscopies to uninsured patients at high risk for CRC can detect early stage disease and be cost-effect...
journal_title:Journal of the American College of Surgeons
pub_type: 临床试验,杂志文章
doi:10.1016/j.jamcollsurg.2016.04.035
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Fibulin-5 is a recently discovered multifunctional extracellular matrix protein that mediates endothelial cell adhesion through integrin ligation, regulates cell growth and motility in a context-specific manner, and prevents elastinopathy in vivo. Because fibulin-5 expression is induced dramatically in endot...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2004.04.021
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Day case surgery (DCS) for uncomplicated acute appendicitis (NCAA) is evaluated. The objective of this prospective, single-center, descriptive, nonrandomized, intention-to-treat cohort study was to assess the feasibility of DCS for NCAA with a critical analysis of the reasons for exclusion and treatment fail...
journal_title:Journal of the American College of Surgeons
pub_type: 临床试验,杂志文章
doi:10.1016/j.jamcollsurg.2016.08.004
更新日期:2016-11-01 00:00:00
abstract:BACKGROUND:Occult hypoperfusion (OH), or global hypoperfusion with normal vital signs, is a risk factor for poor outcomes in elderly trauma patients. We hypothesized that OH is associated with worse outcomes than shock in both young and elderly trauma patients. METHODS:We conducted a single-center cohort study of adul...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2019.12.011
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:Although donation after cardiac death (DCD) liver allografts have been used to expand the donor pool, concerns exist regarding primary nonfunction and biliary complications. Our aim was to compare resource use and outcomes of DCD allografts with donation after brain death (DBD) liver allografts. STUDY DESIG...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2015.01.052
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Pressure ulcers cause significant morbidity and mortality in the surgical intensive care unit (SICU). The purpose of this study was to determine if a dedicated team tasked with turning and repositioning all hemodynamically stable SICU patients could decrease the formation of pressure ulcers. STUDY DESIGN:A ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2012.12.001
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Several authors have questioned the need for axillary lymph node dissection in T1a breast cancer (primary tumors 5 mm or less in diameter), although current practice typically includes routine axillary lymph node dissection. STUDY DESIGN:We retrospectively reviewed the records of 2,242 breast cancers in our...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:Many published accounts of clinical trials report no differences between the treatment arms, while being underpowered to find differences. This study determined how the authors of these reports interpreted their findings. STUDY DESIGN:We examined 54 reports of surgical trials chosen randomly from a database...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2012.09.015
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:The persistent shortage of transplantable organs remains a critical issue around the world. The purpose of this study was to investigate outcomes, including organ procurement, in trauma patients undergoing resuscitative emergency department thoracotomy (EDT). Our hypothesis was that potential organ donor res...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2010.06.012
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:The criteria for organ acceptance remain inconsistent, which limits the ability to standardize critical care practices. We sought to examine predictors of liver graft use and survival to better guide the selection and management of potential organ donors. STUDY DESIGN:A prospective observational study of al...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jamcollsurg.2014.09.020
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:The management of dysplasia arising in Barrett's esophagus is controversial. STUDY DESIGN:Twenty patients (group 1, prompt attitude) underwent operation as soon as high-grade dysplasia (HGD) was discovered (n = 8) or just after either the presence of HGD was confirmed (n = 9) or invasive carcinoma (IC) was ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/S1072-7515(03)00417-4
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:An intraoperative adverse event (iAE) is often directly attributable to the surgeon's technical error and/or suboptimal intraoperative judgment. We aimed to examine the psychological impact of iAEs on surgeons as well as the surgeons' attitude about iAE reporting. STUDY DESIGN:We conducted a web-based cross...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jamcollsurg.2016.12.039
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:Indices for prediction of surgical site infection (SSI) are well documented in the adult population; however, these factors have not been validated in children. STUDY DESIGN:A retrospective case-control study was performed by examining the medical records of children (0 to 18 years) who developed an SSI wit...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2011.01.065
更新日期:2011-06-01 00:00:00
abstract:BACKGROUND:The complications and long-term follow-up results of internal hemipelvectomy are not well documented. STUDY DESIGN:We reviewed 32 internal hemipelvectomies performed between 1976 and 1994. RESULTS:The pathologic diagnoses were soft tissue sarcoma in 15 cases, bone tumor in 14 cases, melanoma in two cases, ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1995-07-01 00:00:00
abstract:BACKGROUND:Effective teamwork in the operating room (OR) is often undermined by the "silo mentality" of the differing professions. Such thinking is formed early in one's professional experience and is fostered by undergraduate medical and nursing curricula lacking interprofessional education. We investigated the immedi...
journal_title:Journal of the American College of Surgeons
pub_type: 临床试验,杂志文章
doi:10.1016/j.jamcollsurg.2013.09.006
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:The value of frozen sections in the intraoperative examination of sentinel nodes (SN) remains controversial. Accurate frozen sections will spare those patients with node metastasis from a second procedure to complete the axillary dissection. We examined our own experience with intraoperative examination of S...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2008.06.341
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Use of Enhanced Recovery After Surgery (ERAS) pathways have evidenced improved outcomes in several surgical specialties. The effectiveness of ERAS pathways specific to hernia surgery, however, has not yet been investigated. We hypothesized that our ERAS pathway would accelerate functional recovery and shorte...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2016.02.015
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Consequences of extrahepatic portal vein obstruction (EHPVO) include variceal bleeding and hypersplenism due to portal hypertension, as well as metabolic abnormalities secondary to impaired portal venous circulation. The purpose of this study was to compare the effectiveness of meso-Rex bypass and portosyste...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2012.09.013
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Pediatric appendicitis is treated by both pediatric and general surgeons. We investigated whether specialty-dependent differences existed in patients' characteristics and outcomes. STUDY DESIGN:A retrospective chart review of 465 consecutive children treated for appendicitis at a university-affiliated child...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2006.10.006
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Controversy exists over the relative advantages of open mesh repair compared with open stitching methods and the laparoscopic approach. STUDY DESIGN:Two thousand nine hundred six (2,906) consecutive unselected adult patients underwent 3,175 primary inguinal hernia repairs using polypropylene mesh, under loc...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(98)00057-x
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:Laparoscopic surgery (LS) is contemplated during long duration space flight, but it typically necessitates intraabdominal hypertension (IAH) from insufflation to create a surgical domain. Because there are spontaneous changes in abdominal wall behavior in weightlessness (0g) that have been previously suggest...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2009.03.026
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Thyroglossal duct remnants are the most common midline neck masses in childhood but can be found in adults and the elderly. Sistrunk's procedure, with dissection of the tract and removal of the hyoid bone, is accepted as the main operation of choice. STUDY DESIGN:Fifty-five patients were treated from Januar...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(01)01171-1
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Accountable care organizations (ACOs) attempt to provide the most efficient and effective care to patients within a region. We hypothesized that patients who undergo surgery closer to home have improved survival due to proximity of preoperative and post-discharge care. STUDY DESIGN:All (17,582) institutiona...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2016.12.017
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Ischemia-reperfusion injury (IRI) can occur during hepatic surgery and transplantation. IRI causes hepatic mitochondrial and microcirculatory impairment, resulting in acute liver dysfunction and failure. We proposed a novel strategy of regulated hepatic reperfusion (RHR) to reverse the cellular metabolic def...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2011.12.010
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Earlier studies of medical students on nonsurgical rotations have shown that clinical clerks usually first interact with their patients late in the clinical course. This would seem disadvantageous to the student's learning because they would have less opportunity to generate diagnoses or a management plan. ...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(02)01326-1
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:The aim of this study is to evaluate the rate and the clinical outcomes of lymph node involvement in patients treated for borderline ovarian tumor (BOT). STUDY DESIGN:Forty-two patients were treated for BOT with a procedure that included lymphadenectomy. Twenty-four patients underwent a pelvic lymphadenecto...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/s1072-7515(02)01250-4
更新日期:2002-09-01 00:00:00
abstract:BACKGROUND:In hepatic resection, it is important to control intrahepatic blood flow to minimize blood loss. Intermittent and selective vascular occlusion, if possible, are advisable. STUDY DESIGN:For this purpose, we created the double balloon catheter, which when introduced into a lobar or a smaller branch of the int...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:Advanced Automatic Crash Notification algorithms use vehicle telemetry measurements to predict risk of serious motor vehicle crash injury. The objective of the study was to develop an Advanced Automatic Crash Notification algorithm to reduce response time, increase triage efficiency, and improve patient outc...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:10.1016/j.jamcollsurg.2016.03.028
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:The etiology of right lower-quadrant pain in pregnant patients is a challenge in diagnosis. We discuss the surgical issues among pregnant patients with right lower-quadrant pain and demonstrate the method to diagnosis. STUDY DESIGN:This was a prospective cohort study with enrollment during 2 years. Pregnant...
journal_title:Journal of the American College of Surgeons
pub_type: 临床试验,杂志文章
doi:10.1016/j.jamcollsurg.2010.06.004
更新日期:2010-10-01 00:00:00
abstract::A nationwide survey of patterns of care for carcinoma of the breast was conducted by the Commission on Cancer of the American College of Surgeons. Information regarding patient history, diagnostic tests, treatment, survival and disease status was obtained for 17,295 patients treated during 1983 and 24,356 patients tre...
journal_title:Journal of the American College of Surgeons
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00