Abstract:
BACKGROUND:Patients want information to search for destination of care for breast-conserving surgery (BCS). To inform patients wanting a lumpectomy, we aimed to develop a pilot project that communicated composite quality measure (QM) results using a '4-star' rating system. Two patient-centered QMs were included in the model-reoperation rate (ROR) and cosmetic outcome (COSM). METHODS:A prospective database was reviewed for stage 0-3 patients undergoing initial lumpectomy by three surgeons from 2010 to 2015. Self-reported COSM was assessed by survey. Multivariate analyses were used to test for interactions between surgeon and other variables known to influence RORs and COSMs. Models of surgeon profiling were developed that summed the ROR and COSM performance scores, then reported results using a Centers for Medicare and Medicaid Services (CMS) star-type system. Functionality for a patient to 'weight' the importance of the ratio of ROR:COSM before profiling was introduced. RESULTS:The unadjusted ROR for stage 1-3 patients for three surgeons was 9.5, 13.0, and 16.3%, respectively (p = 0.179) [overall rate 10.4% (38/366)]. After risk adjustment, differences between surgeons were observed for RORs, but not COSMs. Overall, patients reported excellent, good, fair, and poor COSMs of 55, 30, 11 and 4%, respectively. Composite star scores reflected differences in performance by surgeon, which could increase, or even disappear, dependent on the patient's weighting of the ROR:COSM ratio. CONCLUSION:Composite measures of performance can be developed that allow patients to input their weighted preferences and values into surgeon profiling before they consider a destination of care for BCS.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Dunham AL,Ramirez LD,Vang CA,Linebarger JH,Landercasper Jdoi
10.1245/s10434-018-6479-5subject
Has Abstractpub_date
2018-07-01 00:00:00pages
1943-1952issue
7eissn
1068-9265issn
1534-4681pii
10.1245/s10434-018-6479-5journal_volume
25pub_type
杂志文章abstract:BACKGROUND:With cholangiocarcinoma, the only hope of a cure is resection. This study was undertaken to determine the impact of margin status, stage, tumor location, and adjuvant therapy on survival after resection of extrahepatic cholangiocarcinoma. METHODS:From 1985-2006, 91 patients underwent resections of cholangio...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9756-2
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Head and neck oncologic surgery with reconstruction represents one of the most complex operations in otolaryngology. Unplanned return to the operating room represents an objective measure of postoperative complications. The purpose of this study was to identify reasons and risk factors for unplanned return t...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07675-3
更新日期:2020-02-01 00:00:00
abstract::A 54-year-old woman with multiple telangiectatic hepatocellular adenoma without degeneration (>5 cm) underwent laparoscopic right hepatectomy with the hanging maneuver. The patient was installed in the supine position with the legs spread apart. Five trocars were used for the intervention. The liver hanging maneuver w...
journal_title:Annals of surgical oncology
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doi:10.1245/s10434-014-3809-0
更新日期:2014-11-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2363-x
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Thyroidectomy and parathyroidectomy are the most commonly performed endocrine operations, and are increasingly being completed on a same-day basis; however, few data exist regarding the outpatient postoperative pain requirement of these patients. We aimed to describe the outpatient narcotic medication needs ...
journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
doi:10.1245/s10434-017-5781-y
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Current understanding of the lymphatic system of the breast is derived mainly from the work of the anatomist Sappey in the 1850s, with many observations made during the development and introduction of breast lymphatic mapping and sentinel node biopsy contributing to our knowledge. METHODS:Twenty four breast...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-007-9709-9
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Magnetic resonance cholangiopancreatography (MRCP) is a new noninvasive diagnostic method for pancreaticobiliary (PB) imaging without endoscopy, sedation, or iodinated contrast. The purpose of this study was to evaluate the ability of MRCP to depict pancreatic and biliary ductal anatomy compared to that of e...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02303747
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:The 5th edition of Breast Imaging Reporting and Data System subdivides suspicious calcifications into two categories: 4B-amorphous, coarse heterogeneous, and fine pleomorphic calcifications; 4C-fine linear or fine linear branching calcifications. We investigated whether these revised categories are appropria...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4362-6
更新日期:2015-09-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-017-6319-z
更新日期:2018-03-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1468-3
更新日期:2011-07-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3688-4
更新日期:2014-09-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
doi:10.1245/ASO.2004.04.018
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:Persistent/recurrent primary hyperparathyroidism (pHPT) occurs frequently in multiple endocrine neoplasia type 1 (MEN1). We assessed the usefulness of intraoperative PTH (IOPTH) and preoperative localizing studies based on the outcome of patients with MEN1-associated pHPT undergoing reoperative surgery. MET...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-016-5467-x
更新日期:2016-12-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-4056-0
更新日期:2015-02-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07453-1
更新日期:2019-08-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08518-2
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Whether breast cancer surgeons are adequately trained, skilled, and experienced to provide breast cancer genetic assessment, testing, and counseling came under debate in September 2013 when a major third-party payer excluded nongenetics specialists from ordering such testing. A literature search having faile...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-014-3711-9
更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Occult breast cancer (OBC) is a rare clinical entity. Current surgical management includes axillary lymphadenectomy (ALND) with or without mastectomy. We sought to investigate the role of sentinel lymph node biopsy (SLNB) in patients with OBC treated with neoadjuvant chemotherapy (NAC). METHODS:Patients wit...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08227-w
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Liver fibrosis influences liver regeneration and surgical outcomes, and several noninvasive models based on laboratory data have been developed to predict liver fibrosis. This study was performed to determine whether the Fibrosis-4 (FIB-4) index, a noninvasive fibrosis marker, can predict the prognosis in pa...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-020-08828-5
更新日期:2020-09-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-010-1443-z
更新日期:2011-07-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2014-01-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2011-10-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2012-04-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2019-12-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
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更新日期:2014-10-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-012-2345-z
更新日期:2012-09-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2015-05-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-019-07321-y
更新日期:2019-07-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
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更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:The prognosis for patients with locally advanced thoracic esophageal cancer is extremely unfavorable. We have been administering neoadjuvant chemoradiotherapy (CRT) followed by esophagectomy to these patients and studying whether REG I expression in untreated endoscopic biopsy specimens is predictive of pati...
journal_title:Annals of surgical oncology
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更新日期:2006-12-01 00:00:00