Abstract：
BACKGROUND:The US Department of Veterans Affairs (VA) Office of Quality and Performance's July 2009 report detailed the quality of VA colorectal cancer (CRC) care on the basis of 10 quality indicators (QIs). Of 21 Veterans Integrated Service Networks (VISNs), the authors' VISN ranked last or near last on more than half of the QIs. The aim of this study was to compare a national-level assessment of performance with an institutional-level clinical review. METHODS:The authors reabstracted all patients seen at surgical hospitals within their VISN during the time period of the Office of Quality and Performance report and reanalyzed their performance on the 10 QIs. A number of quality improvement efforts were also implemented to further boost performance, including the creation of a computerized patient record system CRC order set and quarterly surveillance meetings. RESULTS:After reanalysis of the VISN's QI performance for CRC patients during the time period of the OQP report, the VISN performed 18% better than reported and 2% better than the national average. Since that time, a multidisciplinary CRC committee has implemented quality improvement measures that have further improved QI performance. CONCLUSIONS:There is variability between administrative quality assessments and clinically abstracted data. Care must be taken when analyzing QIs at the national level.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Hayman AV,Chang ET,Molokie RE,Kahng LS,Prystowsky JB,Bentrem DJdoi
10.1016/j.amjsurg.2010.07.008subject
Has Abstractpub_date
2010-11-01 00:00:00pages
572-6issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(10)00451-4journal_volume
200pub_type
杂志文章abstract：:One hundred thirty-four patients suspected of having pancreas cancer successfully underwent gray scale ultrasound examination of the pancreas. The prospective ultrasound findings were correlated with the final diagnoses, laparotomy findings, and pathology findings. Fifty-four patients had pancreas cancer, confirmed by...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90313-6
更新日期：1978-11-01 00:00:00
abstract：BACKGROUND:It was hypothesized that splenectomy following trauma results in hypercoagulability. METHODS:A prospective, nonrandomized, single-center study was performed to evaluate coagulation parameters in trauma patients with splenic injury. RESULTS:Patients with splenectomy (n = 30) and nonoperative management (n =...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.01.015
更新日期：2010-05-01 00:00:00
abstract：BACKGROUND:This 17-year review was undertaken to examine clinical outcomes and the changing trends in resource utilization for lower extremity bypass grafts performed in a managed care setting. PATIENTS AND METHODS:Between 1979 and 1995, 338 bypasses in 276 patients (199 men, 77 women; 62% diabetics) were carried out ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00130-4
更新日期：1996-08-01 00:00:00
abstract：:The technique of regional pancreatectomy as detailed is divided into five phases. The procedure includes en bloc regional lymph node dissection, peripancreatic soft tissue resection, and resection with reconstruction of the pancreatic segment of portal vein. The pancreatic resection can be subtotal or total. ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90444-1
更新日期：1985-11-01 00:00:00
abstract：BACKGROUND:Perihilar cholangiocarcinoma is usually unresectable at the time of diagnosis. Only few patients are candidates for a potential curative treatment. For those patients, prognosis is strongly related to negative resection margin and lymph node status. Thus, a certain benchmark of lymph node count is necessary ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2015.05.015
更新日期：2015-10-01 00:00:00
abstract：BACKGROUND:The use of biologic markers to aid in individualizing wound treatment may help improve outcomes. A biologic marker that has been demonstrated to be predictive of healing in both chronic and acute wounds is wound tissue bacterial level. The objective of this study was to determine whether tissue bacterial lev...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.09.009
更新日期：2011-08-01 00:00:00
abstract：BACKGROUND:Data concerning the long-term efficacy of laparoscopic sleeve gastrectomy in the treatment of morbid obesity remain scarce. In this retrospective, the authors present 5-year follow-up of 30 patients having undergone laparoscopic sleeve gastrectomy. METHODS:Since 2004, 30 patients underwent laparoscopic slee...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.04.006
更新日期：2015-02-01 00:00:00
abstract：BACKGROUND:Procedural teaching and the ability to detect and correct errors are important components of surgical education. This study evaluates whether review of an instructional video will improve residents' ability to detect errors. We hypothesized that clinical experience and confidence do not correlate with abilit...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.08.026
更新日期：2017-06-01 00:00:00
abstract：OBJECTIVE:The purpose of our study is to further clarify the incidence of ductal carcinoma in situ (DCIS) patients that are upstaged upon final pathology and/or have metastatic disease in the axilla. METHODS:All patients were diagnosed with DCIS or DCIS with microinvasion (DCISm) on their diagnostic biopsy and receive...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.06.011
更新日期：2005-10-01 00:00:00
abstract：BACKGROUND:Because of the increase in the geriatric population, an increasing number of elderly patients are being treated for colorectal cancer. The purpose of this study was to evaluate perioperative morbidity and mortality in this population. METHODS:A retrospective chart review was performed for patients 80 years ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.12.022
更新日期：2008-03-01 00:00:00
abstract：INTRODUCTION:Patient Reported Outcomes (PROs) capture peri-operative fatigue, pain, and quality of life and influence outcomes in gastrointestinal surgery. We compared peri-operative PROs in patients undergoing colorectal operations for neoplastic versus non-neoplastic processes. METHODS:Patients undergoing colectomy ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.08.017
更新日期：2020-12-01 00:00:00
abstract：BACKGROUND:The extent of tissue loss amenable to primary healing after revascularization is unknown. Salvage of limbs with large soft-tissue defects with exposed tendon, joint, or bone lies beyond the limits of conventional techniques. We report our results using free tissue transfer as an adjunct to lower extremity va...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00175-x
更新日期：1997-12-01 00:00:00
abstract：BACKGROUND:Melanomas are aggressive neoplasms with limited therapeutic options. Therefore, developing new therapies with low toxicity is of utmost importance. Honokiol is a natural compound that recently has shown promise as an effective anticancer agent. METHODS:The effect of honokiol on melanoma cancer cells was ass...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.09.001
更新日期：2012-12-01 00:00:00
abstract：:Despite undergoing a curative resection, many patients with colorectal cancer will develop and die of metastatic disease. It has been shown clinically and experimentally that surgery causes a transient period of immunosuppression, and it is postulated that this may encourage both the implantation of surgically dissemi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(94)90070-1
更新日期：1994-01-01 00:00:00
abstract：:One hundred thirty-six patients meeting our criteria for one or more of eight clinical conditions were prospectively observed for the development of the adult respiratory distress syndrome. A high risk population was identified, including those with sepsis syndrome (38 percent), documented aspiration of gastric conten...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90612-2
更新日期：1982-07-01 00:00:00
abstract：:Fifty-two patients with ulcerative colitis and colorectal cancer undergoing colectomy at the Mount Sinai Hospital between 1973 and 1988 were studied retrospectively to determine the correlation of age, sex, duration of colitis, tumor location, number of cancers, tumor differentiation, colloid content, presence of sign...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80638-5
更新日期：1992-07-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.03.017
更新日期：2011-04-01 00:00:00
abstract：:Much of the confusion surrounding the repair of asymptomatic abdominal aortic aneurysms related to inaccuracies in their measurement, both preoperatively and intraoperatively. Multiple measurements of aneurysms at operation have convinced us that the largest and least variable diameter is the anteroposterior diameter ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90539-6
更新日期：1982-12-01 00:00:00
abstract：:The value of barium enema examination in diagnosing acute appendicitis in patients with equivocal findings has been confirmed by our experience with five patients. Cecal spasm, extrinsic compression of the cecum, nonvisualization of the appendix, and partial visualization of the appendix appear to be useful roentgenog...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90306-4
更新日期：1979-12-01 00:00:00
abstract：BACKGROUND:Invasion of the larynx by differentiated thyroid gland carcinoma is uncommon but causes serious morbidity and mortality when present. METHODS:The clinicopathologic characteristics of 5 patients in which a total laryngectomy had to be performed for differentiated thyroid carcinoma are analyzed. Special refer...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2005.04.009
更新日期：2005-07-01 00:00:00
abstract：:Familial visceral myopathy is a form of chronic intestinal pseudoobstruction in which fibrosis of the smooth muscle of the alimentary tract causes protean symptoms of disordered visceral motility. Based on our 8 year observation of six members of one family with familial visceral myopathy and review of the few well-do...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(85)90017-0
更新日期：1985-07-01 00:00:00
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journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)90072-6
更新日期：1997-08-01 00:00:00
abstract：:Esophageal transection with the EEA stapler was performed in five patients with bleeding esophageal varices. Bleeding from varices has not recurred in surviving patients during follow-up of up to 27 months. One death occurred during the postoperative period. Esophageal transection with the EEA stapler is an effective ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90125-7
更新日期：1980-12-01 00:00:00
abstract：BACKGROUND:Because the implications of micrometastases found on sentinel node biopsy (SNB) for ductal carcinoma in situ (DCIS) or ductal carcinoma in situ with microinvasion (DCISM) are largely unknown, we wished to determine if SNB pathology predicted recurrence risk in DCIS/DCISM. METHODS:Retrospective chart review ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.06.011
更新日期：2008-10-01 00:00:00
abstract：:The histopathology, clinical features, treatment, and results are reported in twenty-nine patients with thymoma. Benign and malignant thymomas are differentiated by their invasive characteristics. Surgical excision is recommended for benign lesions. Surgical excision and postoperative irradiation are recommended for m...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90199-x
更新日期：1978-07-01 00:00:00
abstract：:Hemorrhage is a major cause of trauma deaths. Coagulopathy exacerbates hemorrhage and is commonly seen during major trauma resuscitation, suggesting that current practice of coagulation factor transfusion is inadequate. Reversal of coagulopathy involves normalization of body temperature, elimination of the causes of d...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2005.03.034
更新日期：2005-09-01 00:00:00
abstract：BACKGROUND:Strategies for splenic preservation for trauma patients have gained acceptance; however, meaningful outcome evaluations have not been performed. To better understand the consequences of managing patients with splenic injuries, the short-term outcomes of different types of management strategies were examined....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.07.037
更新日期：2008-08-01 00:00:00
abstract：BACKGROUND:We hypothesized that the increasing body mass index of the population has affected general surgery malpractice claims. METHODS:We queried the Physician Insurers Association of America database from 1990 to 1999 (ie, period 1) and 2000 to 2009 (ie, period 2) for claims associated with obesity and morbid obes...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.10.023
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:The adipocyte hormone leptin has been shown to increase migration and angiogenesis in epithelial cells. Therefore, we hypothesized that leptin would induce prostate cancer cell migration and growth factor expression in vitro. METHODS:Prostate cancer cell lines DU145 and PC-3 (androgen-resistant) were treate...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2004.07.031
更新日期：2004-11-01 00:00:00
abstract：:Five patients with infected abdominal aortoiliac aneurysms were treated. The diagnosis was made preoperatively based upon fever, leukocytosis, positive blood culture findings, and presence of an aneurysm in all five patients. Two patients had salmonella species, two had staphylococcus species, and one had bacteroides ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80137-5
更新日期：1988-05-01 00:00:00
