Abstract:
BACKGROUND:Making a conflict of interest declaration is now mandatory at continuing medical education CME accredited events. However, these declarations tend to be largely perfunctory. This study sought to better understand physician perceptions surrounding conflict of interest. METHODS:The same PowerPoint (Microsoft, Canada) presentation (http://www.youtube.com/watch?v=mQSOvch7Yg0&feature=g-upl) was delivered at multiple University of Alberta and Royal College CME-accredited events to surgeons, internists, and learners. After each talk, the audience was invited to complete an anonymous, pretested, and standardized 5-point Likert scale (strongly disagree to strongly agree) questionnaire. RESULTS:A total of 136 surveys were analyzed from 31 surgeons, 49 internists, and 56 learners. In response to the question regarding whether by simply making a declaration, the speaker had provided adequate proof of any conflicts of interest, 71% of surgeons thought so, whereas only 35% of internists and 39% of learners agreed or strongly agreed (P = .004). Further probing this theme, the audience was asked whether a speaker must declare fees or monies received from industry for consulting, speaking, and research support. Once again there was a variance of opinion, with only 43% of surgeons agreeing or strongly agreeing with this statement; yet, 80% of internists and 71% of learners felt that such a declaration was necessary (P = .013). On the topic of believability (a speaker declaration makes him or her and the presentation more credible), the 3 groups were less polarized: 50% of surgeons, 41% of internists, and 52% of learners (P = .2) felt that this was the case. Although two thirds of surgeons (68%) and learners (66%) and nearly all internists (84%) felt that industry-sponsored research was biased, these differences were not significant (P = .2). CONCLUSIONS:Even when they are completely open and honest, conflict of interest declarations do not negate the biases inherent in a speaker's talk or research when it is industry sponsored. The larger issue is how best to manage these conflicts.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
de Gara CJ,Rennick KC,Hanson Jdoi
10.1016/j.amjsurg.2013.01.012subject
Has Abstractpub_date
2013-05-01 00:00:00pages
541-5; discussion 545-6issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(13)00111-6journal_volume
205pub_type
杂志文章abstract:BACKGROUND:We previously identified serum creatinine values >2 mg/dL (176.8 micromol/L) and pathological chest radiographs due to the presence of pleural effusions or pulmonary densifications as two early prognostic factors of life-threatening acute pancreatitis (AP). The aim of the present study was to validate their ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(98)00296-7
更新日期:1999-01-01 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::Between 1973 and 1989, 49 patients with gastrointestinal lymphomas were treated at the Virginia Mason Medical Center, Seattle, Washington, and followed in the tumor registry. The purpose of this review was to determine the influence of treatment on long-term survival of these patients. The mean age was 63 years (range...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90902-p
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:Experience with laparoscopic procedures and recent advances in laparoscopic devices have created an evolving interest in the application of these techniques to liver resection. However, laparoscopic liver resection has not been widely developed and anatomical segmental liver resection is not currently perfor...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.10.027
更新日期:2008-10-01 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::Abnormal persistent of the embryonic axial blood supply to the leg, the sciatic artery, is a rare but often clinically important condition. The sciatic artery may vary from a small collateral in the upper thigh to a very large vessel that is the leg's sole arterial blood supply. The abnormal artery is prone to aneurys...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90122-8
更新日期:1983-05-01 00:00:00
abstract:BACKGROUND:Crohn's disease is an aggressive chronic inflammatory disorder, and despite medical advances no cure exists. There is a great risk of requiring an operative intervention, with evidence of recurrence developing in up to 80-90% of cases. Therefore, we sought to systematically review the current status in the p...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2017.04.016
更新日期:2017-11-01 00:00:00
abstract::The clinical findings and histologic features of 154 parotid gland tumors treated at the Health Sciences Centre, Winnipeg, Canada, from 1957 to 1970 were reviewed. The study illustrates a wide variation in the natural history and degree of malignancy of parotid tumors. Approximately 80 per cent were benign; among thes...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(75)90344-x
更新日期:1975-06-01 00:00:00
abstract::During the past 5 years, extended cholecystectomy and/or more radical procedures, including pancreatoduodenectomy and extended hepatic lobectomy, were performed on 48 patients with carcinoma of the gallbladder in an attempt to cure the disease. It was retrospectively proven from microscopic analysis of the surgical sp...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(92)90109-5
更新日期:1992-02-01 00:00:00
abstract:BACKGROUND:This study analyzed presentation and management of hemorrhage after pancreaticoduodenectomy (PD) to determine the respective role of surgery and embolization. METHODS:From January 1992 to March 2005, 411 patients underwent PD and were analyzed with regard to postoperative hemorrhage. RESULTS:Hemorrhage occ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2006.08.088
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:The standard paradigm for acutely injured patients involves evaluation in an emergency department (ED). Our center has employed a policy for bypassing the ED and proceeding directly to the operating room (OR) based on prehospital criteria. METHODS:This is a retrospective analysis of all trauma patients admi...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2012.06.001
更新日期:2012-08-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to assess the malignancy rate in patients with Hürthle cell metaplasia (HCM) on fine-needle aspiration biopsy (FNAB). METHODS:The pathology results of patients with benign colloid (BC) and HCM on FNAB were compared using a prospective database. RESULTS:One hundred fifty-three (6...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2011.09.019
更新日期:2012-03-01 00:00:00
abstract::Despite immediate operation, patients with abdominal aortic injuries and profound hypovolemic shock do not respond to the usual methods of resuscitation and die soon after celiotomy, prior to control and repair of the aortic injury. The rate of aortic hemorrhage exceeds the ability to restore blood volume. Shock becom...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90385-4
更新日期:1979-08-01 00:00:00
abstract::Thrombosis and its major sequela, embolism, continue to contribute significantly to morbidity and mortality, both as primary disorders and as complications of other systemic systems. The understanding of the etiology of thromboembolism and the role of platelets, endothelium, and the plasma proteins in the development ...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/s0002-9610(05)80743-3
更新日期:1990-12-01 00:00:00
abstract::Cholecystostomy in patients with noninflammatory disease of the biliary tract has rarely been evaluated. Our experience with 124 patients suggests that, in addition to being helpful in inflammatory conditions, cholecystostomy is helpful in performing cholangiography, in removing stones and in decompressing an otherwis...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90192-6
更新日期:1981-03-01 00:00:00
abstract::A survey was made of 112 cases of gallstone ileus reported in the Japanese literature, including 3 of our cases. The ratio of males to females was 1 to 1.1, the age range was 13 to 87 years, and biliary-enteric fistulas were demonstrated in 81 percent of the patients. Although cholecystoduodenal fistula was most commo...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90185-3
更新日期:1980-09-01 00:00:00
abstract::The experience with gastrointestinal cancer at a single large hospital has been utilized as a "micro-model" of the experience for the country at large, and the reasons why such a comparison might be possible have been presented. The incidence of various lesions has been discussed in terms of sex, age, and race. The ch...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(78)90002-8
更新日期:1978-01-01 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: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::Approximately 60% of patients who die from melanoma have gastrointestinal (GI) metastases at autopsy, yet antemortem diagnosis is uncommon. A retrospective review was completed on 32 patients who underwent an operation at Memorial Sloan-Kettering Cancer Center between 1977 and 1987 for complications of melanoma metast...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90070-t
更新日期:1991-09-01 00:00:00
abstract::As discussed by Urschel [13], 50 to 70 percent of patients with symptoms of thoracic outlet syndrome may be treated conservatively by nonsurgical methods. Patients who still have symptoms after years of such therapy are referred to us for surgical treatment. Failure to obtain symptomatic relief after scalenotomy alone...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90351-7
更新日期:1980-05-01 00:00:00
abstract::Among 400 patients with adenocarcinoma of the distal large bowel, anterior resection resulted in more anastomotic leaks, postoperative urinary retention and diarrhea when used for lesions of the mid-rectum than when used for lesions of the proximal rectum or sigmoid colon. However, the operative mortality, long-term m...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90235-4
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:As laparoscopic experience increases, ever more challenging cases are attempted. Enlarged surgeon experience, along with better technology, has been lauded as improving outcomes. The purpose of this study is to see if this applies to the management of acute cholecystitis. METHODS:We reviewed our experience ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(02)01089-9
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:A multicenter, randomized, clinical trial was initiated to evaluate the possible benefits of extended D2 (D2+) lymphadenectomy after potentially curative resection of gastric cancer. METHODS:Standard D2 lymphadenectomy was defined according to the Japanese Gastric Cancer Association classification. D2+ lymp...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.amjsurg.2006.04.018
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:A clear understanding of simulation-based curricula in use at American College of Surgeons Accredited Education Institutes (ACS-AEIs) is lacking. METHODS:A 25-question online survey was sent to ACS-AEIs. RESULTS:The response rate approached 60%. The most frequent specialties to use the ACS-AEIs are general...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2016.08.011
更新日期:2017-04-01 00:00:00
abstract::Over a 10 year period, 54 patients presented with pancreatic trauma. During the first 5 years of the study, when pancreatography was not utilized for the assessment of pancreatic duct injury, 55 percent of the patients had major pancreatic complications. During the subsequent 5 years, suspected proximal duct injury wa...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(82)90173-8
更新日期:1982-05-01 00:00:00
abstract::The lifetime risk for developing thin (< or =1 mm) melanoma continues to increase steadily. Although generally associated with an excellent prognosis, it also has a proven capacity to metastasize. There has been increasing interest in using sentinel lymph node biopsy to improve staging for thin melanoma. However, it i...
journal_title:American journal of surgery
pub_type: 杂志文章,评审
doi:10.1016/j.amjsurg.2005.05.011
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Primary hyperparathyroidism (HPT) is an undertreated disease. This study's purpose is to determine if the calcium levels correlate with prevalence of symptoms and surgical treatment in patients with primary HPT. METHOD:Patients treated in 2006-2015 with serum calcium≥10.0 mg/dL and PTH>65 pg/mL were identif...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.09.010
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:We surveyed surgeons to document their attitudes, practice, and risk tolerance regarding the treatment of appendicitis. METHODS:A web-based survey was sent to the EAST membership. The primary composite endpoint was defined as 1-year incidence of perioperative complications, antibiotic failure, infections, E...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2018.08.019
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:A critical outcome analysis of a large, single-institution experience provides a better frame of reference for an assessment of the role of laparoscopic colectomy for colorectal pathology. METHODS:Review of a prospectively gathered database was performed of a consecutive series of laparoscopic colectomy pat...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2005.10.039
更新日期:2006-03-01 00:00:00