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Editor's Audio Summary

February 25, 2014

JAMA Surgery, 2014-02-19 Online First articles, Editor's Audio Summary

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 Showing 1-20 of 38 Articles
David C. Chang, PhD, MPH, MBA; Christopher Evans, BS; Joseph Parker, PhD
More than a decade has passed since the Institute of Medicine released the Crossing the Quality Chasm report, highlighting the challenges in health care–quality improvements.1 The proposals outlined by this report have extensive data needs. Given the ubiquitous nature of administrative databases that are already being generated from hospital billings, ...
Original Investigation 
Csaba Gajdos, MD; Deidre Kile, MS; Mary T. Hawn, MD, MPH; Emily Finlayson, MD, MS; William G. Henderson, PhD; Thomas N. Robinson, MD, MS
Includes: Supplemental Content

Importance  With an aging population, preoperative assessment of the frail older adult requires evaluation beyond simply accounting for chronic diseases. Impaired cognition is a recognized characteristic of the frail older adult.

Objective  To examine the effect of preoperative impaired sensorium (IS) on general surgical outcomes.

Design, ...

Original Investigation  FREE
Kristy L. Kummerow, MD; Liping Du, PhD; David F. Penson, MD, MPH; Yu Shyr, PhD; Mary A. Hooks, MD, MBA
Includes: Supplemental Content

Importance  Accredited breast centers in the United States are measured on performance of breast conservation surgery (BCS) in the majority of women with early-stage breast cancer. Prior research in regional and limited national cohorts suggests a recent shift toward increasing performance of mastectomy in patients eligible for ...

Brief Report 
Lillias H. Maguire, MD; Mingyang Song, MD; Lisa L. Strate, MD, MPH; Edward L. Giovannucci, MD, ScD; Andrew T. Chan, MD, MPH
Includes: Supplemental Content

Importance  The incidence of diverticulitis has been associated with geographic and seasonal variation. Low levels of circulating vitamin D are associated with diverticulitis. We investigated the association between UV light and diverticulitis.

Observations  We identified nonelective diverticulitis admissions in the Nationwide Inpatient Sample and linked hospital ...

Invited Commentary 
Bonnie Sun, MD; Michael E. Zenilman, MD
After the landmark National Surgical Adjuvant Breast and Bowel Project–B27 study, which showed no survival difference between mastectomy and lumpectomy with radiation, breast conservation surgery (BCS) emerged as the preferred option for early-stage cancers.1,2 This led to a steady increase in BCS, but the seminal article in this issue by ...
Research Letter 
Philip P. Goodney, MD, MS; Massimo Tarulli, BS; Adrienne E. Faerber, PhD; Andreas Schanzer, MD, MS; Robert M. Zwolak, MD, PhD
Although severe lower extremity peripheral arterial disease affects more than 12 million people in the United States,1,2 secular trends in the risk of amputation remain unexplored in recent years. Using national billing and survey data sets from the Centers for Medicare and Medicaid Services and the Behavioral Risk Factor Surveillance ...
Original Investigation 
Lee G. Wilke, MD; Tomasz Czechura, MPH; Chih Wang, PhD; Brittany Lapin, MPH; Erik Liederbach, BS; David P. Winchester, MD; Katharine Yao, MD

Importance  Although complete excision of breast cancer is accepted as the best means to reduce local recurrence and thereby improve survival, there is currently no standard margin width for breast conservation surgery. As a result, significant variability exists in the number of additional operations or repeat surgeries ...

Original Investigation 
Joshua C. Grimm, MD; Isibor Arhuidese, MD, MPH; Robert J. Beaulieu, MD; Umair Qazi, MD; Bruce A. Perler, MD, MBA; Julie A. Freischlag, MD; Mahmoud B. Malas, MD, MHS

Importance  While the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) has been widely accepted as a landmark trial establishing an equivalent risk of major adverse events following carotid endarterectomy (CEA) or carotid artery stenting (CAS), the applicability of these findings to single centers has been questioned owing ...

Original Investigation 
Rachel H. Bhak, MS; Michael Wininger, PhD; Gary R. Johnson, MS; Frank A. Lederle, MD; Louis M. Messina, MD; David J. Ballard, MD, MSPH, PhD; Samuel E. Wilson, MD; for the Aneurysm Detection and Management (ADAM) Study Group
Includes: Supplemental Content

Importance  Because of the high mortality rate after rupture of small abdominal aortic aneurysms (AAAs), surveillance is recommended to detect aneurysm expansion; however, the effects of clinical risk factors on long-term patterns of AAA expansion are poorly characterized.

Objective  To identify significant clinical risk factors associated ...

Invited Commentary 
Julie A. Margenthaler, MD; Aislinn Vaughan, MD
The definition of a sufficient margin after attempted breast conservation surgery for breast cancer has been a hotly debated topic for decades. Although there has been widespread acceptance that breast conservation surgery confers an equivalent survival outcome to mastectomy in prospective randomized trials,1,2 there is a paradoxical reluctance to agree ...
JAMA Surgery Clinical Challenge 
Franck Billmann, MD, PhD; Therezia Bokor-Billmann, MD; Christopher Beck, MD
Andrew J. Schoenfeld, MD, MSc; Mitchel B. Harris, MD; Matthew Davis, MD, MAPP
Physicians are regularly challenged to make treatment recommendations for patients whose diagnosis and prognosis are uncertain and for whom the highest-quality evidence is inconclusive. Consequently, physicians are generally accustomed to functioning in the fog of uncertainty. Until now, the dynamics of clinical decisions in the midst of uncertainty have been ...
Original Investigation 
Jamie E. Anderson, MD, MPH; David C. Chang, PhD, MPH, MBA

Importance  Risk adjustment is an important component of quality assessment in surgical health care. However, data collection places an additional burden on physicians. There is also concern that outcomes can be gamed depending on the information recorded for each patient.

Objective  To determine whether a number ...

Original Investigation 
Alexandra Gangi, MD; Ilana Cass, MD; Daniel Paik, MD; Galinos Barmparas, MD; Beth Karlan, MD, PhD; Catherine Dang, MD; Andrew Li, MD; Christine Walsh, MD; Bobbie J. Rimel, MD; Farin F. Amersi, MD

Importance  BRCA mutation carriers are at increased risk of developing breast cancer. However, the incidence of breast cancer after a diagnosis of epithelial ovarian cancer (EOC), one of the tubal/peritoneal cancers collectively referred to as pelvic serous carcinomas, is not well known. Optimal breast cancer surveillance and ...

Original Investigation 
Christina E. Bailey, MD, MSCI; Chung-Yuan Hu, MPH, PhD; Y. Nancy You, MD, MHSc; Brian K. Bednarski, MD; Miguel A. Rodriguez-Bigas, MD; John M. Skibber, MD; Scott B. Cantor, MD; George J. Chang, MD, MS

Importance  The overall incidence of colorectal cancer (CRC) has been decreasing since 1998 but there has been an apparent increase in the incidence of CRC in young adults.

Objective  To evaluate age-related disparities in secular trends in CRC incidence in the United States.

Design, Setting, and ...

Invited Commentary 
Kiran K. Turaga, MD, MPH
The public health burden of colorectal cancer is a significant challenge, with more than 50 000 deaths annually in the United States. Widespread adoption of the US Preventative Task Force Guidelines for mandatory screening for colon cancer, along with improvement in access to advanced fiber optic technology and training of ...
Original Investigation 
Mahmoud B. Malas, MD, MHS; Umair Qazi, MD, MPH; Natalia Glebova, MD; Isibor Arhuidese, MD, MPH; Thomas Reifsnyder, MD; James Black, MD; Bruce A. Perler, MD; Julie A. Freischlag, MD

Importance  To our knowledge, there is no level 1 evidence comparing open bypass with angioplasty and stenting in TransAtlantic Inter-Society Consensus (TASC II) B and C superficial femoral artery lesions. The Revascularization With Open Bypass vs Angioplasty and Stenting of the Lower Extremity Trial (ROBUST) is the ...

Original Investigation 
David Arterburn, MD, MPH; J. David Powers, MS; Sengwee Toh, ScD; Sarit Polsky, MD, MPH; Melissa G. Butler, PharmD, MPH; J. Dickman Portz, PhD; William T. Donahoo, MD; Lisa Herrinton, PhD; Rebecca J. Williams, DrPH, MPH; V. Vijayadeva, PhD, MBBS, MPH; David Fisher, MD; Elizabeth A. Bayliss, MD, MSPH
Includes: Supplemental Content

Importance  Laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (AGB) are 2 of the most commonly performed bariatric procedures worldwide. However, few large, multisite studies have directly compared the benefits and harms of these procedures.

Objective  To compare the effect of laparoscopic RYGB vs ...

Brief Report 
Brian J. Pottorf, MD; Farah A. Husain, MD; H. Whitton Hollis Jr, MD; Edward Lin, DO, MBA

Importance  Duodenal obstruction by compression from the superior mesenteric artery (SMA) can be managed using minimally invasive techniques initially developed for bariatric patients requiring gastric bypass.

Observations  This retrospective review evaluates 12 patients with SMA syndrome who were treated with laparoscopic enteric bypass. Technical considerations are ...

Invited Commentary 
Justin B. Dimick, MD, MPH; Jonathan F. Finks, MD
For many years, laparoscopic gastric bypass and adjustable gastric banding were the only 2 bariatric procedures performed by most bariatric surgeons. The trade-offs for the 2 procedures were seemingly straightforward: gastric bypass had higher risks but more weight loss; the laparoscopic band was safer but had lower weight loss. However, ...

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