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 Showing 1-20 of 101 Articles
Original Investigation 
Brodie A. Parent, MD; Max Seaton, MD; Ravi F. Sood, MD, MS; Haiwei Gu, PhD; Danijel Djukovic, PhD; Daniel Raftery, PhD; Grant E. O’Keefe, MD, MPH
Includes: Supplemental Content

Importance  Metabolomics is the broad and parallel study of metabolites within an organism and provides a contemporaneous snapshot of physiologic state. Use of metabolomics in the clinical setting may help achieve precision medicine for those who have experienced trauma, where diagnosis and treatment are tailored to the ...

Review  FREE
Linwah Yip, MD; Julie Ann Sosa, MD, MA

Importance  Thyroid cancer incidence is increasing, and when fine-needle aspiration biopsy results are cytologically indeterminate, the diagnosis is often still established only after thyroidectomy. Molecular marker testing may be helpful in guiding patient-oriented and tailored management of thyroid nodules and thyroid cancer.

Objective  To summarize available ...

Surgical Innovation 
Jamii St Julien, MD, MPH; Nancy D. Perrier, MD

This article reports on how video telementoring is likely to play an increasing role in surgical education.

Research Letter 
Joshua D. Rouch, MD; Jessica A. Keeley, MD; Andrew Scott, MD; Roman Sydorak, MD; Daniel DeUgarte, MD; Steven L. Lee, MD

This case series compares unroofing and marsupialization vs wide local excision as surgical therapy for pilonidal disease.

Correction  FREE

In the Research Letter titled “Comparing Publicly Reported Surgical Outcomes With Quality Measures From a Statewide Improvement Collaborative,”1 published online March 16, 2016, the first sentence of the figure legend miscategorized the methods used by the Surgeon Scorecard. The sentence should read as follows: “The complication rate ...

Original Investigation 
Caitlin W. Hicks, MD, MS; Joseph K. Canner, MHS; Isibor Arhuidese, MD, MPH; Tammam Obeid, MD; James H. Black III, MD; Mahmoud B. Malas, MD, MHS

Importance  Patient- and hospital-level factors affecting outcomes after open and endovascular abdominal aortic aneurysm (AAA) repair are each well described separately, but not together.

Objective  To describe the association of patient- and hospital-level factors with in-hospital mortality after elective AAA repair.

Design, Setting, and Participants  ...

Invited Commentary: Aortic Centers of Excellence; Edward D. Gifford, MD; Christian de Virgilio, MD
Original Investigation 
Joaquim M. Havens, MD; Alexandra B. Columbus, MD; Olubode A. Olufajo, MD, MPH; Reza Askari, MD; Ali Salim, MD; Kenneth B. Christopher, MD, SM

Importance  Emergency general surgery (EGS) patients have a disproportionate burden of death and complications. Chronic liver disease (CLD) increases the risk of complications following elective surgery. For EGS patients with CLD, long-term outcomes are unknown and risk stratification models do not reflect severity of CLD.

Objective  ...

Invited Commentary: Mind MELD or Ignore It at Your Peril; Ali Zarrinpar, MD, PhD
Invited Commentary 
Edward D. Gifford, MD; Christian de Virgilio, MD

The Leapfrog initiative was created with the goal of improving in-hospital mortality for high-risk procedures, including elective abdominal aortic aneurysm (AAA) repair.1 The aim was to lower perioperative AAA mortality by at least 50% by referring patients to high-volume centers because high volume was felt to be ...

Invited Commentary 
Ali Zarrinpar, MD, PhD

Chronic liver disease (CLD) and its attendant increased risk of operative mortality and morbidity give appropriate pause to many surgeons and patients prior to undertaking any operation, especially an emergency. While the American College of Surgeons National Surgical Quality Improvement Project Surgical Risk Calculator1 does not yet ...

JAMA Surgery Clinical Challenge 
Run-De Jiang, MD; Zong-Li Zhang, MD; Tao Li, MD

A man in his mid-50s was referred to our hospital because he had a cystic mass in his spleen that was discovered incidentally during a routine physical examination. He had no history of abdominal trauma, infection, or surgery. What is your diagnosis?

Comment & Response 
Richard S. Matulewicz, MD, MS; Joshua J. Meeks, MD, PhD

To the Editor We commend Wright and colleagues1 on their assessment of several external, nonmedical factors associated with the use of robotic-assisted surgery (RAS). In their study,1 3 urologic procedures were included. They demonstrated that robotic-assisted laparoscopic prostatectomies were performed in a greater percentage of cases ...

Comment & Response 
Jason D. Wright, MD; Dawn L. Hershman, MD

In Reply We appreciate the interest of Matulewicz and Meeks in our work. The objective of our analysis was to examine the association between regional market competition and hospital financial status regarding 5 common urologic and gynecologic procedures. For all of the procedures, we noted a strong association ...

Viewpoint 
Steven Yule, PhD; Greg D. Sacks, MD, MPH; Melinda Maggard-Gibbons, MD, MSHS

This Viewpoint highlights various initiatives for improving nontechnical surgical culture and also several studies on the association between improved surgical culture and its effects on quality of patient care.

Original Investigation 
Mark A. Healy, MD; Andrew J. Mullard, MS; Darrell A. Campbell Jr, MD; Justin B. Dimick, MD, MPH
Includes: Supplemental Content

Importance  Increased costs of surgical complications have been borne mostly by third-party payers. However, numerous policy changes aimed at incentivizing high-quality care shift more of this burden to hospitals. The potential effect of these policies on hospitals and payers is poorly understood.

Objective  To evaluate costs ...

Invited Commentary: Complications, Costs, and Financial Incentives for Quality; Jonah J. Stulberg, MD, PhD, MPH; Karl Y. Bilimoria, MD, MS
Invited Commentary 
Jonah J. Stulberg, MD, PhD, MPH; Karl Y. Bilimoria, MD, MS

As we move away from a fee-for-service model of health care reimbursement toward value-based purchasing, payers are assuming these new models will drive down costs while simultaneously improving quality by shifting the financial burden of complications to providers. The complexities of our health care reimbursement systems and cost-accounting ...

Research Letter 
Kemi M. Doll, MD; Stacie B. Dusetzina, PhD; Whitney Robinson, PhD

This study analyzes the trends in inpatient and outpatient hysterectomy and oophorectomy rates among commercially insured women in the United States from 2000 to 2014.

Original Investigation 
Courtney J. Balentine, MD, MPH; Aanand D. Naik, MD; David H. Berger, MD, MHCM; Herbert Chen, MD; Daniel A. Anaya, MD; Gregory D. Kennedy, MD, PhD

Importance  Advanced age is an important risk factor for discharge to postacute care (PAC) facilities including skilled nursing and rehabilitation. Factors modifying the age-related risk of discharge to PAC have not been adequately examined for surgical patients.

Objective  To evaluate how preoperative functional status and postoperative ...

Invited Commentary: Thinking Beyond Age in a New Surgical Era; Anne M. Suskind, MD, MS; Emily Finlayson, MD, MS
Original Investigation 
Alessandra Storino, MD; Manuel Castillo-Angeles, MD; Ammara A. Watkins, MD; Christina Vargas, MD; Joseph D. Mancias, MD; Andrea Bullock, MD; Aram Demirjian, MD; A. James Moser, MD; Tara S. Kent, MD
Includes: Supplemental Content

Importance  The degree to which patients are empowered by written educational materials depends on the text’s readability level and the accuracy of the information provided. The association of a website’s affiliation or focus on treatment modality with its readability and accuracy has yet to be thoroughly elucidated....

Invited Commentary 
Anne M. Suskind, MD, MS; Emily Finlayson, MD, MS

By the year 2030, more than 20% of the population will be aged 65 years or older.1 Currently, this older population represents more than 35% of all inpatient procedures, accounting for a disproportionate use of health care resources and expenditures.2,3 This use of resources ...

JAMA Surgery Clinical Challenge 
Vasileios Mitrousias; Evangelos Alexiou; Anargyros Giaglaras

A 57-year-old woman presented to the emergency department with a 1 day history of upper abdominal pain. What is your diagnosis?

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