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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 44 Articles
JAMA Surgery Clinical Challenge 
Carla N. Holcomb, MD; Mary T. Hawn, MD, MPH
Invited Commentary 
Frank G. Opelka, MD
Using a large data set, Lucas et al1 studied the importance of appropriate risk adjustment when applying performance measures in payment and accountability programs. Despite limited variation in readmissions for colorectal cancer, a readmission rate of 12.3% should encourage all of us to strive to get below 10%. It is ...
Original Investigation 
Mahmoud Malas, MD, MHS; Isibor Arhuidese, MBBS, MPH; Umair Qazi, MD, MPH; James Black, MD; Bruce Perler, MD, MBA; Julie A. Freischlag, MD

Importance  Because of the restrictions applied to the conduct of randomized clinical trials, the risks reported in their comparison of open and endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAA) may not be applicable to real-world vascular surgical practice. The magnitude of this deviation is indeterminate....

Original Investigation 
Donald J. Lucas, MD, MPH; Aslam Ejaz, MD; Danielle A. Bischof, MD; Eric B. Schneider, PhD; Timothy M. Pawlik, MD, MPH, PhD

Importance  Hospital readmission after colorectal surgery is common, with reported 30-day readmission rates ranging from 10% to 14%. Readmission has become a major hospital quality metric, but it is unclear whether there is much difference in readmission among hospitals after appropriate risk adjustment.

Objective  To assess ...

Original Investigation 
Kendall Likes, BS; Danielle H. Rochlin, BA; Diana Call, BA; Julie A. Freischlag, MD

Importance  Patients with neurogenic thoracic outlet syndrome (NTOS) may have signs and symptoms of arterial compromise without thrombosis or aneurysm.

Objective  To evaluate these patients’ presentation, duration of signs and symptoms, and outcomes of immediate surgical operation.

Design, Setting, and Participants  Demographic and clinical data ...

Original Investigation 
Hani Y. Hasan, MD; J. Louis Hinshaw, MD; Edward J. Borman, MD; Alison Gegios, BA; Glen Leverson, PhD; Emily R. Winslow, MD

Importance  Few long-term data describe the natural history of hepatic hemangiomas. Because these lesions are frequently imaged repetitively on studies performed for other indications, health care professionals are commonly confronted with the problem of a growing hemangioma. Because the rate and magnitude of normal growth is not ...

Original Investigation 
Shervin M. Shirvani, MD, MPH; Jing Jiang, MS; Joe Y. Chang, MD, PhD; James Welsh, MD; Anna Likhacheva, MD, MPH; Thomas A. Buchholz, MD; Stephen G. Swisher, MD; Benjamin D. Smith, MD
Includes: Supplemental Content

Importance  The incidence of early-stage non–small cell lung cancer (NSCLC) among the elderly is expected to rise dramatically owing to demographic trends and increased computed tomographic screening. However, to our knowledge, no modern trials have compared the most common treatments for NSCLC.

Objective  To determine clinical ...

Viewpoint 
Terry Shih, MD; Justin B. Dimick, MD, MPH
This Viewpoint discusses the implications of reference pricing, where patients are financially responsible for any excess difference in cost between the agreed-on price for a specific service and the provider’s actual price.
JAMA Surgery Clinical Challenge 
Jen-Fu Huang, MD; Chien-Hung Liao, MD; Ta-Sen Yeh, MD, PhD
Invited Commentary 
Shawn L. Hervey-Jumper, MD; Paul Park, MD
Cervical total disc replacement was developed to treat symptoms associated with disc degeneration while preserving physiological motion. Several clinical trials have compared its use with traditional anterior cervical discectomy and fusion for both single-level and multilevel disease.1,2 Ament et al3 analyzed data from a published multicenter randomized clinical trial by ...
Original Investigation 
Michael J. Hughes, MBChB, MRCS; Nicholas T. Ventham, MBChB, MRCS; Stephen McNally, PhD, FRCS; Ewen Harrison, PhD, FRCS; Stephen Wigmore, MD, FRCS
Includes: Supplemental Content

Importance  The optimal analgesic technique following open abdominal surgery within an enhanced recovery protocol remains controversial. Thoracic epidural is often recommended; however, its role is increasingly being challenged and alternative techniques are being suggested as suitable replacements.

Objective  To determine by meta-analysis whether epidurals are superior ...

Original Investigation 
Jared D. Ament, MD, MPH; Zhuo Yang, MS; Pierce Nunley, MD; Marcus B. Stone, PhD; Kee D. Kim, MD
Includes: Supplemental Content

Importance  Cervical total disc replacement (CTDR) was developed to treat cervical spondylosis, while preserving motion. While anterior cervical discectomy and fusion (ACDF) has been the standard of care for 2-level disease, a randomized clinical trial (RCT) suggested similar outcomes. Cost-effectiveness of this intervention has never been elucidated....

Special Communication  FREE
American Board of Surgery; American College of Surgeons; Association of Program Directors in Surgery; Association for Surgical Education
The following statement on surgical pre-residency preparatory courses has been approved by the American Board of Surgery (ABS), the American College of Surgeons (ACS), the Association of Program Directors in Surgery (APDS), and the Association for Surgical Education (ASE).
Invited Commentary 
Jonathan F. Finks, MD; Justin B. Dimick, MD, MPH
The last time the National Institutes of Health (NIH) convened a consensus panel on bariatric surgery, many of our current medical students were still in diapers. At that time, fewer than 10 000 bariatric procedures were done annually and the most commonly performed bariatric operations were the vertical banded gastroplasty ...
Original Investigation  FREE
Kyle H. Sheetz, MD, MS; Justin B. Dimick, MD, MPH; Amir A. Ghaferi, MD, MS
Includes: Supplemental Content

Importance  Hospitals’ care intensity varies widely across the United States. Payers and policy makers have become focused on promoting quality, low-cost, efficient health care.

Objective  To evaluate whether increased hospital care intensity (HCI) is associated with improved outcomes following major surgery.

Design, Setting, and Participants  ...

Special Communication 
Anita P. Courcoulas, MD, MPH; Susan Z. Yanovski, MD; Denise Bonds, MD, MPH; Thomas L. Eggerman, MD; Mary Horlick, MD; Myrlene A. Staten, MD; David E. Arterburn, MD, MPH

Importance  The clinical evidence base demonstrating bariatric surgery’s health benefits is much larger than it was when the National Institutes of Health last held a consensus panel in 1991. Still, it remains unclear whether ongoing studies will address critical questions about long-term complication rates and the sustainability ...

JAMA Surgery Clinical Challenge 
Shawn S. Fu, MD; Jeffrey A. McDavit, MD; Ilia Gur, MD
Research Letter 
Hillary J. Mull, PhD, MPP; Qi Chen, MD, PhD; Michael Shwartz, PhD, MBA; Kamal M. F. Itani, MD; Amy K. Rosen, PhD
The use of surgical quality measures to target quality improvement efforts and evaluate hospital performance is now standard. Surgical quality in Veterans Affairs (VA) hospitals is measured by the VA Surgical Quality Improvement Program (VASQIP),1 the Surgical Care Improvement Program (SCIP),2 and the Patient Safety Indicators (PSIs).3 Each approach has ...
Research Letter 
John J. Tackett, MD; Lisa M. Walke, MD; Linda Accordino, MSN; Emily Melin, MSN; Troy Bishop; Chandrika Kumar, MD, MBBS; Ronnie A. Rosenthal, MD, MS
Half of the people older than 65 years of age will undergo a surgical procedure in their remaining lifetime.1 With more than 1 million veterans currently older than 84 years of age, many compromised individuals will be seeking surgical care in Veterans Affairs (VA) hospitals.2 Postoperatively, discharge needs are often ...
Research Letter 
Juliet Nissan, MD; Valkiria Campos, RN, BSN, CPAN; Hector Delgado, RN, MSN, MHA; Christina Matadial, MD; Seth Spector, MD
For decades, high-risk industries have relied on safety checklists to limit the adverse consequences of human error.1 The checklist model has only recently been adapted in the surgical field after the World Health Organization launched the “Safe Surgery Saves Lives” campaign in 2006.2,3 Various studies4,5 have shown that the use ...

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