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Basic View | Expanded View
 Showing 1-20 of 128 Articles
Todd A. Jaffe, BBA; Steven J. Hasday, BS; Justin B. Dimick, MD, MPH

This Viewpoint explores the limits of the methods used in the Surgeon Scorecard, uses laparoscopic cholecystectomy data to illustrate the inherent statistical challenges the Scorecard faces, and suggests improvements for future surgical performance assessments.

Original Investigation 
Lynne Moore, PhD; François Lauzier, MD, MSc, FRCPC; Henry T. Stelfox, MD, PhD, FRCPC; John Kortbeek, MD, FRCSC; Richard Simons, MA, FRCSC; Simon Berthelot, MD, MSc, FRPCP; Julien Clément, MD, FRCSC; Gilles Bourgeois, MD; Alexis F. Turgeon, MD, MSc, FRCPC
Includes: Supplemental Content

Importance  The rate of complications among injury admissions has been estimated to be more than 3 times that observed for general admissions, and complications have been targeted as an important quality-of-care metric. Despite the negative effect of complications on resource use and patient mortality and morbidity, there ...

Original Investigation  FREE
Matthias Bock, MD, Priv Doz; Antonio Fanolla, MS; Isabelle Segur-Cabanac, MD; Franco Auricchio, MD; Carla Melani, MS; Flavio Girardi, MD; Horand Meier, MD; Armin Pycha, MD
Includes: Supplemental Content

Importance  The appropriately coached implementation of surgical safety checklists (SSCs) reduces the incidence of perioperative complications and 30-day mortality of patients undergoing surgery. The association of the introduction of SSCs with 90-day mortality remains unclear.

Objective  To assess the association between the implementation of SSCs and ...

Invited Commentary: The Surgical Checklist; William Berry, MD, MPH; Alex Haynes, MD, MPH; Janaka Lagoo, MD
Invited Commentary 
William Berry, MD, MPH; Alex Haynes, MD, MPH; Janaka Lagoo, MD

Surgical safety checklists (SSCs) are associated with reductions in postoperative morbidity and mortality and have now achieved widespread implementation, although the quality of implementation remains unclear in many settings.1,2 In this issue of JAMA Surgery, Bock and colleagues3 evaluate the effect of introducing ...

JAMA Surgery Clinical Challenge 
Daniel J. Gross, MD; Gainosuke Sugiyama, MD; Antonio Alfonso, MD

An asymptomatic 47-year-old woman with a mediastinal mass complained of mild but worsening orthopnea that was exacerbated when she would lie down. What is your diagnosis?

Comment & Response 
Simon Erridge; Swathikan Chidambaram

To the Editor We would first like to thank Hatoum et al1 for their contribution to the discussion on identifying improved predictors of the response of comorbidities to bariatric surgery. In their study,1 they determined remission of comorbidities via records of diagnosis and prescription drug fills. ...

Original Investigation 
Marco Milone, MD; Loredana Maria Sosa Fernandez, MD; Mario Musella, MD; Francesco Milone, MD
Includes: Supplemental Content

Importance  Video-assisted ablation of pilonidal sinus (VAAPS) is a new minimally invasive treatment based on the complete removal of the sinus cavity with a minimal surgical wound.

Objective  To validate the safety and efficacy of VAAPS.

Design, Setting, and Participants  From January 1, 2012, through ...

Invited Commentary 
Benjamin K. Poulose, MD, MPH; Brent D. Matthews, MD; Michael J. Rosen, MD

The work by Heurta et al1 in this issue of JAMA Surgery highlights a fundamental problem in surgery: balancing the need for innovation with the practicalities of demonstrating clinical benefit for novel ideas. This issue is particularly timely given an unsustainable trajectory of health care spending in ...

Sergio Huerta, MD; Anubodh Varshney, MD; Prachi M. Patel, BS; Helen G. Mayo, MLS; Edward H. Livingston, MD
Includes: Supplemental Content

Importance  Expensive biological mesh materials are increasingly used to reinforce abdominal wall hernia repairs. The clinical and cost benefit of these materials are unknown.

Objectives  To review the published evidence on the use of biological mesh materials and to examine the US Food and Drug Administration ...

Invited Commentary: Biological Meshes in Hernia; Benjamin K. Poulose, MD, MPH; Brent D. Matthews, MD; Michael J. Rosen, MD
Research Letter 
Breanne V. Britton, BA; Neeraja Nagarajan, MD, MPH; Cheryl K. Zogg, MSPH, MHS; Shalini Selvarajah, MD, MPH; Maya J. Torain, BS; Ali Salim, MD; Adil H. Haider, MD, MPH

This pilot study assesses US surgeons’ awareness of racial/ethnic disparities in surgical outcomes and processes of surgical care.

Comment & Response 
David N. Blitzer, BA; Rajan Gupta, MD; Gregory L. Peck, DO

To the Editor We read the insightful Viewpoint by Debas1 describing the “emergence and future of global surgery.” Indeed, we agree with the need for competency standards, societal involvement, and resource support as means to sustainability, but we suggest the following additional points: (1) encouraging surgeons early ...

Comment & Response 
Kathleen M. Casey, MD; Alexander A. Hannenberg, MD

To the Editor We applaud the recent Viewpoint by Debas1 calling for the formation of a “Consortium for Global Surgery” composed of academic institutions and surgical associations and organizations. Coordination and collaboration will be essential in effectively mobilizing assets from the United States and beyond to address ...

Comment & Response 
Charles E. Edmiston Jr, PhD; David Leaper, MD

To the Editor We want to report incomplete potential conflict of interest disclosures for the Original Investigation entitled, “Evidence for a Standardized Preadmission Showering Regimen to Achieve Maximal Antiseptic Skin Surface Concentrations of Chlorhexidine Gluconate, 4%, in Surgical Patients,”1 which was published online in JAMA Surgery on ...

In the Original Investigation entitled “Evidence for a Standardized Preadmission Showering Regimen to Achieve Maximal Antiseptic Skin Surface Concentrations of Chlorhexidine Gluconate, 4%, in Surgical Patients” published online August 26, 2105, and in the November 2015 issue of JAMA Surgery,1 2 authors should have reported additional ...

Krislynn M. Mueck, MD, MPH; Luke R. Putnam, MD, MS; Lillian S. Kao, MD, MS

This Viewpoint discusses Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 and how they can be used for to plan and design a quality improvement intervention.

Original Investigation 
Jeffrey H. Silber, MD, PhD; Paul R. Rosenbaum, PhD; Matthew D. McHugh, PhD, JD, RN, MPH; Justin M. Ludwig, MA; Herbert L. Smith, PhD; Bijan A. Niknam, BS; Orit Even-Shoshan, MS; Lee A. Fleisher, MD; Rachel R. Kelz, MD, MSCE; Linda H. Aiken, PhD, RN
Includes: Supplemental Content

Importance  The literature suggests that hospitals with better nursing work environments provide better quality of care. Less is known about value (cost vs quality).

Objectives  To test whether hospitals with better nursing work environments displayed better value than those with worse nursing environments and to determine ...

Invited Commentary: Revisiting Nursing’s Effect on Surgical Quality and Cost; Amir A. Ghaferi, MD, MS; Christopher R. Friese, PhD, RN, AOCN
Original Investigation 
Daniel I. McIsaac, MD, MPH, FRCPC; Gregory L. Bryson, MD, FRCPC, MSc; Carl van Walraven, MD, FRCPC, MSc
Includes: Supplemental Content

Importance  Single-center studies identify frailty as a risk factor for 30-day postoperative mortality. The long-term and population-level effect of frailty on postoperative mortality is, to our knowledge, poorly described, as are the interactions of frailty with important predictors of mortality.

Objective  To measure the population-level effect ...

Invited Commentary: Frailty and Mortality After Surgery in Elderly Individuals; Jason M. Johanning, MD, MS; Daniel Hall, MD, MDiv, MS; Shipra Arya, MD, MS
Invited Commentary 
Amir A. Ghaferi, MD, MS; Christopher R. Friese, PhD, RN, AOCN

Improvements in surgical safety remain an important focus of hospitals and clinicians. With nearly 100 000 patients dying per year in the United States after undergoing elective surgery and mortality rates varying from 2-fold to 10-fold across hospitals,13 excess surgical mortality qualifies as a significant public ...

Invited Commentary 
Jason M. Johanning, MD, MS; Daniel Hall, MD, MDiv, MS; Shipra Arya, MD, MS

Frailty is increasingly recognized as a key determinant of poor surgical outcomes. The impact of frailty assessment at the patient and system level has significant implications.

JAMA Surgery Clinical Challenge 
Dustin Y. Yoon, MD; Albert A. Nemcek, MD; Melina R. Kibbe, MD

An active man in his early 80s presented to the hospital with a 6-month history of cramping epigastric abdominal pain that occurred 30 minutes after eating solid food and was associated with nausea and vomiting. His medical history was significant for atrial fibrillation and a history of an ...

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