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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
Original Investigation 
John W. Morgan, DrPH, CPH; Liang Ji, MBA; Garrett Friedman, MD; Maheswari Senthil, MD; Crickett Dyke, CTR; Sharon S. Lum, MD
Includes: Supplemental Content

Importance  Cancer center recognition, offered as accreditation by the American College of Surgeons Commission on Cancer or the National Cancer Institute, and quality measure reporting purport to improve the quality of cancer care. For surgically resectable gastric cancer, removal of 15 or more lymph nodes has been ...

Original Investigation 
Mila H. Ju, MD, MS; Clifford Y. Ko, MD, MS, MSHS; Bruce L. Hall, MD, PhD, MBA; Charles L. Bosk, PhD; Karl Y. Bilimoria, MD, MS; Elizabeth C. Wick, MD

Importance  Surgical site infection (SSI) has emerged as the leading publicly reported surgical outcome and is tied to payment determinations. Many hospitals monitor SSIs using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), in addition to mandatory participation (for most states) in the ...

Invited Commentary 
Mary T. Hawn, MD, MPH
Surgical site infection (SSI) prevention has been a national priority for more than a decade. Substantial resources and importance have been placed on the Surgical Care Improvement Project’s infection prevention measures. Unfortunately, little evidence exists that widespread adoption of these measures has resulted in reduced SSI rates.1 As such, the ...
JAMA Surgery Clinical Challenge 
Reshma Brahmbhatt, MD; Ravi Veeraswamy, MD; Shipra Arya, MD, SM
Research Letter 
Jennifer Tseng, MD; Susan L. Orloff, MD
Polycystic liver disease causes devastating symptoms owing to hepatomegaly. Aspiration or fenestration fails to definitively remove the cyst wall and results in the reaccumulation of cyst fluid. Preserved hepatic function generally precludes consideration of a liver transplant, leaving hepatic resection the best available treatment option for patients with impaired quality ...
Research Letter 
Tiffany Wu, MD; Fred Weaver, MD; Steven Katz, MD
With the aging of the adult population, a significant increase in the number of procedures required to alleviate symptoms of lower extremity ischemia has occurred. The ability to predict either a major adverse limb event or a major adverse cardiac event following open infrainguinal revascularization may help us to select ...
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 ...

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