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 Showing 61-80 of 93 Articles
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 ...

Comment & Response 
Maria Chazapis, MA; Suneetha Ramani Moonesinghe, MD(Res)

To the Editor The excellent Viewpoint by Jaffe and coauthors1 discusses the risks associated with inadequately considered surgeon-specific performance comparisons. This resonates with the views expressed when individualized outcome data were first made public for surgeons in the United Kingdom: the large sample sizes needed for comparison ...

Frank A. Lederle, MD

This Viewpoint reviews a meta-analysis investigating whether ultrasound screening for adominal aortic aneurism reduces mortality in men older than 65 years and questions the math and recommendation.

Comment & Response 
Piyush Kalakoti, MD; Christina Notarianni, MD; Anil Nanda, MD, MPH

To the Editor We read with interest the study by Connelly et al1 that proposes a risk factor–based predictive model for venous thromboembolism (VTE) in pediatric trauma patients. Based on data from the National Trauma Data Bank, the authors used robust regression techniques by constructing mixed-effect models ...

Comment & Response 
Christopher R. Connelly, MD; Amy Laird, PhD; Jennifer M. Watters, MD

In Reply We would like to thank Kalakoti and colleagues1 for their insightful comments and careful review of our article, in which we acknowledge a variety of potential sources of bias. We further recognize that a complete case analysis may also introduce bias, and we appreciate the ...

Elizabeth J. Lilley, MD, MPH; Christy E. Cauley, MD, MPH; Zara Cooper, MD, MSc

This Viewpoint discusses how surgeons can integrate principles of palliative care to support surgical care for patients with life-threatening illness, using malignant bowel obstruction as an example.

Original Investigation 
James E. Mitchell, MD; Nicholas J. Christian, PhD; David R. Flum, MD, MPH; Alfons Pomp, MD; Walter J. Pories, MD; Bruce M. Wolfe, MD; Anita P. Courcoulas, MD, MPH; Steven H. Belle, PhD, MScHyg
Includes: Supplemental Content

Importance  Severe obesity (body mass index ≥35 [calculated as weight in kilograms divided by height in meters squared]) is associated with significant medical comorbidity and increased mortality. Bariatric surgery induces weight loss, the extent of which can vary. Postoperative predictors of weight loss have not been adequately ...

Invited Commentary: The Behavior and Biology Behind Bariatric Surgery Outcomes; Amir A. Ghaferi, MD, MS; Marilyn Woodruff, MSN, ANP-BC; Jenna Arnould, MS, RD
Invited Commentary 
Amir A. Ghaferi, MD, MS; Marilyn Woodruff, MSN, ANP-BC; Jenna Arnould, MS, RD

Morbid obesity is a growing public health concern in the United States. There is also increasing recognition of the benefits of bariatric surgery in curbing the obesity epidemic.1 Bariatric surgery is often referred to as a piece in the puzzle required for acute and persistent weight loss. ...

Special Communication 
Todd K. Rosengart, MD; K. Craig Kent, MD; Kirby I. Bland, MD; L. D. Britt, MD, MPH; Timothy J. Eberlein, MD; Bruce Labe Gewertz, MD; John G. Hunter, MD; Keith D. Lillemoe, MD; Carlos A. Pellegrini, MD; Richard D. Schulick, MD, MBA; Steven Charles Stain, MD; Ronald J. Weigel, MD, PhD

This Special Communication summarizes the key points raised at the Society of Surgical Chairs mentorship panel sessions held at the 2014 and 2015 annual meetings of the society. Highlights of these expert panel discussions include senior chairs’ insights into successfully dealing with increasingly complex academic medical organizations and ...

Research Letter 
G. Craig Wood, MS; Tooraj Mirshahi, PhD; Christopher D. Still, DO; Annemarie G. Hirsch, PhD, MPH

This cohort study examines whether the DiaRem score is associated with cure of type 2 diabetes following bariatric surgery.

Comment & Response 
Frederick Thurston Drake, MD, MPH

To the Editor I commend Minneci and colleagues1 for taking an efficacious treatment and studying its effectiveness. They developed a unique study design in which patients were not randomly assigned to a treatment but were prospectively enrolled (if they met inclusion criteria) and then allowed to choose ...

Comment & Response 
Peter C. Minneci, MD, MHSc; Katherine J. Deans, MD, MHSc

In Reply We thank Dr Drake for his insightful comments. As pointed out, our intent was to study the effectiveness of nonoperative management in clinical practice because we believe that the safety and efficacy of antibiotics to treat acute appendicitis are now well established in recent trials and ...

Original Investigation 
Mohamad A. Hussain, MD; Mohammed Al-Omran, MD, MSc; Muhammad Mamdani, PharmD, MA, MPH; Naomi Eisenberg, MEd; Azra Premji, MD, MSc; Lisa Saldanha, MSc; Xuesong Wang, MSc; Subodh Verma, MD, PhD; Thomas F. Lindsay, MDCM, MSc
Includes: Supplemental Content

Importance  Patients with peripheral arterial disease (PAD) are at a high risk for cardiovascular events, yet, to our knowledge, no studies have examined the effect of a comprehensive risk-reduction program on long-term outcomes for patients with PAD.

Objective  To investigative whether a program that focuses on ...

Invited Commentary: A Risk-Reduction Program for Patients With Peripheral Arterial Disease; William P. Robinson, MD; Gilbert R. Upchurch Jr, MD
Invited Commentary 
William P. Robinson, MD; Gilbert R. Upchurch Jr, MD

In their observational cohort study, Hussain et al1 present a thoughtful case for the efficacy of a guideline-based risk-reduction program, the Systematic Assessment of Vascular Risk (SAVR) program, for patients with peripheral arterial disease (PAD). Based on comparison with a group of patients from other tertiary centers ...

Research Letter 
Christina A. Minami, MD; Allison R. Dahlke, MPH; Cynthia Barnard, MBA; Christine V. Kinnier, MD, MS; Ravi R. Rajaram, MD, MS; Gary A. Noskin, MD; Karl Y. Bilimoria, MD, MS

This study evaluates the association between hospital characteristics and surgical site infection measures.

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