ArticleBMJ (Clinical research ed.)2004
Improving mortality of coronary surgery over first four years of independent practice: retrospective examination of prospectively collected data from 15 surgeons.
Article in BMJ (Clinical research ed.), 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 2 of them syntheses that pooled it.
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Who cites it
29 citing papers in PubMed, 2 syntheses or guidelines pooled it, 72 citations in OpenAlex.
- Pooled it
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- Construction and Surgical Training of Coronary Anastomosis on a Low-Cost Portable Simulator: Experience in a Peruvian Multicenter Study.Brazilian journal of cardiovascular surgery · 2024Observational
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- A learning curve in 3D virtual surgical planned orthognathic surgery.Clinical oral investigations · 2023Article
- Arteriovenous anastomosis learning curve using low cost simulator.Jornal vascular brasileiro · 2020Article
- Relation between surgeon age and postoperative outcomes: a population-based cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2020Article
- The Learning Curve in Surgical Practice and Its Applicability to Rhinoplasty.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2018Article
- Association of Surgeon Age and Experience With Congenital Heart Surgery Outcomes.Circulation. Cardiovascular quality and outcomes · 2017Article
- Surgeon length of service and risk-adjusted outcomes: linked observational analysis of the UK National Adult Cardiac Surgery Audit Registry and General Medical Council Register.Journal of the Royal Society of Medicine · 2014Article
- Association between physicians' experience after training and maternal obstetrical outcomes: cohort study.BMJ (Clinical research ed.) · 2013Article
- Learning by doing, scale effects, or neither? Cardiac surgeons after residency.Health services research · 2009Article
- Orthopaedic surgeons prefer to participate in expertise-based randomized trials.Clinical orthopaedics and related research · 2008Article
- Learning curves in surgical practice.Postgraduate medical journal · 2007Article
- 'Per ardua...'Training tomorrow's surgeons using inter alia lessons from aviation.Journal of the Royal Society of Medicine · 2006Review
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Authors and funding
7 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo study the "learning curve" associated with independent practice in coronary artery surgery.
designRetrospective analysis of prospectively collected data.
settingAll NHS centres in north west England that carry out cardiac surgery in adults.
participants18 913 patients undergoing coronary artery surgery for the first time between April 1997 and March 2003, 5678 of whom were operated on by 15 surgeons in the first four years after their consultant appointment.
main outcome measuresObserved and predicted mortality (EuroSCORE) for surgeons in their first, second, third, and fourth years after appointment as a consultant compared with figures for established surgeons.
resultsOverall mortality decreased over the six years of study (P = 0.01). Of the patients operated on by established surgeons or newly appointed consultants, 265/13,235 (2.0%) and 109/5678 (1.9%), respectively, died (P = 0.71). There was a progressive decrease in observed mortality with time after appointment as a consultant from 2.2% in the first year to 1.2% in the fourth year (P = 0.049). This result remained significant after adjustment for time and case mix (P = 0.019).
conclusionsMortality in patients operated on by newly appointed consultant surgeons is similar to mortality in patients operated on by established surgeons. There are significant decreases in crude and risk adjusted mortality in the four years after appointment. These findings should influence the nature of practice in newly appointed surgeons.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.