ArticleJAMA otolaryngology-- head & neck surgery2017
Evaluating Surgeon-Specific Performance for Endoscopic Sinus Surgery.
Article in JAMA otolaryngology-- head & neck surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- The Relationship Between Nasal Septal Deviation and Rhinosinusitis: A Systematic Review.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-facialePooled it
- The Efficacy of Dupilumab as an Adjuvant Treatment After Endoscopic Sinus Surgery for Chronic Rhinosinusitis With Nasal Polyps: A Retrospective Cohort Analysis.Clinical and experimental otorhinolaryngology · 2025Article
- Work productivity and activity impairment in patients with chronic rhinosinusitis undergoing endoscopic sinus surgery-A prospective, multi-institutional study.International forum of allergy & rhinology · 2023Observational
- Article
- The Doctors' Effect on Patients' Physical Health Outcomes Beyond the Intervention: A Methodological Review.Clinical epidemiology · 2022Article
- Is There a Surgeons' Effect on Patients' Physical Health, Beyond the Intervention, That Requires Further Investigation? A Systematic Review.Therapeutics and clinical risk management · 2022Review
- Qualitative Study of Medical Doctors on Their Experiences and Opinions of the Characteristics of Exceptionally Good Doctors.Advances in medical education and practice · 2022Article
- Characteristics of Exceptionally Good Doctors: A Protocol for a Cross-Sectional Survey of Adults.Patient related outcome measures · 2022Article
- Olfactory Function After Surgical Treatment of CRS: A Comparison of CRS Patients to Healthy Controls.American journal of rhinology & allergy · 2021Observational
- Lack of impact of radiologic septal measurements upon patient symptoms and performance of septoplasty during endoscopic sinus surgery.Rhinology · 2020Article
- Operative time and cost variability for functional endoscopic sinus surgery.International forum of allergy & rhinology · 2019Article
- THE 2017 13International forum of allergy & rhinology · 2017Article
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 2 countries.
Funding
Abstract
Importance: Several identified factors have raised questions concerning the quality of care for endoscopic sinus surgery (ESS), including the presence of large geographic variation in the rates and extent of surgery, poorly defined indications, and lack of ESS-specific quality metrics. Combined with the risk of major complications, ESS represents a high-value target for quality improvement. Objective: To evaluate differences in surgeon-specific performance for ESS using a risk-adjusted, 5-year ESS revision rate as a quality metric. Design, Setting, and Participants: This retrospective study used a population-based administrative database to study adults (≥18 years of age) with chronic rhinosinusitis (CRS) who underwent primary ESS in Alberta, Canada, between March 1, 2007, and March 1, 2010. The study period ended in 2015 to provide 5 years of follow-up. Interventions: Endoscopic sinus surgery for CRS. Main Outcomes and Measures: Primary outcomes were the 5-year observed and risk-adjusted ESS revision rate. Logistic regression was used to develop a risk adjustment model for the primary outcome. Results: A total of 43 individual surgeons performed primary ESS in 2168 patients with CRS. Within 5 years after the primary ESS procedure, 239 patients underwent revision ESS, and the mean crude 5-year ESS revision rate was 10.6% (range, 2.4%-28.6%). After applying the risk adjustment model and 95% CI to each surgeon, 7 surgeons (16%) had lower-than-expected performance and 2 surgeons (5%) had higher-than-expected performance. Three variables had significant associations with surgeon-specific, 5-year ESS revision rates: presence of nasal polyps (odds ratio [OR], 2.07; 95% CI, 1.59-2.70), more annual systemic corticosteroid courses (OR, 1.33; 95% CI, 1.19-1.48), and concurrent septoplasty (OR, 0.70; 95% CI, 0.55-0.89). Conclusions and Relevance: Evaluating surgeon-specific performance for ESS may provide information to assist in quality improvement. Although most surgeons had comparable risk-adjusted, 5-year ESS revision rates, 16% of surgeons had lower-than-expected performance, indicating a potential to improve quality of care. Future studies are needed to evaluate more surgeon-specific variables and validate a risk adjustment model to provide appropriate feedback for quality improvement.
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Registered trials
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