Evidence map›Paper›PMID 29404734›Full record

Observational studySurgical endoscopy2018

Hospital variation in rates of concurrent fundoplication during gastrostomy enteral access procedures.

Anne M Stey, Charles D Vinocur, R Lawrence Moss, Bruce L Hall, Mark E Cohen, Kari Kraemer, Clifford Y Ko, Brian D Kenney, Loren Berman

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 10 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

Anne M SteyIcahn School of Medicine at Mount Sinai Medical Center, 1 Gustave Levy Place, New York, NY, 10029, USA. as013j@gmail.com.
Charles D VinocurNemours/Alfred I. duPont Hospital for Children, Jefferson Medical College, Wilmington, DE, USA.
R Lawrence MossNationwide Children's Hospital, The Ohio State University, Columbus, OH, USA.
Bruce L HallDepartment of Surgery, Olin Business School, and Center for Health Policy, Washington University School of Medicine in Saint Louis, St. Louis, MO, USA.
Mark E CohenAmerican College of Surgeons, Chicago, IL, USA.
Kari KraemerAmerican College of Surgeons, Chicago, IL, USA.
Clifford Y KoDavid Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Brian D KenneyNationwide Children's Hospital, The Ohio State University, Columbus, OH, USA.
Loren BermanNemours/Alfred I. duPont Hospital for Children, Jefferson Medical College, Wilmington, DE, USA.
American College of Surgeons · USAlfred I. duPont Hospital for Children · USIcahn School of Medicine at Mount Sinai · USNationwide Children's Hospital · USThe Ohio State University · USUniversity of California, Los Angeles · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed to determine whether (1) the propensity for concurrent fundoplication during gastrostomy varies among hospitals, and (2) postoperative morbidity differs among institutions performing fundoplication more or less frequently.

methodsChildren who underwent gastrostomy with or without concurrent fundoplication were identified in the American College of Surgeons National Surgical Quality Improvement Program Pediatric (ACS-NSQIP-P). A hierarchical multivariate regression modeled the excess effects that hospitals exerted over propensity for concurrent fundoplication adjusting for preoperative clinical variables. Hospitals were designated as low outliers (significantly lower-adjusted odds of concurrent fundoplication than the average hospital with similar patient mix), average hospitals, and high outliers based on their risk-adjusted concurrent fundoplication practice. The postoperative morbidity rates were compared among low-outlier, average, and high-outlier hospitals.

resultsBetween 2011 and 2013, 3775 children underwent gastrostomy at one of 54 ACS-NSQIP-P participating hospitals. The mean hospital concurrent fundoplication rate was 11.7% (range 0-64%). There was no significant difference in unadjusted morbidity rate in children with concurrent fundoplication, 11.0% compared to 9.7% in children without concurrent fundoplication. After controlling for clinical variables, 8 hospitals were identified as low outliers (fundoplication rate of 0.4%) and 16 hospitals were identified as high outliers (fundoplication rate of 34.6%). The average unadjusted morbidity rate among hospitals with low, average, and high odds of concurrent fundoplication were 9.6, 10.6, and 8.4%, respectively.

conclusionHospitals vary significantly in propensity for concurrent fundoplication during gastrostomy yet postoperative morbidity does not differ significantly among institutions performing fundoplication more or less frequently.

Indexed as

FundoplicationGastrostomyAnalysis of VarianceChildEnteral NutritionHumansIntubation, GastrointestinalPostoperative ComplicationsRetrospective StudiesFundoplicationHospital variationPediatric surgery

Identifiers

PMID29404734
OpenAlexW2794011267

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.