Evidence map›Paper›PMID 32590658›Full record

ArticlePlastic and reconstructive surgery2020

Feasibility of Surgeon-Delivered Audit and Feedback Incorporating Peer Surgical Coaching to Reduce Fistula Incidence following Cleft Palate Repair: A Pilot Trial.

Thomas J Sitzman, Raymond W Tse, Alexander C Allori, David M Fisher, Thomas D Samson, Stephen P Beals, Damir B Matic, Jeffrey R Marcus, Daniel H Grossoehme, Maria T Britto

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Plastic and reconstructive surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Observational
  4. Video recording in GI endoscopy.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2025
    Article
  5. Coaching for Surgeons: A Scoping Review of the Quantitative Evidence.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2022
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Thomas J SitzmanFrom the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Division of Plastic, Maxillofacial & Oral Surgery, Duke University Hospital & Children's Health Center; the Cleft Lip and Palate Program, Division of Plastic Surgery, The Hospital for Sick Children; the Department of Surgery, University of Toronto; the Departments of Surgery, Pediatrics, and Neurosurgery, Penn State Hershey Medical Center; the Barrow Cleft and Craniofacial Center; the Division of Plastic and Reconstructive Surgery, Division of Paediatric Surgery, and the Department of Paediatrics, University of Western Ontario; Akron Children's Hospital; and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, and the University of Cincinnati College of Medicine.
Raymond W TseFrom the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Division of Plastic, Maxillofacial & Oral Surgery, Duke University Hospital & Children's Health Center; the Cleft Lip and Palate Program, Division of Plastic Surgery, The Hospital for Sick Children; the Department of Surgery, University of Toronto; the Departments of Surgery, Pediatrics, and Neurosurgery, Penn State Hershey Medical Center; the Barrow Cleft and Craniofacial Center; the Division of Plastic and Reconstructive Surgery, Division of Paediatric Surgery, and the Department of Paediatrics, University of Western Ontario; Akron Children's Hospital; and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, and the University of Cincinnati College of Medicine.
Alexander C AlloriFrom the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Division of Plastic, Maxillofacial & Oral Surgery, Duke University Hospital & Children's Health Center; the Cleft Lip and Palate Program, Division of Plastic Surgery, The Hospital for Sick Children; the Department of Surgery, University of Toronto; the Departments of Surgery, Pediatrics, and Neurosurgery, Penn State Hershey Medical Center; the Barrow Cleft and Craniofacial Center; the Division of Plastic and Reconstructive Surgery, Division of Paediatric Surgery, and the Department of Paediatrics, University of Western Ontario; Akron Children's Hospital; and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, and the University of Cincinnati College of Medicine.
David M FisherFrom the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Division of Plastic, Maxillofacial & Oral Surgery, Duke University Hospital & Children's Health Center; the Cleft Lip and Palate Program, Division of Plastic Surgery, The Hospital for Sick Children; the Department of Surgery, University of Toronto; the Departments of Surgery, Pediatrics, and Neurosurgery, Penn State Hershey Medical Center; the Barrow Cleft and Craniofacial Center; the Division of Plastic and Reconstructive Surgery, Division of Paediatric Surgery, and the Department of Paediatrics, University of Western Ontario; Akron Children's Hospital; and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, and the University of Cincinnati College of Medicine.
Thomas D SamsonFrom the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Division of Plastic, Maxillofacial & Oral Surgery, Duke University Hospital & Children's Health Center; the Cleft Lip and Palate Program, Division of Plastic Surgery, The Hospital for Sick Children; the Department of Surgery, University of Toronto; the Departments of Surgery, Pediatrics, and Neurosurgery, Penn State Hershey Medical Center; the Barrow Cleft and Craniofacial Center; the Division of Plastic and Reconstructive Surgery, Division of Paediatric Surgery, and the Department of Paediatrics, University of Western Ontario; Akron Children's Hospital; and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, and the University of Cincinnati College of Medicine.
Stephen P BealsFrom the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Division of Plastic, Maxillofacial & Oral Surgery, Duke University Hospital & Children's Health Center; the Cleft Lip and Palate Program, Division of Plastic Surgery, The Hospital for Sick Children; the Department of Surgery, University of Toronto; the Departments of Surgery, Pediatrics, and Neurosurgery, Penn State Hershey Medical Center; the Barrow Cleft and Craniofacial Center; the Division of Plastic and Reconstructive Surgery, Division of Paediatric Surgery, and the Department of Paediatrics, University of Western Ontario; Akron Children's Hospital; and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, and the University of Cincinnati College of Medicine.
Damir B MaticFrom the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Division of Plastic, Maxillofacial & Oral Surgery, Duke University Hospital & Children's Health Center; the Cleft Lip and Palate Program, Division of Plastic Surgery, The Hospital for Sick Children; the Department of Surgery, University of Toronto; the Departments of Surgery, Pediatrics, and Neurosurgery, Penn State Hershey Medical Center; the Barrow Cleft and Craniofacial Center; the Division of Plastic and Reconstructive Surgery, Division of Paediatric Surgery, and the Department of Paediatrics, University of Western Ontario; Akron Children's Hospital; and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, and the University of Cincinnati College of Medicine.
Jeffrey R MarcusFrom the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Division of Plastic, Maxillofacial & Oral Surgery, Duke University Hospital & Children's Health Center; the Cleft Lip and Palate Program, Division of Plastic Surgery, The Hospital for Sick Children; the Department of Surgery, University of Toronto; the Departments of Surgery, Pediatrics, and Neurosurgery, Penn State Hershey Medical Center; the Barrow Cleft and Craniofacial Center; the Division of Plastic and Reconstructive Surgery, Division of Paediatric Surgery, and the Department of Paediatrics, University of Western Ontario; Akron Children's Hospital; and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, and the University of Cincinnati College of Medicine.
Daniel H GrossoehmeFrom the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Division of Plastic, Maxillofacial & Oral Surgery, Duke University Hospital & Children's Health Center; the Cleft Lip and Palate Program, Division of Plastic Surgery, The Hospital for Sick Children; the Department of Surgery, University of Toronto; the Departments of Surgery, Pediatrics, and Neurosurgery, Penn State Hershey Medical Center; the Barrow Cleft and Craniofacial Center; the Division of Plastic and Reconstructive Surgery, Division of Paediatric Surgery, and the Department of Paediatrics, University of Western Ontario; Akron Children's Hospital; and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, and the University of Cincinnati College of Medicine.
Maria T BrittoFrom the Division of Plastic Surgery, Phoenix Children's Hospital; the Department of Surgery, Mayo Clinic College of Medicine; the Americleft Task Force Surgeon Subgroup; the Divisions of Craniofacial and Plastic Surgery and Plastic Surgery, Department of Surgery, Seattle Children's Hospital; the Division of Plastic, Maxillofacial & Oral Surgery, Duke University Hospital & Children's Health Center; the Cleft Lip and Palate Program, Division of Plastic Surgery, The Hospital for Sick Children; the Department of Surgery, University of Toronto; the Departments of Surgery, Pediatrics, and Neurosurgery, Penn State Hershey Medical Center; the Barrow Cleft and Craniofacial Center; the Division of Plastic and Reconstructive Surgery, Division of Paediatric Surgery, and the Department of Paediatrics, University of Western Ontario; Akron Children's Hospital; and the James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, and the University of Cincinnati College of Medicine.

Funding

Understanding and Reducing Variation in Outcomes of Cleft Lip and Palate SurgeryK23DE025023 · NIDCR · PHOENIX CHILDREN'S HOSPITAL · PI SITZMAN, THOMAS JAMES · 2016 to 2020
$598k
NIDCR NIH HHS K23 DE025023
6 · The paper itself

Abstract

backgroundImproving surgeons' technical performance may reduce their frequency of postoperative complications. The authors conducted a pilot trial to evaluate the feasibility of a surgeon-delivered audit and feedback intervention incorporating peer surgical coaching on technical performance among surgeons performing cleft palate repair, in advance of a future effectiveness trial.

methodsA nonrandomized, two-arm, unblinded pilot trial enrolled surgeons performing cleft palate repair. Participants completed a baseline audit of fistula incidence. Participants with a fistula incidence above the median were allocated to an intensive feedback intervention that included selecting a peer surgical coach, observing the coach perform palate repair, reviewing operative video of their own surgical technique with the coach, and proposing and implementing changes in their technique. All others were allocated to simple feedback (receiving audit results). Outcomes assessed were proportion of surgeons completing the baseline audit, disclosing their fistula incidence to peers, and completing the feedback intervention.

resultsSeven surgeons enrolled in the trial. All seven completed the baseline audit and disclosed their fistula incidence to other participants. The median baseline fistula incidence was 0.4 percent (range, 0 to 10.5 percent). Two surgeons were unable to receive the feedback intervention. Of the five remaining surgeons, two were allocated to intensive feedback and three to simple feedback. All surgeons completed their assigned feedback intervention. Among surgeons receiving intensive feedback, fistula incidence was 5.9 percent at baseline and 0.0 percent following feedback (adjusted OR, 0.98; 95 percent CI, 0.44 to 2.17).

conclusionSurgeon-delivered audit and feedback incorporating peer coaching on technical performance was feasible for surgeons.

Indexed as

AdultCleft PalateFeasibility StudiesFemaleFistulaFormative FeedbackHumansMaleMentoringPilot ProjectsPlastic Surgery ProceduresPostoperative ComplicationsVideo Recording

Identifiers

PMID32590658
PMCPMC7323885

What OpenQuestion holds

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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.