Evidence map›Paper›PMID 33416505›Full record

ArticleJMIR research protocols2021

Novel Assessments of Technical and Nontechnical Cardiac Surgery Quality: Protocol for a Mixed Methods Study.

Donald Likosky, Steven J Yule, Michael R Mathis, Roger D Dias, Jason J Corso, Min Zhang, Sarah L Krein, Matthew D Caldwell, Nathan Louis, Allison M Janda and 4 more

Abstract read
In one paragraph

Article in JMIR research protocols, 2021. 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
–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. Review
  2. Observational
  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

14 authors.

Donald Likosky *Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0003-0416-9359
Steven J Yule *Department of Clinical Surgery, University of Edinburgh, Edinburgh, United Kingdom.ORCID https://orcid.org/0000-0001-9889-9090
Michael R Mathis *Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0002-9697-2212
Roger D Dias *STRATUS Center for Medical Simulation, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States.ORCID https://orcid.org/0000-0003-4959-5052
Jason J Corso *Department of Electrical Engineering and Computer Science, School of Engineering, University of Michigan, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0001-6454-9594
Min Zhang *Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0003-3331-3583
Sarah L Krein *Department of Internal Medicine, University of Michigan, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0003-2111-8131
Matthew D Caldwell *Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0001-7648-7239
Nathan Louis *Department of Electrical Engineering and Computer Science, School of Engineering, University of Michigan, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0003-4502-6012
Allison M Janda *Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0001-5080-5630
Nirav J Shah *Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0001-7704-5141
Francis D Pagani *Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0003-4430-9969
Korana Stakich-Alpirez *Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0002-0850-9667
Milisa M Manojlovich *School of Nursing, University of Michigan, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0002-6101-5535

Funding

Developing Standardized Intraoperative Process Models to Enhance Surgical SafetyR01HL126896 · NHLBI · HARVARD MEDICAL SCHOOL · PI ZENATI, MARCO A. · 2016 to 2023
$3.7M
Novel Assessments of Technical and Non-Technical Cardiac Surgery QualityR01HL146619 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI LIKOSKY, DONALD S, PAGANI, FRANCIS D · 2020 to 2024
$3.4M
University of Michigan Anesthesiology Post-Doctoral Research Training ProgramT32GM103730 · NIGMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Chad M Brummett, SACHIN KHETERPAL · 2014 to 2026
$1.9M
AHRQ HHS R01 HS026003HSRD VA IK6 HX003399NHLBI NIH HHS R01 HL126896NHLBI NIH HHS R01 HL146619NIGMS NIH HHS T32 GM103730
6 · The paper itself

Abstract

backgroundOf the 150,000 patients annually undergoing coronary artery bypass grafting, 35% develop complications that increase mortality 5 fold and expenditure by 50%. Differences in patient risk and operative approach explain only 2% of hospital variations in some complications. The intraoperative phase remains understudied as a source of variation, despite its complexity and amenability to improvement.

objectiveThe objectives of this study are to (1) investigate the relationship between peer assessments of intraoperative technical skills and nontechnical practices with risk-adjusted complication rates and (2) evaluate the feasibility of using computer-based metrics to automate the assessment of important intraoperative technical skills and nontechnical practices.

methodsThis multicenter study will use video recording, established peer assessment tools, electronic health record data, registry data, and a high-dimensional computer vision approach to (1) investigate the relationship between peer assessments of surgeon technical skills and variability in risk-adjusted patient adverse events; (2) investigate the relationship between peer assessments of intraoperative team-based nontechnical practices and variability in risk-adjusted patient adverse events; and (3) use quantitative and qualitative methods to explore the feasibility of using objective, data-driven, computer-based assessments to automate the measurement of important intraoperative determinants of risk-adjusted patient adverse events.

resultsThe project has been funded by the National Heart, Lung and Blood Institute in 2019 (R01HL146619). Preliminary Institutional Review Board review has been completed at the University of Michigan by the Institutional Review Boards of the University of Michigan Medical School.

conclusionsWe anticipate that this project will substantially increase our ability to assess determinants of variation in complication rates by specifically studying a surgeon's technical skills and operating room team member nontechnical practices. These findings may provide effective targets for future trials or quality improvement initiatives to enhance the quality and safety of cardiac surgical patient care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/22536.

Indexed as

cardiac surgerycomplicationscoronary artery bypass grafting surgeryimprovementintraoperativepatient riskprotocolqualitystudyvariation

Identifiers

PMID33416505
PMCPMC7822723

What OpenQuestion holds

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Registered trials

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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.