Evidence map›Paper›PMID 34486089›Full record

ArticleAnnals of surgical oncology2022

Identification and Adjudication of Adverse Events Following Rectal Cancer Surgery: Observational Case Series in a Region of Ontario, Canada.

Marko Simunovic, Vanja Grubac, Christopher Hillis, Ilun Yang, Cagla Eskicioglu, Jessica Bogach, Erin Kennedy, Geoff Porter, Christine Fahim, James Wright and 5 more

Abstract read
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.1field-weighted citation impact, top 53% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. 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

15 authors at 6 institutions in 1 country.

Marko SimunovicDepartment of Surgery, McMaster University, Hamilton, ON, Canada. simunovi@hhsc.ca.ORCID http://orcid.org/0000-0003-2245-3468
Vanja GrubacDepartment of Surgery, McMaster University, Hamilton, ON, Canada.
Christopher HillisDepartment of Oncology, McMaster University, Hamilton, ON, Canada.
Ilun YangDepartment of Surgery, McMaster University, Hamilton, ON, Canada.
Cagla EskiciogluDepartment of Surgery, McMaster University, Hamilton, ON, Canada.
Jessica BogachDepartment of Surgery, McMaster University, Hamilton, ON, Canada.
Erin KennedyDepartment of Surgery, Mount Sinai Hospital, Toronto, ON, Canada.
Geoff PorterDepartment of Surgery, Dalhousie University, Halifax, NS, Canada.
Christine FahimLi Ka Shing Knowledge Institute, Toronto, ON, Canada.
James WrightDepartment of Oncology, McMaster University, Hamilton, ON, Canada.
Tariq AzizDepartment of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
Scott TsaiDepartment of Radiology, McMaster University, Hamilton, ON, Canada.
Christian B van der PolDepartment of Radiology, McMaster University, Hamilton, ON, Canada.
P J DevereauxDepartment of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, ON, Canada.
G R BakerInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.
McMaster University · CADalhousie University · CAImpact · CAMount Sinai Hospital · CAOntario Clinical Oncology Group · CAUniversity of Toronto · CA

Funding

Canadian Cancer Society Contract# 706927CIHR MOP 119489
6 · The paper itself

Abstract

backgroundFor patients undergoing rectal cancer surgery, we evaluated whether suboptimal preoperative surgeon evaluation of resection margins is a latent condition factor-a factor that is common, unrecognized, and may increase the risk of certain adverse events, including local tumour recurrence, positive surgical margin, nontherapeutic surgery, and in-hospital mortality.

methodsIn this observational case series of patients who underwent rectal cancer surgery during 2016 in Local Health Integrated Network 4 region of Ontario (population 1.4 million), chart review and a trigger tool were used to identify patients who experienced the adverse events. An expert panel adjudicated whether each event was preventable or nonpreventable and identified potential contributing factors to adverse events.

resultsAmong 173 patients, 25 (14.5%) had an adverse event and 13 cases (7.5%) were adjudicated as preventable. Rate of surgeon awareness of preoperative margin status was low at 50% and similar among cases with and without an adverse event (p = 0.29). Suboptimal surgeon preoperative evaluation of surgical margins was adjudicated a contributing factor in all 11 preventable local recurrence, positive margin, and nontherapeutic surgery cases. Failure to rescue was judged a contributing factor in the two cases with preventable in-hospital mortality.

conclusionsSuboptimal surgeon preoperative evaluation of surgical margins in rectal cancer is likely a latent condition factor. Optimizing margin evaluation may be an efficient quality improvement target.

Indexed as

Rectal NeoplasmsHumansMargins of ExcisionNeoplasm Recurrence, LocalOntarioPreoperative Care

Identifiers

PMID34486089
OpenAlexW3196514748

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.