Evidence map›Paper›PMID 34723215›Full record

ArticleEuropean urology open science2021

Defining Factors Associated with High-quality Surgery Following Radical Cystectomy: Analysis of the British Association of Urological Surgeons Cystectomy Audit.

Wei Shen Tan, Jeffrey J Leow, Maya Marchese, Ashwin Sridhar, Giles Hellawell, Matthew Mossanen, Jeremy Y C Teoh, Sarah Fowler, Alexandra J Colquhoun, Jo Cresswell and 4 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European urology open science, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.7field-weighted citation impact, top 17% 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

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. Radical cystectomy and urinary diversion in women.Translational andrology and urology · 2023
    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 at 11 institutions in 4 countries.

Wei Shen TanDivision of Surgery & Interventional Science, University College London, London, UK.
Jeffrey J LeowDepartment of Urology, Tan Tock Seng Hospital, Singapore.
Maya MarcheseCenter for Surgery and Public Health, Division of Urological Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Ashwin SridharDivision of Surgery & Interventional Science, University College London, London, UK.
Giles HellawellDepartment of Urology, Northwick Park Hospital, London North West University Healthcare NHS Trust, London, UK.
Matthew MossanenLank Center for Genitourinary Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA.
Jeremy Y C TeohThe S H Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong.
Sarah FowlerBritish Association of Urological Surgeons, London, UK.
Alexandra J ColquhounDepartment of Urology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Jo CresswellDepartment of Urology, James Cook University Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK.
James W F CattoAcademic Urology Unit, University of Sheffield, Sheffield, UK.
Quoc-Dien TrinhLank Center for Genitourinary Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, USA.
John D KellyDivision of Surgery & Interventional Science, University College London, London, UK.
BAUS Section of Oncology
Dana-Farber Brigham Cancer Center · USUniversity College London Hospitals NHS Foundation Trust · GBBrigham and Women's Hospital · USBritish Association of Urological Surgeons · GBCambridge University Hospitals NHS Foundation Trust · GBChinese University of Hong Kong · HKJames Cook University Hospital · GBLondon North West Healthcare NHS Trust · GBNanyang Technological University · SGRoyal Free London NHS Foundation Trust · GBUniversity of Sheffield · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRadical cystectomy (RC) is associated with high morbidity.

objectiveTo evaluate healthcare and surgical factors associated with high-quality RC surgery. DESIGN SETTING AND

participantsPatients within the prospective British Association of Urological Surgeons (BAUS) registry between 2014 and 2017 were included in this study. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: High-quality surgery was defined using pathological (absence of positive surgical margins and a minimum of a level I lymph node dissection template with a minimum yield of ten or more lymph nodes), recovery (length of stay ≤10 d), and technical (intraoperative blood loss <500 ml for open and <300 ml for minimally invasive RC) variables. A multilevel hierarchical mixed-effect logistic regression model was utilised to determine the factors associated with the receipt of high-quality surgery and index admission mortality. RESULTS AND LIMITATIONS: A total of 4654 patients with a median age of 70.0 yr underwent RC by 152 surgeons at 78 UK hospitals. The median surgeon and hospital operating volumes were 23.0 and 47.0 cases, respectively. A total of 914 patients (19.6%) received high-quality surgery. The minimum annual surgeon volume and hospital volume of ≥20 RCs/surgeon/yr and ≥68 RCs/hospital/yr, respectively, were the thresholds determined to achieve better rates of high-quality RC. The mixed-effect logistic regression model found that recent surgery (odds ratio [OR]: 1.22, 95% confidence interval [CI]: 1.11-1.34,

conclusionsWe report that annual surgeon operating volume and use of minimally invasive RC were predictors of high-quality surgery. Patients receiving high-quality surgery were independently associated with lower index admission mortality. Our results support the role of centralisation of complex oncology and implementation of a quality assurance programme to improve the delivery of care. PATIENT SUMMARY: In this registry study of patients treated with surgical excision of the urinary bladder for bladder cancer, we report that patients treated by a surgeon with a higher annual operative volume and a minimally invasive approach were associated with the receipt of high-quality surgery. Patients treated with high-quality surgery were more likely to be discharged alive following surgery.

Indexed as

Bladder cancerBritish Association of Urological Surgeons auditCentralisationOutcomesQuality surgeryRadical cystectomy

Identifiers

PMID34723215
PMCPMC8546928
OpenAlexW3042544353

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.