ArticleAnnals of surgery2023
Surgeon-reported Factors Influencing Adoption of Quality Standards for Goal-concordant Care in Patients With Advanced Cancer: A Qualitative Study.
Article in Annals of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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.
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.
Who cites it
7 citing papers in PubMed.
- Patient Perceptions of Palliative Care in Surgery: A Qualitative Study.Journal of pain and symptom management · 2026Article
- Understanding Surgeon Engagement with Palliative Care Practices for Seriously Ill Patients: A Qualitative Study.Annals of surgery · 2026Article
- A Scoping Review on Goals of Care Discussions in Surgery: How Are We Doing and How Can We Do Better?World journal of surgery · 2025Article
- Enhancing diagnostics through flow cytometry: overcoming barriers in low resource settings.Frontiers in oncology · 2025Article
- Palliative care in acute care surgery: research challenges and opportunities.Trauma surgery & acute care open · 2025Review
- Ensuring Goal-Aligned Care in a Busy Surgical Practice.Seminars in colon & rectal surgery · 2024Article
- How surgeons use risk calculators and non-clinical factors for informed consent and shared decision making: A qualitative study.American journal of surgery · 2023Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveThis study explored surgical oncologists' perspectives on factors influencing adoption of quality standards in patients with advanced cancer.
backgroundThe American College of Surgeons Geriatric Surgery Verification Program includes communication standards designed to facilitate goal-concordant care, yet little is known about how surgeons believe these standards align with clinical practice.
methodsSemistructured video-based interviews were conducted from November 2020 to January 2021 with academic surgical oncologists purposively sampled based on demographics, region, palliative care certification, and years in practice. Interviews addressed: (1) adherence to standards documenting care preferences for life-sustaining treatment, surrogate decision-maker, and goals of surgery; and (2) factors influencing their adoption into practice. Interviews were audio-recorded, transcribed, qualitatively analyzed, and conducted until thematic saturation was reached.
resultsTwenty-six surgeons participated (57.7% male, 8.5 mean years in practice, 19.2% palliative care board-certified). Surgeons reported low adherence to documenting care preferences and surrogate decision-maker and high adherence to discussing, but not documenting, goals of surgery. Participants held conflicting views about the relevance of care preferences to preoperative conversations and surrogate decision-maker documentation by the surgeon and questioned the direct connection between documentation of quality standards and higher value patient care. Key themes regarding factors influencing adoption of quality standards included organizational culture, workflow, and multidisciplinary collaboration.
conclusionsAlthough surgeons routinely discuss goals of surgery, documentation is inconsistent; care preferences and surrogate decision-makers are rarely discussed or documented. Adherence to these standards would be facilitated by multidisciplinary collaboration, institutional standardization, and evidence linking standards to higher value care.
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Registered trials
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