Evidence map›Paper›PMID 36536198›Full record

ArticleAnnals of surgical oncology2023

Surgeon Perspectives on Determinants of Same-Day Mastectomy: A Roadmap for Implementing Change.

Brandon L Ellsworth, Daniel J Settecerri, Nicole M Mott, Andrew Vastardis, Ahmad M Hider, Jessica Thompson, Lesly A Dossett, Tasha M Hughes

Open access · bronzeAbstract read
In one paragraph

Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.1field-weighted citation impact, top 22% 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

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. 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

8 authors at 2 institutions in 1 country.

Brandon L EllsworthUniversity of Michigan School of Medicine, Ann Arbor, MI, USA.
Daniel J SettecerriCenter for Healthcare Outcomes and Policy, Michigan Medicine, Ann Arbor, MI, USA.
Nicole M MottUniversity of Michigan School of Medicine, Ann Arbor, MI, USA.
Andrew VastardisCenter for Healthcare Outcomes and Policy, Michigan Medicine, Ann Arbor, MI, USA.
Ahmad M HiderUniversity of Michigan School of Medicine, Ann Arbor, MI, USA.
Jessica ThompsonDepartment of Surgery, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
Lesly A DossettDepartment of Surgery, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA.
Tasha M HughesDepartment of Surgery, Michigan Medicine, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109, USA. tmhughes@med.umich.edu.
Michigan Medicine · USUniversity of Michigan–Ann Arbor · US

Funding

SHORT-TERM TRAINING IN HEALTH PROF SCHOOLST35HL007690 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI FLAHERTY, KEVIN R · 1990 to 2024
$3.3M
NRSA Training CoreTL1TR002242 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLINSTAT, MICHAEL ALLAN · 2017 to 2021
$2.8M
National Institute of Health TL1TR002242NCATS NIH HHS TL1 TR002242NHLBI NIH HHS T35 HL007690
6 · The paper itself

Abstract

backgroundSame-day discharge after mastectomy without immediate reconstruction (MwoR) has been shown to be safe, with improved patient satisfaction when compared with patients discharged 1 or more days after surgery. Nevertheless, only 16% of patients undergoing MwoR in Michigan are discharged on the day of surgery, with significant variation between facilities (3-88%). Our objective was to explore determinants of same-day discharge and offer strategies for broader implementation of this practice.

methodsWe conducted semi-structured interviews with surgeons performing MwoR across the state of Michigan. Recruitment utilized purposeful and snowball sampling methods. The Tailored Implementation in Chronic Disease (TICD) framework was used to inform the creation of the interview guide. Interviews were transcribed and then analyzed using directed content analysis guided by the TICD framework. Salient determinants were organized into patient, provider, and system-level factors.

resultsParticipants (n = 26) included general surgeons, breast surgeons, and surgical oncologists. Most surgeons (n = 18, 69%) reported that they discharged fewer than 60% of patients the same day after MwoR. The most common barriers included patient knowledge at the patient level; awareness of evidence, surgeon dogma, and peer influence at the provider level; and team processes and operating room logistics at the system level.

conclusionWe identified surgeon-defined determinants of same-day discharge after MwoR. For the identified barriers, potential implementation strategies could include incorporation of preoperative drain teachings for patients, utilizing consensus statements and opinion leaders to disseminate evidence supporting same-day mastectomies, and conducting workshops with relevant stakeholders to establish consistent facility practice patterns among surgical teams.

Indexed as

Breast NeoplasmsSurgeonsFemaleHumansMastectomyMichiganPreoperative Care

Identifiers

PMID36536198
PMCPMC9762864
OpenAlexW4312113719

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.