Evidence map›Paper›PMID 36881022›Full record

ArticleJournal of surgical oncology2023

Interpreting the risk analysis index of frailty in the context of surgical oncology.

Jamie L Estock, Cameron Schlegel, Myrick C Shinall, Patrick Varley, Ada O Youk, Richard Hoehn, Daniel E Hall

Open access · bronzeAbstract read
In one paragraph

Article in Journal 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, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 32% 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, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Frailty Screening Using the Risk Analysis Index: A User Guide.Joint Commission journal on quality and patient safety · 2025
    Pooled it
  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

7 authors at 5 institutions in 1 country.

Jamie L EstockCenter for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Cameron SchlegelDepartment of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Myrick C ShinallDepartment of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Patrick VarleyDepartment of Surgery, University of Wisconsin, Madison, Wisconsin, USA.
Ada O YoukCenter for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Richard HoehnDepartment of Surgery, University Hospitals, Cleveland, Ohio, USA.ORCID http://orcid.org/0000-0003-1455-6758
Daniel E HallCenter for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.ORCID http://orcid.org/0000-0001-6382-0522
University of Pittsburgh · USVanderbilt University Medical Center · USUniversity Hospitals of Cleveland · USUniversity of Wisconsin–Madison · USVA Pittsburgh Healthcare System · US

Funding

Vanderbilt Clinical Oncology Research Career Development ProgramK12CA090625 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Debra L. Friedman, Paula Jill Hurley · 2001 to 2026
$16.9M
Specialist Palliative Care in Surgical OncologyK76AG068436 · NIA · VANDERBILT UNIVERSITY MEDICAL CENTER · PI SHINALL, MYRICK C · 2020 to 2022
$714k
Pilot Testing Prehabilitation Services Aimed at Improving Outcomes of Frail Veterans Following Major Abdominal SurgeryI21HX002345 · VA · VETERANS HEALTH ADMINISTRATION · PI HALL, DANIEL E · 2019 to 2019
–
HSRD VA I21 HX002345NCI NIH HHS K12 CA090625NIA NIH HHS K76 AG068436NIA NIH HHS K76AG068436
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe Risk Analysis Index (RAI) accurately predicts adverse postoperative outcomes but the inclusion of cancer status in the RAI has raised two key concerns about its suitability for use in surgical oncology: (1) the potential over classification of cancer patients as frail, and (2) the potential overestimation of postoperative mortality for patients with surgically curable cancers.

methodsWe performed a retrospective cohort analysis to assess the RAI's power to appropriately identify frailty and predict postoperative mortality in cancer patients. We assessed discrimination for mortality and calibration across five RAI models-the complete RAI and four variants that removed different cancer-related variables.

resultsWe found that the presence of disseminated cancer was a key variable driving the RAI's power to predict postoperative mortality. The model including only this variable [RAI (disseminated cancer)] was similar to the complete RAI in the overall sample (c = 0.842 vs. 0.840) and outperformed the complete RAI in the cancer subgroup (c = 0.736 vs 0.704, respectively, p < 0.0001, Max R

conclusionThe RAI demonstrates somewhat less discrimination when applied exclusively to cancer patients, but remains a strong predictor of postoperative mortality, especially in the setting of disseminated cancer.

Indexed as

FrailtySurgical OncologyHumansPostoperative ComplicationsRetrospective StudiesRisk AssessmentRisk Factorsfrailtypostoperative complicationssurgical oncology

Identifiers

PMID36881022
PMCPMC10079577
OpenAlexW4323348533

What OpenQuestion holds

Textmetadata
LicenceTDM
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.