Evidence map›Paper›PMID 37626234›Full record

ArticleSurgical endoscopy2023

Development of a prospective biliary dashboard to compare performance and surgical cost.

William M Tian, Doreen Chang, Melissa Pressley, Makala Muhammed, Philip Fong, Wendy Webster, Garth Herbert, Scott Gallagher, Christopher R Watters, Jin S Yoo and 4 more

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 21% 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, 4 citations in OpenAlex.

  1. Article
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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 2 institutions in 1 country.

William M TianSchool of Medicine, Duke University, Durham, NC, USA.
Doreen ChangDepartment of Surgery, Duke University, Durham, NC, USA.
Melissa PressleyPerformance Services, Duke University Health System, Durham, NC, USA.
Makala MuhammedPerformance Services, Duke University Health System, Durham, NC, USA.
Philip FongDepartment of Surgery, Duke University, Durham, NC, USA.
Wendy WebsterDepartment of Surgery, Duke University, Durham, NC, USA.
Garth HerbertDepartment of Surgery, Duke University, Durham, NC, USA.
Scott GallagherDepartment of Surgery, Duke University, Durham, NC, USA.
Christopher R WattersDepartment of Surgery, Duke University, Durham, NC, USA.
Jin S YooDepartment of Surgery, Duke University, Durham, NC, USA.
Sabino ZaniDepartment of Surgery, Duke University, Durham, NC, USA.
Suresh AgarwalDepartment of Surgery, Duke University, Durham, NC, USA.
Peter J AllenDepartment of Surgery, Duke University, Durham, NC, USA.
Keri A SeymourDepartment of Surgery, Duke University, Durham, NC, USA. keri.seymour@duke.edu.ORCID 0000-0002-2735-0786
Duke University · USDuke University Health System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTransparency around surgeon level data may align healthcare delivery with quality care for patients. Biliary surgery includes numerous procedures performed by both general surgeons and subspecialists alike. Cholecystectomy is a common surgical procedure and an optimal cohort to measure quality outcomes within a healthcare system.

methodsData were collected for 5084 biliary operations performed by 68 surgeons in 11 surgical divisions in a health system including a tertiary academic hospital, two regional community hospitals, and two ambulatory surgery centers. A privacy protected dashboard was developed to compare surgeon performance and cost between July 2018 and June 2022. A sample cohort of patients ≥ 18 years who underwent cholecystectomy were compared by operative time, cost, and 30-day outcomes.

resultsOver 4 years, 4568 cholecystectomy procedures were performed by 57 surgeons. Operations were done by 57 surgeons in four divisions and included 3846 (84.2%) laparoscopic cholecystectomies, 601 (13.2%) laparoscopic cholecystectomies with cholangiogram, and 121 (2.6%) open cholecystectomies. Patients were admitted from the emergency room in 2179 (47.7%) cases while 2389 (52.3%) cases were performed in the ambulatory setting. Individual surgeons were compared to peers for volume, intraoperative data, cost, and outcomes. Cost was lowest at ambulatory surgery centers, yet only 4.2% of elective procedures were performed at these facilities. Prepackaged kits with indocyanine green were more expensive than cholangiograms that used iodinated contrast. The rate of emergency department visits was lowest when cases were performed at ambulatory surgery centers.

conclusionData generated from clinical dashboards can inform surgeons as to how they compare to peers regarding quality metrics such as cost, time, and complications. In turn, this may guide strategies to standardize care, optimize efficiency, provide cost savings, and improve outcomes for cholecystectomy procedures. Future application of clinical dashboards can assist surgeons and administrators to define value-based care.

Indexed as

Biliary TractCholecystectomy, LaparoscopicCholangiographyCholecystectomyHumansProspective StudiesRetrospective StudiesCholecystectomyDashboardGallbladderQualityValue

Identifiers

PMID37626234
OpenAlexW4386160984

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.