Evidence map›Paper›PMID 9742915›Full record

ArticleAnnals of surgery1998

The importance of surgeon experience for clinical and economic outcomes from thyroidectomy.

J A Sosa, H M Bowman, J M Tielsch, N R Powe, T A Gordon, R Udelsman

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PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgery, 1998. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 309 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
309citing papers in PubMed, 9 pooled it
8.3field-weighted citation impact, top 2% 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

309 citing papers in PubMed, 9 syntheses or guidelines pooled it, 1,105 citations in OpenAlex.

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  7. Anaplastic Thyroid Carcinoma, Version 2.2015.Journal of the National Comprehensive Cancer Network : JNCCN · 2015
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249 more citing papers are in PubMed but not listed here.

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

6 authors at 1 institution in 1 country.

J A SosaDepartment of Surgery, Robert Wood Johnson Clinical Scholars Program, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
H M Bowman
J M Tielsch
N R Powe
T A Gordon
R Udelsman
Johns Hopkins University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine whether individual surgeon experience is associated with improved short-term clinical and economic outcomes for patients with benign and malignant thyroid disease who underwent thyroid procedures in Maryland between 1991 and 1996. SUMMARY BACKGROUND DATA: There is a prevailing belief that surgeon experience affects patient outcomes in endocrine surgery, but there is a paucity of objective evidence outside of clinical series published by experienced surgeons that supports this view.

methodsA cross-sectional analysis of all patients who underwent thyroidectomy in Maryland between 1991 and 1996 was conducted using a computerized statewide hospital discharge data base. Surgeons were categorized by volume of thyroidectomies over the 6-year study period: A (1 to 9 cases), B (10 to 29 cases), C (30 to 100 cases), and D (>100 cases). Multivariate regression was used to assess the relation between surgeon caseload and in-hospital complications, length of stay, and total hospital charges, adjusting for case mix and hospital volume.

resultsThe highest-volume surgeons (group D) performed the greatest proportion of total thyroidectomies among the 5860 discharges, and they were more likely to operate on patients with cancer. After adjusting for case mix and hospital volume, highest-volume surgeons had the shortest length of stay (1.4 days vs. 1.7 days for groups B and C and 1.9 days for group A) and the lowest complication rate (5.1 % vs. 6.1% for groups B and C and 8.6% for group A). Length of stay and complications were more determined by surgeon experience than hospital volume, which had no consistent association with outcomes.

conclusionsIndividual surgeon experience is significantly associated with complication rates and length of stay for thyroidectomy.

Indexed as

Clinical CompetenceCross-Sectional StudiesFemaleGeneral SurgeryHumansMaleMiddle AgedMultivariate AnalysisPostoperative ComplicationsThyroid DiseasesThyroidectomyTreatment Outcome

Identifiers

PMID9742915
PMCPMC1191485
OpenAlexW1981565562

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.