SciCombinator

Discover the most talked about and latest scientific content & concepts.

Journal: Surgery

168

Past studies identify an association between provider volume and outcomes, but less is known about the volume-cost relationship for cancer surgery. We analyze the volume-cost relationship for 6 cancer operations and explore whether it is influenced by the occurrence of complications and/or utilization of processes of care.

43

BACKGROUND: Surgical never events are being used increasingly as quality metrics in health care in the United States. However, little is known about their costs to the health care system, the outcomes of patients, or the characteristics of the providers involved. We designed a study to describe the number and magnitude of paid malpractice claims for surgical never events, as well as associated patient and provider characteristics. METHODS: We used the National Practitioner Data Bank, a federal repository of medical malpractice claims, to identify malpractice settlements and judgments of surgical never events, including retained foreign bodies, wrong-site, wrong-patient, and wrong-procedure surgery. Payment amounts, patient outcomes, and provider characteristics were evaluated. RESULTS: We identified a total of 9,744 paid malpractice settlement and judgments for surgical never events occurring between 1990 and 2010. Malpractice payments for surgical never events totaled $1.3 billion. Mortality occurred in 6.6% of patients, permanent injury in 32.9%, and temporary injury in 59.2%. Based on literature rates of surgical adverse events resulting in paid malpractice claims, we estimated that 4,082 surgical never event claims occur each year in the United States. Increased payments were associated with severe patient outcomes and claims involving a physician with multiple malpractice reports. Of physicians named in a surgical never event claim, 12.4% were later named in at least 1 future surgical never event claim. CONCLUSION: Surgical never events are costly to the health care system and are associated with serious harm to patients. Patient and provider characteristics may help to guide prevention strategies.

Concepts: Health care, Health care provider, Medicine, Hospital, United States, Physician, Illness, Medical malpractice

28

This study examines the relationship between the number of lymph nodes removed during modified radical neck dissection and the incidence of disease recurrence.

Concepts: Epidemiology, Cancer, Senescence, Lymph node, Lymph, Neck dissection

28

Anaplastic thyroid cancer (ATC) is an aggressive neoplasm for which a paucity of data exist about the relative role of operative procedures in disease management.

Concepts: Epidemiology, Cancer, Oncology, Patient, Types of cancer, Thyroid disease

28

Coactivation of tyrosine kinase limits the efficacy of tyrosine kinase inhibitors. We hypothesized that a strategic combination therapy could overcome tyrosine kinase coactivation and compensatory oncogenic signaling in patients with adrenocortical carcinoma (ACC).

Concepts: Cancer, Signal transduction, Receptor tyrosine kinase, Protein kinase, Protein kinase inhibitor, Adrenocortical carcinoma

28

Cowden syndrome (CS) is dominantly inherited and predisposes patients to tumors in multiple organs. We characterized CS-associated malignant and benign thyroid disease.

Concepts: Cancer, Medical terms, Benign tumor, Thyroid disease, Thyroid, Graves' disease, Thyroidectomy, Cowden syndrome

28

Hyperglycemia is associated with severe complications AND Gastric bypass surgery has emerged as a cure for hyperglycemia AND Gastric bypass surgery results in exclusion of the proximal intestine from alimentary flow AND The proximal intestine serves as a neuroendocrine regulator of glycemic control SO Jejunal feeding of hyperglycemic patients will improve glycemic control.

Concepts: Medicine, Nutrition, Diabetes mellitus, Digestive system, Physician, Small intestine, Bariatric surgery, Duodenum

27

The purpose of this study was to examine the natural history and growth rate of pancreatic serous cystadenomas (SCAs) to determine which factors lead to resection for these benign neoplasms.

Concepts: Natural environment, Benign tumor, Nature, History of science, Natural science, Natural history, Big History, History of biology

26

Melanoma antigen gene family (MAGE)-A4, a member of the cancer testis antigen family, has been reported in various cancers including melanoma, bladder, head and neck, oral, and lung, and is a potential target for T-cell-receptor-based immunotherapy. Baseline expression levels of the MAGE-A4 gene in thyroid cancer cell lines have not been previously studied thoroughly.

Concepts: Gene, Gene expression, Cancer, Metastasis, Oncology, Human papillomavirus, Lung cancer, Types of cancer

24

Late recurrence of gastric cancer is rare and there are few data on recurrence in patients who are disease free for >5 years after gastrectomy. The aim of this study was to evaluate the predictors and status of tumor recurrence among these patients.

Concepts: Cancer, Disease, Stomach