Multicomponent Deimplementation Strategy to Reduce Low-Value Preoperative Testing.

Importance: Routine preoperative blood tests and electrocardiograms before low-risk surgery do not prevent adverse events or change management but waste resources and can cause patient harm. Given this, multispecialty organizations recommend against routine testing before low-risk surgery.

Objective: To determine whether a multicomponent deimplementation strategy (the intervention) would reduce low-value preoperative testing before low-risk general surgery operations.

Black/White disparities in low birth weight across maternal trajectories of social mobility in South Carolina.

Persistent racial disparities in low birth weight (LBW) in the United States may be better understood through the adoption of a life course perspective that considers differential exposure and vulnerability of Black and White women to socioeconomic position across generations. Using a multigenerational dataset of singleton birth certificates from South Carolina from 1989 to 2020 linked along the maternal line, we constructed intergenerational social mobility trajectories of grandmaternal and maternal education and compared unadjusted and adjusted associations between trajectories and LBW among Black and White women. We found that White women were more likely to be upwardly mobile, and Black women to be downwardly mobile.

Long-Term Outcomes of Component Separation for Abdominal Wall Hernia Repair.

Importance: Component separation is a reconstructive technique used to facilitate midline closure of large or complex ventral hernias. Despite a contemporary surge in popularity, the incidence and long-term outcomes after component separation remain unknown.

Objective: To evaluate the incidence and long-term outcomes of component separation for abdominal wall hernia repair.

Comparisons of 30-day outcomes after ventral hernia repair by body mass index and surgical approach: a retrospective cohort study.

Introduction: Obesity is a known risk factor for postoperative complication after ventral or incisional hernia repair (VIHR). Whether minimally invasive techniques can mitigate this risk for certain patients remains unknown. This study investigates whether MIS approaches offer advantages in reducing any medical or surgical complication after VIHR across clinically meaningful BMI categories.

Long-term patient reported outcomes after robotic, laparoscopic, and open ventral hernia repair.

Introduction: Current evidence demonstrates questionable incremental benefit of robotic abdominal wall (ventral) hernia repair when compared to other approaches. However, data are mainly limited to 30-day outcomes and do not capture long-term patient reported outcomes (PROs) where the robotic may provide distinct advantages.

Methods: We analyzed patients who underwent ventral hernia repair from January 2020-September 30, 2022 in the Michigan Surgical Quality Collaborative Core Optimization Hernia Registry (MSQC-COHR).

Pilot testing a patient decision aid as a strategy to reduce overtreatment for older women with early-stage breast cancer.

Background: Despite national guidelines recommending omission of sentinel lymph node biopsy (SLNB) and post-lumpectomy radiotherapy (RT) in older women with early-stage, hormone receptor-positive (HR+) breast cancer, these practices persist. This pilot study assesses whether a decision aid can target patient-level determinants of low-value treatments.

Methods: We adapted and pilot-tested a decision aid in women ≥70 years old with early-stage HR ​+ ​breast cancer.