Publications by authors named "Lindsay E Kuo"

Background: Endocrine surgery is a core component of general surgery training. The landscape of endocrine surgery education in surgical residency and association with entrance into endocrine surgery fellowships is unknown.

Methods: In total, 353 Accreditation Council for Graduate Medical Education-accredited general surgery program websites were identified and categorized by US region, program type and size, and endocrine surgery educational experience type.

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Article Synopsis
  • Future income potential is a significant factor influencing surgical trainees' decisions to subspecialize, as it often requires additional training that can affect career value.
  • The study calculated the Net Present Value (NPV) of eight surgical subspecialties and general surgery over 35 years, considering aspects like salary, educational debt, and inflation.
  • Results showed that while some subspecialties benefited from not pursuing research years, others faced negative financial returns after adding research time, particularly in academic settings.
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  • Primary hyperparathyroidism (PHPT) can cause kidney stones, but doctors don't always check for it in patients with these stones.
  • In a study of 2264 patients with kidney stones, 383 had high calcium levels, and only 107 had their parathyroid hormone (PTH) tested.
  • Most patients tested had high PTH levels, but many didn't see a specialist, even though those referred had higher calcium and PTH levels.
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Introduction: Medicare determines reimbursement rates for medical services, often setting a benchmark that is followed by private insurers. Across various medical specialties, decreases in Medicare reimbursement have been observed. However, the extent of Medicare reimbursement for endocrine surgery remains unexplored.

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Background: Some patients undergo thyroidectomy while hospitalized for a related or independent indication. Outcomes have not been described in this group.

Methods: The 2016-2018 thyroidectomy-targeted NSQIP datasets were queried for patients admitted for ≥1 day preoperatively.

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Article Synopsis
  • - The study highlights the need for breast cancer (BC) information to be accessible at a sixth-grade reading level for the general public, noting that BC is the second-most common cancer in women and the readability of online resources in English and Spanish is unclear.
  • - Researchers analyzed 60 websites in each language using different readability frameworks, discovering that most English-language sites were hospital-affiliated and had higher reading difficulty, while Spanish sites mostly came from foundations and were easier to read.
  • - The findings revealed that many websites in both languages exceed the recommended sixth-grade reading level, suggesting the need for improved readability standards, especially for Spanish translations.
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Introduction: Parathyroidectomy is recommended for severe secondary hyperparathyroidism (SHPT) due to end-stage kidney disease (ESKD), but surgery is underutilized. High quality and accessible online health information, recommended to be at a 6th-grade reading level, is vital to improve patient health literacy. This study evaluated available online resources for SHPT from ESKD based on information quality and readability.

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Introduction: Medicare significantly influences reimbursement rates, setting a standard that impacts private insurance policies. Despite declining rates in various specialties, the magnitude of these trends has not been examined in breast surgery. This study examines Medicare reimbursement trends for breast surgery operations.

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Background: Stigma surrounds parental leave during general surgery residency, yet 25% to 29% of general surgery residents have children. Parental leave experiences of non-childbearing general surgery resident parents have not been described. This study aimed to describe the non-childbearing population's parental leave experiences.

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Introduction: Patients use the internet to learn more about health conditions. Non-English-speaking patients may face additional challenges. The quality of online breast cancer information, the most common cancer in women, is uncertain.

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Introduction: Adrenalectomy generally has favorable outcomes. It is unknown if patients with functional adrenal tumors experience different clinical outcomes than those with benign adrenal tumors, due to the presence of comorbid conditions secondary to the functional tumor. We investigated outcomes following open and laparoscopic adrenalectomy for benign nonfunctional (BNF) versus functional adrenal masses.

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Introduction: The risk of adverse outcomes after adrenal metastasectomy is not well defined. Knowledge of these risks is essential to guide patient counseling.

Methods: The 2015-2020 National Surgical Quality Improvement Program datasets were combined.

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Introduction: Most adrenal incidentalomas are not appropriately evaluated. Reporting the mass in the radiology report summary and providing recommendations in the report can positively impact evaluation. This study evaluated the effect of reporting Hounsfield units(HU) on adrenal incidentaloma follow-up.

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Background: Practice consolidation by vertical and horizontal integration is a growing trend in surgery. Practice consolidation has not been previously examined in vascular surgery.

Methods: The Medicare Provider Enrollment, Chain, and Ownership System data were used to identify vascular providers and vascular surgery practices in the United States in 2015 and 2020.

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The significant volume-outcome relationship has triggered interest in improving quality of care by directing patients to high-volume centers and surgeons. However, significant disparities exist for different racial/ethnic, geographic, and socioeconomic groups for thyroid, parathyroid, adrenal, and pancreatic neuroendocrine surgical diseases disease.

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Article Synopsis
  • Surgical residents' decisions on debt repayment plans and practice settings significantly influence their long-term career earnings, with modeling showing variability in career value based on financial choices.* -
  • The study calculates net present value (NPV) of a surgeon's career, finding that general surgeons can repay debt levels of $100,000-$300,000 within 10-25 years, but practice settings affect career value, particularly for academic surgeons (NPV of $382,000 compared to $500,000 for nonacademic peers).* -
  • While the scenarios don't cover all aspects of financial burdens, the results suggest that pursuing a career in general surgery remains financially viable despite student debt and varying repayment plans.*
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Background: Adrenalectomy is well tolerated with low complication rates. It is unclear if these excellent outcomes are consistent across all age groups.

Methods: The 2015-2020 American College of Surgeons National Surgical Quality Improvement Program datasets were used.

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Background: Racial disparities in care exist for diseases with heterogeneous treatment guidelines. The impact of these disparities on outcomes after parathyroidectomy for secondary(2HPT) and tertiary hyperparathyroidism(3HPT) was explored.

Methods: The 2015-2019 NSQIP datasets were used.

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Introduction: Tertiary hyperparathyroidism (3HPT) is common after renal transplant. However, guidelines for diagnosis are not clear and few patients are treated surgically. This study aims to determine rates of diagnosis and treatment of 3HPT in renal transplant patients with hypercalcemia.

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Importance: There is a growing trend toward conservative management for certain low-risk cancers. Hospital and health-system factors may play a role in determining how these patients are managed.

Objective: To explore the contribution of hospitals on patients' odds of nonoperative management for low-risk cancer.

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Introduction: In 2019, Centers for Medicare and Medicaid Services (CMS) established a new requirement that all hospitals publish information on the standard costs of services provided. Increased price transparency allows patients to compare healthcare costs and make informed decisions about their care. We investigated compliance with this rule with regards to laparoscopic cholecystectomy, a commonly performed operation and one of the 70 shoppable services (SSs) included in the CMS requirement, among prominent hospitals in the United States.

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Objective: To develop evidence-based recommendations for safe, effective, and appropriate treatment of secondary (SHPT) and tertiary (THPT) renal hyperparathyroidism.

Background: Hyperparathyroidism is common among patients with chronic kidney disease, end-stage kidney disease, and kidney transplant. The surgical management of SHPT and THPT is nuanced and requires a multidisciplinary approach.

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Introduction: Thyroidectomy and parathyroidectomy are relatively safe procedures, with overall morbidity rates of 2%-5%. The increasing age is associated with higher likelihood of poor outcomes. The modified five-point frailty index (mFI-5) is associated with complications, but many surgeons are unfamiliar with mFI-5.

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